Family Information Regarding Ohio Health Insurance

Families

Children are usually covered under a family health plan as long as they live with you. Many plans keep this coverage in effect until the kids graduate from college. When both parents work and they have two separate health plans, there may be situations when both plans can help pay medical bills for a child.

Our baby is due next month. How will my health insurance cover the charges for delivery and after?

Review your coverage to ind out how your health plan handles the costs. Consider all the costs that might apply to your situation: prenatal vitamins, prenatal and neonatal screenings and tests, emergency procedures, delivery and pediatric care.

My partner recently gave birth to our baby daughter. Will my employer-sponsored health plan cover both my partner and daughter?

Ohio law does not require nor prohibit the coverage of domestic partners (same-sex or different-sex) and their families by health plans or private employers. However, a child may not be denied enrollment because the child was born out of wedlock. Check with your Human Resources office for details on your coverage.

My son is two weeks old. He's covered automatically under my health plan from work, right?

No - you must let the plan know about the new baby, normally within 31 days of the birth. Consult with the employer or health insurance provider regarding the notification requirements before your child is born. If you adopt, ask your employer or health plan in advance about requirements for getting the coverage.

We both work and have two separate health plans with family coverage. Which plan covers the children?

Ohio's Coordination of Benefits (COB) rules can allow you to use both health plans to pay your children's claims.

One plan will be the children's primary insurance and pay first. The other plan will be secondary and pay part or all of the remaining amount. Ohio's COB rules cover most situations when there are two health plans.

Make sure to follow all requirements (such as using network providers) for either plan; if you don't, the state's COB rules will not help and both plans could deny your claim.

How long will my plan cover the children?

Check with the plan. Coverage may last as long as the children live with you, graduate from college or until the plan's limiting age (commonly 19 and 23).

In the case of a child who is diagnosed as mentally retarded, the child continues to be an eligible dependent under your insurance policy regardless of age. Medicare may be an option for children who are disabled.