Adult son is covered; grandchild is not

My married adult children are on my insurance plan and their spouses are on their parents’ plans, per “ObamaCare.” My daughter-in-law’s health insurance coverage from her parents does not cover maternity.  What is the best way for her to get maternity coverage? And, would a baby be able to join the same plan as father and/or mother?

Grampy To Be in Utah

Dear Grampy to Be,

Under the Affordable Care Act, pregnancy expenses cannot be denied as a “pre-existing condition”. (A pre-existing condition is a health issue that a person had and got treatment for in the 6 months before he joined the plan.) Therefore, any plan (that covers maternity) will cover her pregnancy from the first day she joins. That’s not to say that she will be able to find an affordable plan or an insurer who is willing to sell her a plan.  Utah allows insurers to refuse to sell her a policy.

If she can find a plan to cover her, the baby should be able to join the same plan. The “ObamaCare” coverage for adult children does not extend to grandchildren. She and your son need to find coverage for the child.

If your son and daughter-in-law are low income, the baby may qualify for Medicaid. The Medicaid plan can cover just the baby or the baby and mother. Visit Utah’s Medicaid website for more information.

Your best bet is to go to healthcare.gov and go through the questionnaire. It will give you the specific options available in Utah. An insurance broker who specializes in individual, non-group coverage might also be helpful for you.

Good luck!

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Linda Riddell

About Linda Riddell

A published author and health policy analyst with 25 years’ experience, Linda Riddell's goal is to alleviate the widespread ailment of not knowing what your health plan can do for you.