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Are newborn and adopted children automatically covered under an HMO program?

April 26, 2017adopted automatically children Covered hmo newborn program

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Are newborn and adopted children automatically covered under an HMO program?

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All HMO contracts which provide coverage, benefits, or services for a member of the family of the subscriber shall provide coverage, benefits, or services to a pre-enrolled newborn from the moment of birth. As for adopted children, all HMO contracts which provide coverage, benefits, or services for a member of the family of the subscriber shall provide coverage, benefits, or services with respect to an adopted child from the moment of placement in the residence of the subscriber. In the case of a newborn child, coverage shall begin from the moment of birth, if a written agreement to adopt such a child has been entered into by the subscriber prior to the birth of the child.

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A. All HMO contracts which provide coverage, benefits, or services for a member of the family of the subscriber shall provide coverage, benefits, or services with respect to an adopted child from the moment of placement in the residence of the subscriber. In the case of a newborn, coverage shall begin from the moment of birth, if a written agreement to adopt such a child has been entered into by the subscriber prior to the birth of the child.