Check your contract or Certificate for details. In most contracts, newborns are covered for their first 31 days of life automatically. Typically, you must enroll your newborn within 31 days from the date of the child's birth to continue coverage without interruption beyond the 31st day. Unless your contract or Certificate states otherwise, a newborn child of a dependent son or daughter does not qualify as a dependent under your coverage.
Check your contract or Certificate for details. In most contracts, adopted children are automatically covered for 31 days from the date of placement or adoption, whichever is earlier. Typically, you must enroll your adopted child within 31 days from the date of the child's placement with you or date of adoption, whichever is earlier to continue coverage without interruption beyond the 31st day. Unless your contract or Certificate states otherwise, an adopted child of a dependent son or daughter does not qualify as a dependent under your coverage.
Check your contract or Certificate. Typically, you need to contact us directly, or via your group if applicable, within 31 days of the event giving rise to the change. Requests for changes in eligibility need to be in writing.
Call Customer Support during normal business hours and request a Change of Eligibility Form. Customer Support numbers can be found on your insurance ID card and are specific to your account and plan.
Note that at any time we discover a person's ineligibility, we may cancel their coverage immediately, and recover from you the costs of any benefits paid on behalf of such person during the period of ineligibility.
Check your contract or Certificate. If a court order requires that you provide coverage for a child who is out-of-state, you must notify us of the court order within 31 days of its receipt, in order for coverage to be effective.
If you are covered through an HMO benefit design and your child is going to college outside of our service area, there may be special circumstances under which your child may be eligible for coverage other than emergency or urgent care benefits. If you are covered through a benefit design other than an HMO product, benefits may be covered for your child who is outside of our service area.
Children inside the service area are typically eligible for coverage, provided they meet the definition of "dependent" under your contract or Certificate. Contact Customer Service for more information and for eligibility guidelines that apply.
For plan years beginning on or after September 23, 2010, it has been our policy that children can remain on their parent's health plan until the end of the month they turn 26. Some self-insured plans or state mandates require us to administer to a different time period or age.
We always recommend that you check your plan specifics. Additionally, a dependent is defined as a child of the subscriber or participant who is under the age of 26. Financial dependency on or residency with the subscriber or participant is not required. Additionally, there is no requirement to be unmarried, student, employed or any combination of these factors.
Plans are also required to provide access to coverage regardless of a dependent's eligibility for other coverage, except for grandfathered group plans prior to 2014. For these grandfathered plans, groups may choose to exclude coverage for children under a parent's policy if they are eligible for their own employer sponsored coverage. For states or plans that cover other children (i.e., step children, children of domestic partners, etc.), that definition will not change.
Check your contract or Certificate. Typically, eligibility will be continued past the standard age limits specified in your contract or Certificate only for those already enrolled, unmarried children who cannot work to support themselves due to certain mental or physical disabilities. These children must be allowed as federal tax exemptions for the subscriber or the subscriber's spouse.
Under many health benefit plans, the disability must have started prior to the end of the period for which they would have otherwise been eligible under your coverage. We must be notified of the disability within 31 days after the child would normally have become ineligible, and we have the right to determine whether the child's condition meets our criteria for being covered under the coverage beyond the normal end date.
From time to time you may be asked to submit proof of continued disability. Failure to provide that information could result in termination of the child's coverage.
Check your contract or Certificate for a definition of "dependent". If you are covered through an HMO benefit design and your child is going to college outside of our service area, there may be special circumstances under which your child may be eligible for coverage other than emergency or urgent care benefits. If you are covered through a benefit design other than an HMO product, benefits may be covered for your child who is outside of our service area. Children inside the service area are typically eligible for coverage, provided they meet the definition of "dependent" under your contract or Certificate. Contact Customer Care for more information and for eligibility guidelines that apply.
Once you're logged in, you can quickly view your benefit or claim information for you and potentially for your dependents on the policy. Dependents who are 18 years or older can adjust their settings in their profile online at any time and may or may not allow you to view thier information online. A dependent can be a spouse, partner or child who is covered on the primary health insurance policy.
