By: Ethan Kalvin
My wife and I own a small business in Florida, and we have to buy health insurance to cover our family. We have four children, two sons and two daughters. Our one daughter has some developmental and health problems. Because of those problems she will always need some help or guidance throughout her life. Because we have a child with special needs, our insurance premiums costs are very high. In fact, you could rent a one-bedroom apartment for less than we pay in monthly insurance premiums.
In June my oldest son moved into an apartment with some friends. Instead of going to college right out of high school, he worked for a year to earn some money and is currently registered to start college in January 2010. In July he became very sick complaining about pains in his side and stomach. Our family doctor examined him and referred us to a specialist. After the specialist examined him, he ran some tests and did some blood work hoping to find the problem. The doctor couldn't make a diagnosis and he wants to run more tests. If he can't find anything, he wants to send my son to another doctor.
Because my son is of age, the receptionist in each office gave him the paperwork to fill out and asked to see his ID. His license has his apartment address on it. Each receptionist asked my son if he was currently enrolled in school or would he be starting school in August or September. He said he would be starting college in January but he wasn't a student at the time.
All of the bills for the doctor visits and tests were submitted to the insurance company. Every claim was denied; it was unbelievable! I knew our son wasn't too old to be covered by our insurance policy. Right after he turned 19 he had an accident and ended up in the emergency room. All we paid then was the deductible. What made this claim different?
Apparently the difference is his status had changed. When we took him to the emergency room he still lived under our roof and we supported him. The issue isn't that he no longer lives with us but that he lives away from us and is not a student. In short, to be covered under our insurance policy if he is not going to school he has to be living in our home or he can have his own place and be enrolled in college with at least 12 credits a semester. Why didn't the insurance company tell us this requirement?
Where we stand right now is we have about $3,000 in bills for office visits and various tests that we are responsible for paying. We were told when my son starts college and we can prove he is taking 12 credits per semester, we can put him back on our insurance. In the meantime, if he needs to see a doctor, then we will have to pay all of the costs.
A couple health insurance quotes will give you a ton of info about different health insurance policies. Keeping the whole family covered by individual health insurance will save you from some nasty bills.
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