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The Politics of Health Care

Health Insurance for Young Adults: What You Need to Know

Published May 20, 2013 2:03 PM by Michael LaMagna
If there is one thing that many of us are guilty of, it's neglecting our own health and focusing on our children and their needs. I am sure that most of us are aware that our health plans are now required to keep young adult children on their parent's health plans until they reach age 26, but many people, including the plan participants, do not know what is covered and what is not. 

Currently, there are more than 3 million young adults covered under their parent's plans.  Although this group may be covered for comprehensive medical needs, young adults who are covered under their parent's plans find themselves not covered for mental health issues, substance abuse and maternity care, which are common healthcare occurrences in the 26 and under crowd. There may be some hope starting in 2014, health plans will no longer be able to turn people down because they have preexisting medical conditions and with the advent of healthcare exchanges, young people will be free to shop around for individual plans if they don't want to stay on their parent's plan. All non-grandfathered healthcare plans will cover 10 essential health occurrences, including maternity and newborn care, mental health and substance abuse services.

In addition to the comprehensive plans available on the exchanges, young people up to age 30 will have the option of choose a catastrophic plan, which will cover preventive services without any cost sharing and three physician visits after a $6,350 deductible is met.

Of course there are exceptions called grandfathered plans, which you should be aware. Large-group employers are exempt from covering the 10 essential health benefits, which may exempt young people from mental health, substance abuse and maternity care. While Medicaid can be an option for specific care, there are strict income and asset guidelines that must be adhered to, which will make it impossible for most non-disabled working people to qualify.

Even still, many mental health professionals and counselors who provide outpatient services may not take many of the health plans or accept Medicaid. It is vital that you become very familiar with your health plans and know your rights regarding coverage and the appeals process in case you or your children get denied coverage. It is common for bills for these services to be in the tens of thousands of dollars, which many people do not have to pay the hospital bills, especially those 26 and under and their parents.  

This article is provided for informational purposes only. Nothing in this article shall be construed as legal advice or should be relied upon as such.  Plan to attend Attorney LaMagna's free seminar, "Talking Dollars and Sense," at the Kensington Assisted Living, White Plains, NY on May 16, 2013 from 6:00-7:30pm. RSVP by calling The Kensington at 914-220-4259.  Michael LaMagna is a Partner at Helwig, Henderson, Ryan, LaMagna and Spinola, practicing Elder Law/Probate/Disability/Wills, Trusts and Estates, Health Care Regulatory, Medicare Appeals, Social Security and General Legal practice in both New York and Connecticut.    Email him at Mlamagna@hhrls.com, call him at 914-437-5955 or visit Attorney LaMagna's website at www.HHRLS.com for more information.     

posted by Michael LaMagna


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