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Ask Law Educator, Esq. Your Own Question
Law Educator, Esq.
Law Educator, Esq., Lawyer
Category: Consumer Protection Law
Satisfied Customers: 111492
Experience:  Attorney experienced in commercial litigation.
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I think this is right category, Has to do with Medical

Customer Question

I think this is right category, Has to do with Medical Insurance through employer and guardianship of a grandchild. Right now my head is spinning because everything they say contridicts itself. Have had permanent legal custody of grand since age 4. She turned 18 2 years ago. This month they wrote saying they are only obligated to cover her till age 18. I told them she is emotionally and educationally impaired and she is still in school. They said too bad. They need a doctor's diagnosis. Not a therapist/psychiatrist or school reports and records. I have 4 or 5 binders of info from age 4.. So I missed the 15 day deadline to get a medical doctor diagnosis but was still working on one. Now we get a letter and said that has nothing to do with it. A medical diagnosis would only give her coverage after she turned 26, They say - now = that i only had temporary custody and that went away at age 18,. My paperwork starts with temporary - letters were issued - and it was turned into permanent,. I am now told I can appeal. Is there any basis to what they are asking? Especially since they both contridict themselves. She is finishing 12th grade this year. And will be in college after that. Basically with a tutor that can help her at any and all times. She is an FASD child. Any advice would help cuz I am totally spun on this one,
Submitted: 9 months ago.
Category: Consumer Protection Law
Expert:  Law Educator, Esq. replied 9 months ago.
Thank you for your question. I look forward to working with you to provide you the information you are seeking for educational purposes only.
The issue is once a child turns 18 that you had guardianship over, you must obtain a new guardianship of an adult in order to continue your benefits on her until 26 or you have to adopt the child. The regular guardianship of a minor ended at 18, so you have to go to court to file a petition for guardianship of an adult and once you get that guardianship, you can seek the coverage until 26 as provided for under the affordable care act. Your other option is to file to adopt her now as an adult, for which you do not need parental consent, and then she would be considered no different than your natural child and under the ACA the insurer has to provide coverage until she turns 26.