Protect your young adult children’s health

By LORRAINE SIMPKINS

As your young adult children come to

the end of their school year or graduate, they may lose eligibility for coverage under your state health insurance and you will need to act quickly to prevent a break in coverage. Your unmarried dependent children

ages 19 through 24 are still eligible for dependent coverage in the NYS Health Insurance Program (NYSHIP) while they are full-time students at an accredited secondary or preparatory school, college or other educational institution, and are otherwise not eligible for employer group or military health care coverage (such as a cadet at a U.S. military academy). Your full-time student

dependent who completes a semester will continue to be covered under NYSHIP until the last day of the third month following the month when he completes the semester, unless he loses eligibility in some other way. For example, if he

completes the Spring semester in May, his last day of coverage would be August 31. However, if he’s 25 before August 31, his coverage will end on his birthday. This 3-month coverage extension applies to each full- time semester he completes, including the one when he graduates. Check your NYSHIP General

Information Book for eligibility information on students who leave school mid-semester.

Continuing under NYSHIP

If your child is no longer eligible, you

must act quickly in one of the two following ways to continue his or her NYSHIP coverage without interruption: • Continue health, dental and vision

coverage in NYSHIP for up to 36 months under the federal Consolidated Omnibus Budget Reconciliation Act (COBRA) at a monthly cost this year of $509.95 (for the Empire Plan option), or • Continue health (not dental or vision)

coverage in NYSHIP under the Young Adult Option (YAO) through age 29 at a

www.pef.org

you may still have options for covering your dependent, but outside NYSHIP. You may be eligible to: • Convert to a direct-pay contract with

the Empire Plan carriers or the HMO you have been using, but the benefit package and the premium costs will be different than under NYSHIP. You must apply directly to the carriers or the HMO; • Enroll in Family Health Plus, a

comprehensive NYS public health insurance program provided through participating managed care plans for adults ages 19-64 with too much income to qualify for Medicaid; or • Enroll in Healthy New York, a NYS

monthly cost this year of $499.07 (for the Empire Plan option). If you wait more than 60 days after

your covered dependent loses NYSHIP eligibility to inform the Employee Benefits Division (EBD) of the state Department of Civil Service, you can scratch COBRA off your list of options. It will not be available.

Other coverage options

If you rule out both COBRA and YAO,

program to help small business owners provide health coverage to employees and their families. Also, uninsured sole proprietors and workers whose employers do not provide health insurance may buy comprehensive coverage directly through Healthy NY.

Where to get help

For more information and instructions

on how to enroll in these programs, go online to www.cs.state.ny.us and select “Benefit Programs.” Then follow the instructions to access NYSHIP Online. Then, for information on: • COBRA – select “Health Benefits & Option Transfer” and then “NYSHIP General Information Book,” and scroll down to “COBRA: Continuation of Coverage;” • YAO – select

“What’s New,” and scroll down to “Young Adult Option Coverage;”

• Direct-pay

contracts – select “Health Benefits & Option Transfer” and then “NYSHIP General Information Book,” and scroll down to “Changing from NYSHIP to a

Direct-Pay Conversion

Contract.” For information on:

• Family Health Plus – visit

www.health.state.ny.us/nysdoh • Healthy NY – call (866) 432-5849

/fhplus/.

or go online to www.ins.state.ny.us and select “Healthy NY.” Starting January 1, 2011, the new

federal health care reform will require NYSHIP to provide coverage for dependent children through age 25. Details such as eligibility criteria and cost are not yet available.

Please note:

The information provided here

applies to 2010. However, see page 10 for information about how the recent national health care reform will likely affect health insurance coverage for young adults starting next year.

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