Last updated on: 8/24/2010 | Author: ProCon.org

Can I get coverage for my child with a pre-existing condition?

General Reference (not clearly pro or con)

The Kaiser Family Foundation (KFF), wrote in its May 2010 brief “Explaining Health Care Reform: Questions About the Extension of Dependent Coverage to Age 26,” available on www.kff.org:

“Uninsured young adults with a pre-existing condition who join a parent’s employer-sponsored coverage plan may face a pre-existing condition exclusion of up to 12 months if they were uninsured for 63 days or more prior to gaining coverage. Young adults joining a parent’s individually purchased policy may also face a pre-existing condition exclusion. In this case, insurers can exclude coverage of pre-existing conditions to the extent that it is allowed by state laws governing health insurance policies purchased by individuals. Starting in 2014, pre-existing condition exclusions will no longer be permitted in either employer-sponsored or individually purchased health plans.”

May 2010

PRO (yes)

Pro

US Department of Health and Human Services (HHS) provided in its June 22, 2010 fact sheet “The Affordable Care Act’s New Patient’s Bill of Rights” on www.healthreform.gov:

“The new Patient’s Bill of Rights regulations [issued under the Patient Protection and Affordable Care Act on June 22, 2010 by HHS] detail a set of protections that apply to health coverage starting on or after September 23, 2010…

No Pre-Existing Condition Exclusions for Children Under Age 19.

The new regulations will prohibit insurance plans from denying coverage to children based on a pre-existing conditions. This ban includes both benefit limitations (e.g., an insurer or employer health plan refusing to pay for chemotherapy for a child with cancer because the child had the cancer before getting insurance) and outright coverage denials (e.g., when the insurer refuses to offer a policy to the family for the child because of the child’s pre-existing medical condition). These protections will apply to all types of insurance except for individual policies that are ‘grandfathered,’ and will be extended to Americans of all ages starting in 2014.”

June 22, 2010

CON (no)

Con

[Editor’s Note: We have been unable to find any cons to this question, and if you know of any, please let us know. Aug. 23, 2010]