It would be a happier, healthier world if we could add our
extended family to our health plans. But health insurers have to
draw the lines somewhere. Here's a look at those lines.
If I get married, can my spouse's child be added to my
health plan? Is there a timeframe in which enrollment must take
Yes, a stepchild is eligible to be a dependent on your health
up to the age of 26
. If your coverage is an employer group plan that provides benefits
to children, you will be given at least 30 days to enroll the new
dependent. An eligible child can be a biological child, adopted
child, stepchild or foster child.
"When you get married and you're seeking to enroll that new
spouse and the children, federal law requires that the employee has
at least 30 days to enroll," says Rich Gisonny, senior consultant
at Towers Watson in White Plains, N.Y.
The federal rule states you have "at least 30 days" but an
employer could give you a longer period of time, adds Gisonny. This
gives employees a reasonable period of time to make a decision and
complete the enrollment.
"There's not a mandate in force today to offer health insurance
to an employee's children," points out Gisonny.
If I am an unmarried man and get a woman pregnant, can I
put the child on my employer health plan?
If a plan covers children, under federal law there cannot be
restrictions on eligibility.
"The employer can't require that the child reside with the
employee or that the child is financially dependent on the
employee," says Gisonny. The plan may require a birth certificate
as proof, or verification of the dependent relationship.
Some health plans are more rigorous in requiring dependent or
biological verification than others. "If a plan so chooses, it has
the discretion or the right to require proof that a dependent
relationship actually exists," says Gisonny.
If my mother lives in my home and is claimed as a legal
dependent on my taxes, but is not old enough to collect Medicare,
can I add her to my health plan?
Gisonny says that health plans typically limit the definition of
dependents to a spouse and children.
He adds that there's no mandate under federal law that an
employer health plan must cover parents of the employee. Some plans
do but they're in the minority.
Can my boyfriend or girlfriend's child be added to my
health plan? Does it make a difference if we are living
According to Colleen King, CEO of Colleen King Insurance Agency
in Los Angeles, some individual health insurance plans will allow
unmarried couples to be on the same plan, along with any legal
dependents, if they are all living together or there's a court
order for the one partner to provide insurance for their child.
"Group health insurance also may allow the same, but it may vary
by carrier and by employer. In some states, employers have the
option to not allow same or opposite domestic partners to be
covered," says King. Some health insurers give employers the option
of whether or not to require that the relationship is a registered
domestic partnership, she adds.
If an adult child is on a parent's health plan and has a
baby, can the baby (i.e. the grandchild) be added to a health
A handful of states mandate that grandchildren must be eligible
dependents, according to the Council for Affordable Health
Insurance. But you're more likely to find that the coverage will
not extend to the baby.
Check out these
pregnancy loopholes in health insurance
If my spouse and I have filed for a legal separation, do
I have a choice whether or not to keep him/her on my health
Legal separation and divorce are both
COBRA qualifying events
for continuing group health coverage. Generally a divorcing spouse
doesn't remain on the plan and is removed by the spouse who carries
the plan through work.
Here's more on how women need to
protect health insurance during divorce