My daughter has type 1 diabetes, and I am concerned about optimizing her options when she reaches 23 and is no longer covered by my company’s health insurance, or what would happen if I die. Is there any type of insurance or plan I can set in motion now that will guarantee or provide her with health insurance when she is past 23 in the event she does not get good insurance from her employer?

I compliment you for looking ahead. The current exclusionary practices of US health insurers require people with chronic disease to plan ahead when seeking to change insurance coverage. In the event of your death, your spouse and dependent children would be entitled to continue coverage through your employer’s plan under COBRA. However, they would have to pay the full cost of the coverage, in advance, plus a 2% administrative fee. Some companies address continuing coverage for survivors as part of their overall benefit program.

For your daughter, I would suggest seeking an individual health insurance policy for her one year before she will be leaving the family health insurance policy. Under current law and regulation most individual health insurance policies are allowed to enforce a one year pre-existing condition exclusion. However, there will be no pre-existing condition exclusion if your daughter obtains coverage through another employer sponsored group health plan.

Of course, there could be many changes between now and when your family will need to engage in this type of “pre-need” planning. However, you are smart to look ahead!

DSH