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January 19, 2002

Insurance/Costs

Question from Reno, Nevada, USA:

Our insurance for our 21 year old son who has diabetes will terminate shortly, and there is a clause in our insurance that says "unless he is dependent and/or disabled," or something to that effect. I realize that at 21 he is hardly a child anymore, but he has been a full-time student and will become a part time student next semester. I read somewhere, a while ago, that children with diabetes fall within the definition of Americans with Disabilities. Is diabetes considered a disability? If we were to label him "disabled", are there consequences down the road to being classified as disabled?

Answer:

Congress did not intend the ADA to create specific rights to insurance coverage for people who allege a disability. Most health insurance plans provide for continuation of eligibility of coverage for children over 21 in the case of “disability”. The policy will also define the term “disability”. Generally, in this context the term means that the child has a significant, severe physical or mental handicap which prevents them from living outside the home or otherwise independently without the guardianship of the parents. By “disability” one should picture a child afflicted with Down’s Syndrome, Cerebral Palsy or other like condition, but again, read the policy because the language there controls.

DSH

[Editor’s comment: If you still will be contributing to more than 50% of your son’s support, he could be considered a dependent and should be allowed coverage under your policy. You also might contact your local American Diabetes Association affiliate for further assistance.

SS]