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Insurance Coverage Information_
Medical – Adoptive Parent 1
(Required)
Company
Address
(Required)
Street, City, and State
Phone
(Required)
Group Number
(Required)
Member ID:
(Required)
Covers Who:
Life – Adoptive Parent 1
(Required)
Company
Address
(Required)
Street, City, and State
Phone
(Required)
Policy Amount
(Required)
Primary Beneficiary
Secondary Beneficiary
Auto – Adoptive Parent 1
(Required)
Company
Address
(Required)
Street, City, and State
Phone
(Required)
Full or liability
(Required)
Covers Who:
Medical – Adoptive Parent 2
(Required)
Company
Address
(Required)
Street, City, and State
Phone
(Required)
Group Number
(Required)
Member ID:
(Required)
Covers Who:
Life – Adoptive Parent 2
(Required)
Company
Address
(Required)
Street, City, and State
Phone
(Required)
Policy Amount
(Required)
Primary Beneficiary
Secondary Beneficiary
Auto – Adoptive Parent 2
(Required)
Company
Address
(Required)
Street, City, and State
Phone
(Required)
Full or liability
(Required)
Covers Who:
At what time does your medical insurance cover expenses for the child? (starting from birth or only at placement)?
Does your medical insurance cover pre-existing conditions for the child? If not, which do they not cover?
For domestic adoptions does your medical insurance cover a birth mom and delivery?
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