Question: My adult daughter is 24 and single. She is no longer our dependent for tax purposes. Due to the ACA, she continues to have insurance through her father's plan through USC until age 26. She is expecting a child in April 2014. Will the child be covered? And will the child continue be covered until our daughter turns 26?
Answer: No. Your newborn grandchild will not be eligible for coverage under your husband's employer-sponsored plan. Your daughter must complete a Covered California application for herself right after the child is born, indicating that she has "been offered affordable, minimum standard value health insurance" and that only the baby will be enrolling. Depending on your daughter's income, her newborn child may be eligible for Medi-Cal or subsidized Covered California coverage.
Kristine, The newborn is covered immediately after birth under the mother’s coverage, how long can vary but no more than 30 days. The baby’s new coverage will be effective 1st of the month after birth.
After reading some more about dependent coverage, I now understand that the ACA did not require insurers to provide coverage to children of dependent children under age 26. I called USC and they said that the only insurer that they use that does provide coverage to children of dependents is Kaiser. Her father’s plan is Anthem BC HMO and the open enrollment period is over for the year. However, I was told that USC does allow plan changes for a life changing event and that the birth of the grandchild would be considered such an event. Both my daughter and her father would have to switch to Kaiser in order to have the grandchild get coverage through USC. Kaiser would be a good option for my daughter who lives in Marin County. But not really an option for her father as he lives in Santa Barbara with virtually no Kaiser providers.
So thank you your suggestion for applying through Covered California. When applying after the birth of a child, is the insurance retroactive to the birth? What if the child needs services immediately following birth.