Generally, dependent children may remain covered under a parent’s health plan until age 26. After reaching age 26, they may have other coverage options available, including COBRA continuation coverage, coverage through their own employer, or coverage through the Health Insurance Marketplace.
An enrolled dependent child who would normally lose eligibility solely because of age may be eligible to continue coverage beyond age 26 if they meet the plan requirements for a disabled dependent.
Eligibility for Continued Coverage
To be considered for continued coverage as a disabled adult dependent, the dependent must have become disabled before reaching age 26. A dependent who becomes disabled after their 26th birthday would not qualify for continued coverage as an overage disabled dependent under the plan.
The dependent must also:
Documentation Requirements
The insurance carrier will require medical documentation from an appropriate healthcare professional certifying the dependent’s disability and inability to be self-supporting. Additional documentation may be required to establish continued eligibility.
Ongoing Eligibility
Requirements for disabled dependent coverage may vary by health plan or insurance carrier. Continued eligibility may be subject to periodic review, and updated medical or other supporting documentation may be required to maintain coverage.
Applying for Continued Coverage
Employees should contact the Benefits Division and/or their insurance carrier as early as possible before the dependent turns age 26 to obtain specific eligibility requirements, required forms, documentation, and applicable deadlines. Approval for continued coverage is determined according to the requirements of the applicable health plan or insurance carrier.