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Health Insurance
Coverage Laws
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Know the Law!
There are federal and state laws that affect health insurance coverage. The Consolidated Omnibus Budget Reconciliation Act
(COBRA)is a federal law that can help you keep your group health insurance. All employers with 20 or more employees have
to offer COBRA. It allows you to extend your group health insurance when you change jobs, if you got through a divorce, when your
child turns 18 years old, or for other life events. The coverage can last up to three years depending on why you extend your
coverage. For example, it helps a person keep health insurance for 29 months after approval and while waiting for Social Security
Disability Insurance and Medicare to start. This law helps you keep your insurance during these life events, but you will have to
payall the premiums. Your doctor can tell you when COBRA will or will not help you and how long you can be covered.
When your child turns 18 years old and is not in school full time, your health insurance may no longer cover your child. COBRA can
help keep them covered for up to three years until their own health insurance starts. Most states have laws that require health
insurance to continue coverage for children who turn 18 years old if they are unable to support themselves because of a physical or
mental condition. This continued coverage lasts until they are able to support themselves. You will have to pay the premiums.
You can request a Continuation of Coverage form from your health insurance company. Your doctor can help to fill out this form.
Some children cannot support themselves when they turn 18. It may be better to get insurance
through a state program. Your doctor can help you find out about your state’s programs. The Health Insurance Portability and
Accountability Act (HIPAA) helps people who have group health insurance. Group insurance can refuse to pay for disease-related
expenses for the first 12 months of insurance if your diagnosis is listed as a preexisting condition. Under HIPAA, you can get credit
for the amount of time you had insurance under another health insurance plan. This is called creditable coverage.
If more than 63 days have passed
without coverage, then your group insurance can refuse to pay for any preexisting condition. This is one reason why it is important to
always have insurance, especially when you change jobs or during a life event.
Remember, COBRA, through your employer, can help you avoid a
gap in insurance greater than 63 days until you get a new job or health insurance. Your doctor has more information about COBRA,
HIPAA, state programs and how to keep your insurance.
Continuation of Coverage
States that do NOT have a law requiring continued health insurance coverage for disabled, dependent children:
- Alabama
- Alaska
- District of Columbia
- Kansas
- Maine
- Oklahoma
- Oregon
Know Your Rights!
Example: You have 10 months of coverageunder a group healthinsurance plan. Then, you obtain a new job and insurance
rightaway. Because of HIPAA, your new plan will give you credit for 10 months of coverage—credit able coverage under the prior plan.
Now, your new plan can only refuse to pay for two months of CF-related expenses instead of 12 months.
Source: The Cystic Fibrosis Foundation
 Or call Toll Free: 1-800-831-3270 , contact or email us!
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