First of all, congratulations! Adopting a child is a very exciting time in many parents’ lives. The decision to add a new child to the family also comes with a variety of considerations, including health insurance coverage. Rest assured that federal law requires your health insurance plan to consider an adopted child the same as it would a biological child. This means that you can add your adopted child to your health insurance plan immediately after the adoption is made official. However, you might also want to shop around for a new plan depending on how the addition of a new child changes your costs.

What Healthcare Costs Am I Responsible For As an Adoptive Parent?

If you’re adopting a newborn or yet-to-be-born child, you will not be required to cover the prenatal or delivery costs of the mother. However, the adoptive parents are responsible for the medical expenses of the child from the time of birth until the child is discharged from the hospital. Depending on the nature of the adoption, some parents will work out prenatal and postnatal coverage agreements with the birth mother. But because the birth mother is not a dependent of the adoptive parents, she cannot be added to any insurance policy. While Medicaid covers healthcare costs for all foster children under the age of 26, adopted children do not receive the same benefits (unless the adoptive family already qualifies for Medicaid). So, if you are adopting a child, you must cover the full costs of healthcare and insurance of the child upon adoption.

It’s important to gain as much understanding about your child’s medical history and needs before adoption. If possible, try to obtain information about the child’s family’s medical history as well. This will help you make a more informed decision when it comes time to select a health insurance plan for your child. It’s also important to remember that under the Affordable Care Act, health insurance companies cannot discriminate against you or your adopted child for preexisting conditions.

How Will My Health Insurance Change?

Adding a child as a dependent, whether adopted or not, will increase your health insurance premium. The amount of the increase will vary depending on your plan and state of residence. Some estimates say that a juvenile dependent will increase your premium costs from $25 to $100 per month.

Under the Affordable Care Act, adopting a child counts as a qualifying life event for the Special Enrollment period. This means that you do not have to wait until the Open Enrollment period to add your child your Marketplace health insurance plan. Additionally, qualifying for Special Enrollment applies to the rest of the adoptive family, so you can make changes to your entire household plan, as long as it’s within 60 days of the adoption.

It’s best to explore your Marketplace options during this period, as there are various different plans available depending on your household size. Certain plans might offer providers that are better suited to meet your adopted child’s specific needs. If you’re adopting a newborn and are enrolling through the Special Enrollment period, the new healthcare coverage can begin the day the baby is born, even if you don’t enroll until 60 days after the adoption is made official. 

Does My Employer-Based Health Insurance Have To Cover My Adopted Child?

Yes! The Health Insurance Portability and Accountability Act of 1996 (HIPAA) closed the health insurance gaps for adoptive parents. The law states that all group health plans must cover adopted children and biological children the same way, whether you receive insurance through the Marketplace or through your employer.

About 10 percent of employers offer adoption assistance, and 29 percent offer paid adoption leave. Adoption assistance includes forms of financial assistance, like helping to pay adoption agency fees or maternity fees for the birth mother. Because adoption can be a costly process, talk to your employer to find out if there are any forms of assistance available to you. As adoptive families gain more recognition, hopefully more and more employers will begin to offer adoption assistance and paid adoption leave.

Conclusion

Adopting a child is a wonderful choice, and as you prepare to bring your new child home, TrueCoverage is here to help with all your insurance needs. We deliver affordable health insurance by partnering with 600+ top insurance companies. Specializing in the Affordable Care Act, we offer the widest choice of plans, making it easy to get you the best health coverage at the lowest rates.

If you’re looking to get started with an affordable healthcare plan for your adopted child during the Special Enrollment period, reach out to our insurance experts. The TrueCoverage customer service team is ready to help!