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Securing Healthcare after Placement | Adoption Law

One of the first issues that arises when the biological mother gives birth is covering her medical bills and that of the newborn child.  If the birth mother already receives Medicaid, the hospital will usually assist her in completing an application for the baby.  This will ensure that the child is covered until the prospective adoptive parents can obtain a custody or guardianship order.


Typically, the adoptive parents are providing care and making medical decisions in the hospital based on a Power of Attorney.  Depending on the law in the state the birth mother delivers, there is usually a waiting period before her parental rights can be terminated.  In Tennessee, this mechanism is call a surrender of parental rights.  The surrender can occur on the fourth calendar day after the birth.  For example, if the baby is born on a Monday, the surrender hearing should not occur prior to that Friday.  Tennessee courts are empowered to make exceptions to the waiting period in limited circumstances.


If the child meets criteria for “special needs”, the child will be able to remain on TennCare.  Keep in mind the adoption assistance agreement must be completed prior to finalization of the adoption.  If the family moves, they can be added to that state’s Medicaid health insurance program.


It is permissible for adoptive parents to pay birth related medical expenses.  The Adoption Law Center recommends that all payments made in connection with the adoption be made through your attorney’s trust account to ensure that all payments are documented accurately and meet Tennessee’s strict statutory requirements.


Birth, adoption, or placement for adoption are all considered qualifying life events that trigger special enrollment under the Health Insurance Portability and Accountability Act of 1996 (HIPPA).  HIPPA prohibits insurance plans from excluding an adopted child from coverage solely on the basis of a preexisting condition if the adoptive parents request enrollment within 30 days of placement.  The Adoption Law Center encourages adoptive families to apply for coverage promptly upon placement.  If the child is born in Tennessee and the adoptive parents reside in Tennessee, check with your insurance company, and make sure you receive a written response that the Order of Guardianship issued within 30 days of the surrender allows you to add the child to your insurance policy.  In Interstate cases, when the receiving State authorizing placement, they will issue a form called “100A”.  The date of ICPC approval is the date of placement.


The Adoption Law Center of Middle TN, PLLC does not practice health care law, and this is not intended as legal advice.  We do assist our clients in every aspect of the adoption process.  We would love to hear from you if you are considering adoption or have questions about adoption.


You can reach us by phone at (615) 543-8640 or email us at [email protected]