Michelle’s Law Makes Health Insurance Companies Cover Students on Medical Leave

Whether you are a college student, or you have one, you know that only full-time college students generally continue to receive health insurance benefits after the age of 19, with no coverage for any student who has gaps in that full-time status. But that is about to change for students undergoing health problems.

Starting next October, college students who have to take time off from school for medical reasons will still be allowed to keep their medical insurance benefits under the parent’ health insurance under “Michelle’s Law”, an amendment to ERISA (Sec. 714, PHSA Secs. 2707 and 2753, and Code Sec. 9813).

The law is named after Michelle Morse, who was a full-time college student at Plymouth State University in New Hampshire when she was diagnosed with colon cancer. Her doctors advised her to cut back on her course load while undergoing chemotherapy, but she could not because she would lose her family’s health insurance. Michelle died while she was still going to school full-time.

Michelle’s Law was passed by the New Hampshire legislature as state law, and an effort was on to pass similar laws state-to-state, but NH US Representative Paul Hodes proposed a national law, which passed late last year, and was signed into law by President Bush. For plan years beginning after October 9, 2009, now, group health plans cannot terminate coverage of a dependent child due to a medically necessary leave of absence before the date that is the earlier of (1) the date that is one year after the first day of the medically necessary leave of absence, or (2) the date on which such coverage would otherwise terminate under the terms of the plan or health insurance coverage.

There are several qualifications. The student has to be full-time until the first day of the leave. The child has to be medically certified (which only becomes a rebuttable presumption that the leave is medically necessary).

In addition, the insurance company has to provide the family with an understandable description of the terms and conditions of the leave.

Other than that, coverage must continue as if the student is still in school. If you have any questions as to whether or not Michele’s Law would apply to your family situation, contact the employment lawyers at Atlanta’s Buckley Bala Wilson Mew LLP.