Insurance Issues

“I was told that this disease is considered a preexisting condition by our insurance company. Will my child be insurable in the future?”

Your child’s diagnosis will determine their insurability. In general, many children with serious illnesses will not be able to get insurance on an individual basis. Organ transplants, leukemia, lymphomas, cystic fibrosis, and most other life-threatening diseases are considered “declinable conditions” no matter how long it has been since the diagnosis. In some cases, if a significant time period has passed since treatment was completed (i.e., ten years) and there have been no additional treatments or symptoms, individual insurance may be available.


Things to consider:


If you are not working or are considered low-income


There may be some programs through your state or county. For example, in California there are programs such as MediCal, Healthy Families and Healthy Kids that are designed to help low income families get coverage. Some of these programs may only be available to children under 18. Check with your local state and county agencies to see what is available to you.


If you are looking for a job


You may be able to get coverage for your dependent through an employer. Not all employers are required to offer insurance but many do, and in many cases the coverage cannot be declined because of a pre-existing condition. However, be aware that there may be a waiting period before the coverage can take effect.


If you have a job with coverage and your child is turning 18 or 19


When your child reaches the age of 18 or 19, they may be terminated from your plan if they are not going to college or their illness prevents them from doing so. They may be eligible for Cobra coverage even though you are not leaving your job. If your child is able to attend college on a full time basis (check with your insurance company for the required number of units) they may be able to continue on your plan. If your child is considered disabled, they may be able to stay on your group plan.


The insurance laws vary from state to state and are based on the size of the group. You need to check with an insurance agent in your area to determine your elibility.


The following resources may provide additional guidance:


• Hospital social worker

• County Social Services or Health Department

• Your employer’s Human Resources Department

• Independent Insurance Agent

• Non-profit agencies such as The United Way



Article written by Vicky Melendy, Insurance Underwriter and mother of Greg