Q. My daughter recently suffered head injuries during a college basketball game. She has needed a good bit of medical care and is having trouble focusing. For that reason, she is having trouble continuing to enroll in school for 12 credits a semester, but if she doesn't enroll at that level, our insurance won't continue to cover her. Is there any way I can keep her on my insurance?
A. If your daughter loses coverage because she is over the age of 18 and not enrolled in college, probably the best option would be to keep her on the same insurance plan through COBRA. COBRA refers to the law that allows people who had been covered under an employer-provided insurance plan (for firms with more than 20 employees) to purchase insurance for a period of time after certain events disqualify them from the subsidized coverage.
COBRA requires that a child in your daughter's situation be allowed to keep the coverage for an additional 18 months, although you will have to pay 102 percent of the costs of that coverage. Since most employers subsidize premiums for employees, this will mean a substantial increase in costs, but it likely will still be much less expensive than insurance you could get anywhere else.
Once COBRA runs out, she will be guaranteed that she can buy individual insurance through arrangements your state makes, but again the costs are likely to be high.
Q. I have a handicapped daughter who is 28 years old and she is covered under my federal retiree insurance. She is not receiving any support from Social Security. Should I apply for that? Would that put her in a better position for when I pass on?
A. If you qualify for Medicare as a government employee, your daughter would be eligible for Medicare coverage (assuming she became totally disabled before age 22 and meets the definitions of disability that Social Security requires and did not qualify on her own by working at some point). The additional coverage under Medicare may be helpful in reducing copayments or other expenses that your federal retiree plan may not cover.
If she qualifies for Medicare Part A, you can purchase Part B (which covers physician and other outpatient services) on her behalf. That expense may be worthwhile, depending upon the health insurance you now have.
Do you have questions about health care coverage? Congress may consider modest reforms in the current session. Meanwhile, changes are occurring in the medical marketplace. The debate over costs, quality and access to care continues, and many questions remain. The Washington Post free telephone information service can take your questions. Call POSTHASTE at 202-334-9000 on a touch-tone phone and enter category code 8500 (in Prince William County, 703-690-4110). Economist Marilyn Moon of the Urban Institute provides answers in a periodic column.