Humana Grievance and Appeals Department

PO 14546

Lexington, KY 40512



Dear Sirs and Madams:


On November 9th, 2012, my family adopted our son GH. He’d been in our care as a foster child for 635 days, covered under a state Medicare plan. We immediately added him to our Humana One plan and took him for a much needed well child visit on December 17, 2012, for which you were billed $195.00. Recently we’ve received notice that our claim was denied because there was a 90 day waiting period for G to have coverage. This waiting period was not disclosed to us upon adding our son to our policy.


In speaking to your representative, I was informed that there is no waiting period when adding biological children to the policy. Your representative confirmed that my son, by virtue of the fact that he was born to people who were unable and unwilling to care for him, who ended up in foster care and later being adopted, does not have the same rights and privileges that our biological children have.


G’s birth certificate shows he is legally my son. It lists my name as his mother, and my husband’s as his father. The state of Texas, and the federal government, recognize him as our legal child, with the same rights, duties, and responsibilities that we have to our biological children. It seems unfair that your company would choose to single adopted foster children out and exclude them from coverage by virtue of the circumstances of their birth. Frankly, it seems ludicrous, and every person in our extensive foster care and adoption community was shocked to discover this is Humana’s policy.


Surely, the reasons behind this waiting period are not meant to punish adopted families and their children. However, by virtue of the fact that your company is choosing to treat the growth of a family by adoption as different than the birth of a new child, this is precisely what is happening.


As a writer, advocate for foster youth, and prolific blogger, I see many examples of companies amending policies so as to be more inclusive for adoptive families. I would expect and hope that Humana would do the same.


You could begin by approving the $195.00 claim (which I must add is less than one percent of the amount my family has paid in premiums over the years) from last December. The claim from a simple doctor visit that my sweet, precious boy needed to ensure he continues to grow strong and healthy, despite the circumstances of his birth.



Sincerely-



Mrs. S


Â