How to establish a POA or Guardianship so my 21 year old son who is high functioning Autistic can have the same medical insurance

[milburn]

Our son is 21. He is on Medi Cal. We live in California. My husband and I and daughter are Private pay Kaiser members. Kaiser is telling me the only way to get him on Kaiser Medi Cal is for the parents to have a Power of Attorney or Guardianship of him. My question is is this a difficult thing to do ? Either POA or Guardianship?

Thank you.

 

[Just Blue]

Our son is 21. He is on Medi Cal. We live in California. My husband and I and daughter are Private pay Kaiser members. Kaiser is telling me the only way to get him on Kaiser Medi Cal is for the parents to have a Power of Attorney or Guardianship of him. My question is is this a difficult thing to do ? Either POA or Guardianship?

Thank you.

Please define "high functioning autistic". Thanks...

 

[adjusterjack]

Just who is it that told you that? Not the name, but the position, title, department?

I ask because it appears that the person is clueless.

Power of Attorney and Guardianship are two entirely different things and are worlds apart. Power of Attorney is a piece of paper that a person signs that allows somebody else to do stuff and sign stuff on his behalf. Guardianship is something you have to be granted by a court and involves being completely in charge of another person's life.

I suggest that you recontact that person and ask to read something in print about qualifying your son.

Or call:

Kaiser Permanente Medicaid Assistance Center at
1-800-557-45151-800-557-4515 (toll free)
8 a.m. to 5 p.m., Monday through Friday.

 

[FlyingRon]

And neither has anything to do with allowing them to remain on your medical insurance.
Frankly, I'd escalate at Kaiser. What they are telling you is like of bovine excrement. Neither MEDI-CAL nor him being on your HMO policy requires power of attorney or guardianship for someone who is COMPETENT.

 

[milburn]

My husband , myself and our daughter have private pay insurance with Kaiser. Thomas because he is Autistic qualifies for Medi Cal. Kaiser is currently not accepting new Medi Cal patients in the county we reside in. But as an option I could call Kaiser Medi Cal Assistance department 800 436 3717 and ask them for what is called a Permit to Enroll.

Because we are not on Medi Cal with Kaiser they said they are not taking new patients and thus would notgive me the Permit to Enroll our son.

Then the person on the phone said the only way Kaiser would give me a Permit to Enroll form was if I had a POA or guardianship of him. I do not have one. If he needs medical attention it would be great if we were all insured under the same company.

 

[Just Blue]

My husband , myself and our daughter have private pay insurance with Kaiser. Thomas because he is Autistic qualifies for Medi Cal. Kaiser is currently not accepting new Medi Cal patients in the county we reside in. But as an option I could call Kaiser Medi Cal Assistance department 800 436 3717 and ask them for what is called a Permit to Enroll.

Because we are not on Medi Cal with Kaiser they said they are not taking new patients and thus would notgive me the Permit to Enroll our son.

Then the person on the phone said the only way Kaiser would give me a Permit to Enroll form was if I had a POA or guardianship of him. I do not have one. If he needs medical attention it would be great if we were all insured under the same company.

What exactly is your son's Dx? Does he live independently? I ask for a reason.

 

[HRZ]

We don't know much about your sons actual plight : A person of insufficient mental capacity to execute a contract might not meet the minimum requirements to execute a durable POA in CA no matter what some other entity wants. ( That said, if son has his better days and he can execute same with requisite competency safely ...so be it...but smarter to use counsel )

There may be broader issues than merely sorting out how to add him to your medical coverage and it might be prudent too sit with paid counsel familiar with issues in CA and consider a limited conservatorship and possibly need for special needs trust .

 

[cbg]

Wait a minute. How old did you say your son is? 21?

Then why does the requirement under the Affordable Care Act that parents must be allowed to cover their children until age 26 not apply here? It applies to private pay insurers too, not just employer-sponsored plans.

 

[milburn]

What exactly is your son's Dx? Does he live independently? I ask for a reason.

His diagnosis is Autism. And currently he lives with us. Not independently.

 

[Just Blue]

His diagnosis is Autism. And currently he lives with us. Not independently.

Is he capable of living independently?

 

[HRZ]

Plus as a matter of state law coverage for a disabled adult child living at home might extend past 26 ...beyond me but double check.

 

[cbg]

I do this for a living. While you are right that coverage may be able to be extended beyond age 26 in the event of a disability, it is rarely if ever a matter of state law; it is a matter of the insurance carrier's policies. My employer has several disabled dependents over the age of 26 covered on our policies, but it is determined by a review of the specific medical situation done by the medical staff of the insurance carrier. And before anyone gets cynical, we use both a national insurance carrier and a regional one, and to the best of our knowledge the only time a disabled dependent was denied extended coverage was in a case where the dependent didn't qualify in the first place. So you're on the right track, but first we need to get the son covered in the first place.

 

[LdiJ]

I do this for a living. While you are right that coverage may be able to be extended beyond age 26 in the event of a disability, it is rarely if ever a matter of state law; it is a matter of the insurance carrier's policies. My employer has several disabled dependents over the age of 26 covered on our policies, but it is determined by a review of the specific medical situation done by the medical staff of the insurance carrier. And before anyone gets cynical, we use both a national insurance carrier and a regional one, and to the best of our knowledge the only time a disabled dependent was denied extended coverage was in a case where the dependent didn't qualify in the first place. So you're on the right track, but first we need to get the son covered in the first place.

In reading between the lines a bit it seems like the issue really is that the autistic son qualifies for Medicaid (medi cal) and therefore his insurance would normally be free. The OP is private pay and it may be that the insurance costs extra to include him on the parent's policy.

 

[cbg]

Which is evidently not the concern of the OP since my reading of it is that she is fighting to get him on the plan and being told she can't without a POA or guardianship.

 

[LdiJ]

Which is evidently not the concern of the OP since my reading of it is that she is fighting to get him on the plan and being told she can't without a POA or guardianship.

Well, then I hope she comes back and clarifies since we are reading it differently.