Adult children on health insurance after 26

[MTPwife 14]

I have a daughter about to age out of my insurance but she is autistic.  I’ve been told that she can remain on the insurance 

because of that.   Has anyone experienced this & can you let me know what you needed to do to keep your kid on your insurance?

any tips,advice or even hassles with keeping them on ?   
 

thanks in advance 

[Decker 1,339]

MTPwife I`ll get the specific info to try and help tomorrow. In the past, contract language almost completely mirrored the federal tax code for dependent eligibility. If you can document the facts on providing a child, step child or adopted child`s support at or higher than the federal guidelines you will be able to list that dependent on your Ford supplied dependent health insurance. I`ll look it up first thing tomorrow morning. 

 

In the past I have used the tax codes to reference eligibility for other members claiming children on tax returns and in the case of special needs individuals age is not taken into consideration. Now at one point and I`m not sure of what age it will be considered but there will be the requirement to apply for Medicaid benefits for the dependent. This would be at the point Ford dependent health insurance would possibly start to reduce benefits but hopefully it would balance out between the two coverages. (hopefully but not equaling in most cases) But most likely twice the paperwork at that point.  

 

The point a member retires the member and dependents are then moved to the IUAW administered VEBA insurance coverage. I believe but will verify also, the dependents and special needs dependents do receive  benefits.  

Edited December 9, 2020 by Decker

[Decker 1,339]

I`m not at a point to give secured "Ford" directives for dependent eligibility in the way of any changes in the last master agreement on this subject. But as for the Fed`s tax code that has yet to change, with eligibility being based on percentage of monetary, housing and supplied services. Taking that in to consideration Ford authorizes dependent coverage on those same reqirements. As for age of dependents with special needs I`m not secure with stating the age factor will need more evidence and/or documentaion to remain on Ford coverage. Getting info from Social Secruity is like learning another lanuage. If there`s anyone that currently is in this dependent situation any info would help cut down on the seaching or the "I`ll have to put you on hold" or "I`ll take your name and number and contact you when I it clearity" syndrome... 

 

There will be a point when with Doctor intervention (paperwork, patient history etc.) mediicaid will come into the picture. Age and condition will play a major part in that Fed decision. 

 

[Decker 1,339]

In our 2019 master agreement there is carry over language (getting a copy is fun) the starts on page 429 in volume 2. Then in subsection (c) is what I believe will help you MTPwife. 

 

On page 435 subsection (c)  (ii) it reads coverage may also be continued beyond the end of the year the child becomes age 19 or age 24 for a child who is a full-time student, if the child has been determined to be totally and permanently disabled. For the purpose of this subsection, totally and permanently disabled means having any medical determinable physical or mental condition which prevents a child from engaging in subsequent or gainful activity and which can be expected to result in death or be a long continued or indefinite duration. A child shall not be deemed to be totally and permanently disabled if he or she is engaged in regular employment or occupation for reimbursements or profit which exceeds 10K annually.

 

If a child has been deemed totally and permanently disabled by Social Security prior to the age of 25 they will be covered for life on the Ford Insurance.
Also autism benefits vary from state to state, some are mandatory by state to be applied for. These benefits along with medicaid will be the suppliments to the Ford coverage. 

 

So please get going with all the phone calls and paperwork. It will be worth it in the long run. Now please dont hold me to it but I can`t seem to get an answer from VEBA about automatic roll over of active employee covered dependents so you may have even more calls and paperwork when that time comes. 

 

 

Edited December 10, 2020 by Decker

[MTPwife 14]

Thank you so much for the information & the effort Decker.  I really appreciate it.  Been really nerved up about it with us being in the middle of a pandemic. 

[fuzzymoomoo 7,348]

22 minutes ago, MTPwife said:

Thank you so much for the information & the effort Decker.  I really appreciate it.  Been really nerved up about it with us being in the middle of a pandemic. 

That's exactly why they’re doing this. A lot of weasels trying to game the system. 

[Decker 1,339]

3 minutes ago, fuzzymoomoo said:

That's exactly why they’re doing this. A lot of weasels trying to game the system. 

 

Yes fuzzy we have so many unsung hero`s of the players of the system. At CAP alone the ceritifing for the state and Federal unemployment benefits while getting direct deposits from Ford is over 1100 and riasing. Then theres all the rona players. 

[fuzzymoomoo 7,348]

49 minutes ago, Decker said:

 

Yes fuzzy we have so many unsung hero`s of the players of the system. At CAP alone the ceritifing for the state and Federal unemployment benefits while getting direct deposits from Ford is over 1100 and riasing. Then theres all the rona players. 

And the weasels will be the ones that bitch the loudest when benefits are reduced in future contracts. 

[MTPwife 14]

On 12/11/2020 at 10:54 AM, fuzzymoomoo said:

That's exactly why they’re doing this. A lot of weasels trying to game the system. 

 

I do hope you are not referring to me & my daughter as weasels ?    I had no idea that we could keep our disabled kids on our insurance past 26 till recently & am certainly not trying to game the system. 

Just trying to keep my kid safe (within our legal rights) , god knows the poor girl has never been cut a break. 

Edited December 13, 2020 by MTPwife

[fuzzymoomoo 7,348]

13 minutes ago, MTPwife said:

 

I do hope you are not referring to me & my daughter as weasels ?    I had no idea that we could keep our disabled kids on our insurance past 26 till recently & am certainly not trying to game the system. 

Just trying to keep my kid safe (within our legal rights) , god knows the poor girl has never been cut a break. 

No, of course not. You have legitimate reasoning and are asking the right questions.

[Decker 1,339]

MTPwife, unfortunitly those with all forms of legitmate and documented issues that should be met with way less stress when appling for earned benefits are the minority in this day and time. It is a shame to admit that "we" in general have more members and growing everyday that play the system than people that the system was intended to help with true documented issues. 

 

Now for the extended stress... you will be in need to go through all the paperwork and phone calls again most likely if and when the change occures when moving from Ford active coverage to VEBA. 

[MTPwife 14]

Waiting on the paperwork to come through now.   Hope it won't be a problem. Finally have docs & therapists that she trusts some & it would

be really rough if we couldn't keep them.   She's such a good kid.  I wish I could take it all off her.  My younger daughter is ASD as well & has a bit

of a tougher time.  Little did I know when I dipped my toe in my hubby's gene pool that it was loaded down with ASD.  ASD kids are really awesome

once you understand their set of issues.  If the world were a lot more kinder it wouldn't be so hard on them.  

 

Thank you again Decker. You helped this overwhelmed Mama not have a nervous breakdown before the Holidays.  LOL  

 

Edited December 20, 2020 by MTPwife

[Decker 1,339]

As it always is, things take to much time to iron out. But, MTPwife you will be ok and the kindala will be just fine insurance wise. I have looked into continuing current Doctors, procedures, therapy as prescribed, meds that are in place and even possible experimental therapy and meds will be covered if documentation is in place with the requests. Will you have the typical paperwork issues here and there and stress... most likely but, hopefully the length of time taken for confirmation of benefits won`t slow any medical or therapy progress. It should not. 

 

Good luck and Shabbat Shalom (may the peace of the Sabbath be with you always)   (Oh, I grew up hearing and being referred too as kindala when I asked Mom and Gramma they said kindala is you. So for years we all understood kindala meant us kids or children.  well becoming older and finding out that a broken english ascent transformed kinder to kindala. So to honor those broken engish bi-lingual grown ups we just went along with the program. I believe your kindala (kinder) with be with the people and services they will need to go with the program the best they can.) 

Edited December 21, 2020 by Decker

[LaWzssts 0]

If your daughter has autism, you can probably keep your insurance. The government is constantly developing mechanisms to protect people with disabilities. But in any case, it is better to consult the insurance company to find more details.

Edited November 23, 2022 by silvrsvt
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