514C.10 Coverage for adopted child.
1. Definitions. For purposes of this section, unless the context otherwise requires:
a. “Child” means, with respect to an adoption or a placement for adoption of a child, an individual who has not attained age eighteen as of the date of the issuance of a final adoption decree, or upon an interlocutory adoption decree becoming a final adoption decree, as provided in chapter 600, or as of the date of the placement for adoption.
b. “Placement for adoption” means the assumption and retention of a legal obligation for the total or partial support of the child in anticipation of the adoption of the child. The child’s placement with a person terminates upon the termination of such legal obligation.
2. Coverage required. A policy or contract providing for third-party payment or prepayment of health or medical expenses shall provide coverage benefits to a dependent child adopted by, or placed for adoption with, an insured or enrollee under the same terms and conditions as apply to a biological, dependent child of the insured or enrollee. The issuer of the policy or contract shall not restrict coverage under the policy or contract for a dependent child adopted by, or placed for adoption with, the insured or enrollee solely on the basis of a preexisting condition of such dependent child at the time that the child would otherwise become eligible for coverage under the plan, if the adoption or placement occurs while the insured or enrollee is eligible for coverage under the policy or contract. This section applies to the following classes of third-party payment provider contracts or policies delivered, issued for delivery, continued, or renewed in this state on or after July 1, 1995:
a. Individual or group accident and sickness insurance providing coverage on an expense-incurred basis.
b. An individual or group hospital or medical service contract issued pursuant to chapter 509, 514, or 514A.
c. An individual or group health maintenance organization contract regulated under chapter 514B.
d. An individual or group Medicare supplemental policy, unless coverage pursuant to such policy is preempted by federal law.
95 Acts, ch 185, §15; 2017 Acts, ch 148, §62
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