Q&A: Dependent Children Coverage

If your policy provides coverage for dependent children, your policy must cover your child until he or she turns 26. This is true regardless of your child’s financial independence, residency with you or any other person, student status or employment.

If your coverage is through a group health plan that began before January 1, 2014 and qualifies as a grandfathered health plan, your plan may exclude coverage for your adult child who is not 26 if that child is eligible to enroll in a different group health plan.

You can add an adult child when your policy is renewed. If you coverage is through your employer, contact your employer for more information on how to add a dependent at renewal time.

If your coverage is through an individual policy (a policy not offered through an employer), Dean Health Plan will notify you of this option during the renewal process – approximately 30-45 days prior to the renewal date.

You may also be able to add your child outside of the renewal date if there is a qualifying event.

Coverage through your employer: If your eligible adult child isn’t currently insured on the policy, you should submit an application to your employer before the renewal date to add your adult child. Coverage for your child will be effective upon your renewal date as long as it’s received by Dean Health Plan within 30 days of the effective date. Example: If your group renews Jan. 1, the application must be submitted to Dean Health Plan prior to Jan. 31, to be considered timely. Your employer should be able to help you with the specifics your company’s application process.

Coverage through an individual policy: You’ll need to submit an application directly to Dean Health Plan to add your dependent. Coverage for your child will be effective upon your renewal date as long as it’s received by us within 30 days of the effective date. If your premium rate is affected, we’ll let you know with the next billing statement.

If your coverage is through an individual policy, your adult dependent will at least be covered through the end of day in which they turn 26. If you purchased your individual coverage through healthcare.gov, your adult dependent may be covered through December 31 of the year in which he or she turns 26 because healthcare.gov isn’t currently able to terminate dependents mid-year.

No. The new mandates require insurance companies to extend dependent coverage to include adult children, but parents have the choice of whether or not they wish to cover their adult children.

Yes, as long as your adult child meets the eligibility requirements.

Yes. This means that we do not need to confirm the disabled status of your child until he or she turns age 26.

If your child was under age 27 and a full-time student at an institution of higher education when he or she was called to federal active duty, he or she may be covered on your policy after returning for as long as he or she is a full-time student.

Since the verification process was largely based on validating full-time student status and support from parents, it is no longer needed.

We may have to confirm full-time student status in limited cases where the military service provision may apply but we will do that on a case-by-case basis.

Note: State and local government (Employee Trust Funds program) employees are required to provide additional student verification. For more information, please see the Department of Employee Trust Funds website. Federal employees should also refer to their benefit materials for information on dependent coverage guidelines.

No, only the adult dependent can be covered under their parents’ plan.