Health Insurance Coverage Eligibility for Family Members

Health Insurance Coverage Eligibility for Family Members

Nov 11, 2021


Health Insurance Coverage Eligibility for Family Members
Health insurance coverage comes with different specifications; however, it is possible to share coverage with your family members, provided they are eligible for health insurance. The eligibility of a family member for health insurance coverage is determined by your employing office, who may or may not require further information about them before deciding whether they are eligible for the health insurance benefits.

Eligible Family Members

  • Self Plus One Enrollment:

    This kind of enrollment qualifies you and another family member for your health insurance coverage. It could be your legally married partner, children (including legally adopted, born out of wedlock, or stepchildren) under the age of 26. These are the family members who might enjoy health insurance coverage benefits under the Self and Family Enrollment.
  • Foster Children:

    Even your foster children can be eligible for health insurance coverage if they meet requirements such as
  • They are under 26 or incapable of self-support
  • They live with you at the moment
  • They have a parent-child relationship with you, although you are not their biological parent
  • You are the only source of their financial support
  • You have been raising them from childhood to adulthood
Your employing office might request documents that prove the child to be your foster child before declaring them eligible. However, if your foster child decides to live with their biological parent, they can be eligible for coverage only if
  • Their biological parent dies, gets imprisoned, or is unable to care for them due to a disability or
  • You obtain a court order for the foster's child's sole parental custody
  • Grandchildren:

    Your grandchildren are not considered eligible for your health insurance coverage except if they qualify as foster children and all the necessary requirements stated above are met.

Non-eligible Family Members

  • A child is not eligible for your health insurance coverage if they have been placed under your care by a social service or a welfare agency where they retain control over the child and pay for maintenance of the child because you do not have the regular parent-child relationship.
  • If a child is living with you temporarily, perhaps for the duration of their school year, they will not be eligible for health insurance coverage because they are not considered as a foster child.
  • Other family members who do not qualify for your health insurance coverage are your parents and other relatives or extended family members, even if they live with or are dependent on you.
Make sure to get the right information on which family member does or doesn't qualify for health insurance coverage to ensure all-round protection for your family. Our agents at Bell Black Insurance are ready to talk to you about the best ways to protect your family. Contact us today to schedule your annual insurance review or to find out more about health insurance coverage.