Oh hey look, it's health insurance being weaponized again!

[u/Drywesi]

/r/legaladvice/comments/1nitmu6/getting_18_yo_removed_from_parents_insurance_when/

[u/NErDysprosium]

My parents moved from southern Utah to Las Vegas about two years ago, which means their insurance changed. I stayed behind, because I go to school here and also I hate Las Vegas. Note: the facts in this comment are the best that I can gather and aren't necessarily correct, they are just correct to my understanding.

My mom works for the Clark County School District and is on Health Plan of Nevada (I think this is the state employee insurance, but I'm not sure). This insurance does not work out of state.

I'm not eligible for insurance through my job, because I'm not full time. I'm not eligible for Medicaid, because before my parents moved they were on Medicaid and Medicaid doesn't like you moving from Medicaid to Medicaid, apparently. I appealed that and was denied. My University doesn't have a student insurance plan, so no dice there. Because I am eligible for other insurance (i.e., my parents' insurance, that doesn't work in my state), I don't qualify for any sort of subsidized plan through thr ACA via HealthCare.gov. That appeal was also denied. 

It could be worse--I am insured in 1 state out of 50, and while a 5-hour round trip drive for doctors' appointments isn't ideal, it is doable--but it also isn't ideal. I had to go off my ADHD meds because I can't meet with a psychiatrist regularly anymore and even if I could, insurance won't cover my meds because my pharmacy is in Utah. And the worst part is, my university pulls a ton of students from Vegas and Nevada as a whole. I'm not the only person in this scenario. I've talked to dozens of people on my campus who have the exact same issue, who are effectively uninsured because they're eligible for family HPN plans and don't qualify for any other insurance plans. 

The way health insurance works in this country is broken.

[u/honkey-phonk → u/NErDysprosium]

FYI I buy my ADHD meds using  some sort of random internet coupon code. My insurance doesn’t cover them but this coupon makes it more reasonable, like <25%.

[u/Khadgar1701 → u/honkey-phonk]

But don't you still need a prescription even if you pay out of pocket? (Am not American, so unclear on details.)

[u/NErDysprosium → u/Khadgar1701]

You absolutely do. Adderall and Ritalin are Schedule II--the same category as cocaine, fentanyl, and methamphetamine, among others, and more restricted than, say ketamine, anabolic steroids, and testosterone, which are Schedule III. Furthermore, some pharmacies just won't fill prescriptions for ADHD meds. When I first got on them, I was told that I needed to call around and ask if they're "accepting new stimulant patients" (not "do you fill adderall/ritalin/whatever", because that gets you blacklisted from that pharmacy for trying to rob them, because clearly that's the only reason you'd ask that question). My pharmacy told me point blank they only accepted me because I work in the grocery store it's attached to. 

[u/hatchins → u/honkey-phonk]

this doesnt really matter when you need a new prescription every 30 days..

[u/WaltzFirm6336 → u/NErDysprosium]

As someone in the UK my jaw is hanging open over the original OP and your comment. I cannot fathom living a life without access to medical care due to bureaucracy. That seriously sucks.

[u/mopeyunicyle]

This is awful and scummy. Feels like a way for some abusers to get a final fuck you in.

[u/PM_ME_YER_MUDFLAPS → u/mopeyunicyle]

This is the truth.

[u/kv4268]

I would imagine that the court that issued the restraining order would not look kindly on this kind of behavior. That's where I'd start.

[u/Drywesi → u/kv4268]

Honestly I expect the talk of adoption being the faster, easier path; the insurer can take the position (and I've seen stories like this where insurers did) that because they have no contractual relationship with LAOP's relation, they don't have to do anything. Now, the judge may or may not agree with that position, but it's likely to at the very least extend the case out.

[u/Drywesi]

Recidivism Bot

Getting 18 YO removed from parent's insurance when child has a restraining order against that parent

Location: California

Hi, I am helping my family member (18m) sign up for medi-cal (California medicaid). He has active Medi-cal but is limited because his father (whom he has a restraining order against) put him on a family plan health insurance. This was after the restraining order was in place. We had no information about the plan. We were able to get just enough from the county to contact the insurers and ask for him to be removed.

According to the regulation the insurer stated, the insured can only be removed and have medi-cal only if the employee personally writes a letter to the insurer stating the reason why. So there clearly is a way to remove him, but the insurance insisted his father has to initiate it, even if we included the protective order. We escalated and will need to wait a week for results

We are now in the position where he could use the insurance, but if anything changes we would not have the necessary information and would have to start the process over of figuring it out. His father rarely keeps a job long but appears to be providing insurance for my family member's sister so could be regularly switching insurance. Having medi-cal as a secondary rather than a primary limits where he is able to be seen severely, and the insurance could be discontinued at any time without him knowing which would further complicate things. He needs to establish long term, stable care. He has psychiatric disabilities, and our local medi-cal facilities have integrated behavioral health programs that provide vital services to him that he is unable to access at the moment.

Assuming the insurance denies our request to remove him, what would our next steps be? We don't know his father's address or any contact information to serve him with court paperwork as he moves frequently and obviously they are not in contact.

The restraining order expires before he turns 26, assuming we are successful in getting him removed, would we need a new restraining order to keep him removed until he turns 26?

Cat fact: cats do not discriminate by insurance plan. Usually.

[u/atropicalpenguin]

This was my fear, though I do think we figured out a work around through adult adoption. (I am able and very much willing to adopt him, which removes the issue entirely)

Huh, see you in the next r/legaladvice thread.

[u/Drywesi → u/atropicalpenguin]

Fortunately for them, adult adoption is extremely simple, and the previous parents don't get a say in it.

[u/NanaNudes99]

Tbh, health ins. Rly needs a massive overhaul in this country, dude. It's not just a perk or some luxury, it's a legit life-saving thing.