OK, just got off the phone from Office of Personnel Management. They were very nice and will be sending me the forms I need to complete and have the MD complete for review to determine whether D can remain on H’s family policy as a disabled dependent. They expect review and a decision by them to take 60-90 days, so that we will still have time before she turns 26 to explore her other options. I did discuss briefly with D and she’s confident that her treating infectious disease specialist is quite familiar with helping his patients with disability forms, since many are bedbound and having a terrible time carrying out activities of ordinary life. I’ll wait until I see what forms are received before we proceed.
The insurance agents – one left two messages and the other never even called back. I tried to contact the one who left message but kept getting her message machine. I think I prefer this route for now anyway. In her message, the agent indicated that usually policies are determined 60 days before being effective or even closer to the effective date because there is so much “fluidity” in the insurance industry at this point.
An update–after working on this issue since we filed paperwork with H’s former employer, the federal government in September, getting our insurer and US Senator’s office involved, we were finally able to get an answer in mid-May! D will be allowed to remain on H’s family policy as a disabled dependent, retroactive to when she turned 26, so no gaps in coverage and all outstanding claims can be resubmitted for reprocessing. Phew! It has been a process and the US Senator’s office and our insurer are pleasantly surprised it was happily resolved.
Because we weren’t sure she would be covered, we also sent in a Temporary Continuation of Coverage application (like cobra), which we have proof we mailed but no one at the fed govt has acknowledged ever receiving! At this point, perhaps this is a good thing, so we won’t have to cancel this and haggle over being reimbursed for premiums.
If anyone is even considering seeking disabled dependent status to keep their child on their medical insurance family plan beyond age 26, I’d urge you to apply much earlier than we did. 60 days before they turn 26 is not enough time for the fed govt. I had wanted to apply 150 days prior but D didn’t get to see the MD for the letter in support of the application until 60 days prior.
Yes, it is such a relief–I was spending a LOT of time and energy on this issue for over a year now. It feels so wonderful that is has finally resolved! D has no reason to defer medical care now!
Happily the policy allows her to get care anywhere and does have higher reimbursement when she sees an in-network BCBS provider.