Family health coverage is of vital importance, so adding family members to your health insurance is likely to have both advantages and drawbacks. One major upside of including them all in your policy is providing all family members access to comprehensive health care.
Typically, only immediate family and domestic partners are eligible to be added onto a medical plan; however, non-family members may still obtain quality health coverage through either Health Insurance Marketplace or Medicare.
Immediate Family Members
Addition of a dependent to your health insurance plan requires meeting specific criteria. Family members typically qualify as dependents; these individuals must be related by blood or marriage and depend on you for more than half their financial support. These qualifications ensure that the individual will enjoy equal coverage as you do while also being subject to any benefits or restrictions associated with that coverage.
Age can also play a key role when considering adding someone to your policy. Children can remain on their parent’s health insurance until age 26, after which time they must either purchase their own coverage or enroll in COBRA. Children can be added to a spouse’s plan until either turning 26 or becoming legally married at which point they must obtain separate coverage of their own.
Your health insurance dependent can only be added during an open enrollment period or when experiencing a qualifying life event such as marriage, having children, or moving. These periods typically last a certain length of time and if missed then any necessary changes to coverage must wait until the next open enrollment period to take place.
If your elderly relatives need health coverage that they cannot add as dependents to your family policy, Medicare could be the perfect solution. This federal health insurance program offers quality healthcare at a more reasonable cost to those who qualify. If you are wondering whether one or more of your family members are eligible for Medicare, contact a representative from either a health insurance marketplace or your local Social Security office and get all the answers that will provide a clear path. This article was taken directly from AARP website (http://www.aarp.org/health/health-insurance/advanced-topics/adult-children.html), an independent, nonprofit, nonpartisan group working on behalf of people over 50.
Non-Family Members
Health insurance policies typically only extend coverage to immediate family members; such as spouses, children, parents, siblings and grandparents. There may be special circumstances where non-family members qualify for inclusion on a health plan; it is important to understand all requirements and benefits associated with adding someone new.
Age is often used as a criteria for eligibility in health insurance plans; once your child reaches 26 they no longer qualify as dependents and should seek their own coverage or enroll through the Health Insurance Marketplace.
Most medical plans impose other criteria when adding someone, in addition to age. These could include meeting the plan’s residency requirement and possessing a valid Social Security Number. Furthermore, policies usually give individuals a certain window of time in which they can add or drop coverage; typically around an open enrollment period or major life events like marriage or divorce.
As an example, adding your spouse to your health insurance can open up access to new doctors or hospital services not available with individual plans – an advantage especially useful if their health needs differ from yours.
However, adding non-immediate family members can add cost. Most health insurance providers charge premiums per individual covered on your plan; more people means higher monthly costs.
As additional family members can reduce your health insurance tax deduction, to avoid potential penalties you must become familiar with the regulations for both your state and health insurer.
If you are thinking about adding non-family members to your health insurance, it would be beneficial to speak to an agent to learn about requirements and costs. Depending on your specific circumstances, comprehensive coverage could give you peace of mind that comes from knowing all bases are covered should anyone ever require care.
Domestic Partners
Many states recognize domestic partnerships as an alternative form of marriage, meaning if you live with someone of opposite gender and can provide proof, they could potentially qualify for coverage under your health insurance plan. It depends on each state, employer and plan; for more details be sure to speak to both them directly about how this might work for them.
As a general guideline, to qualify as your health insurer’s definition of domestic partner they must receive at least 50% of your financial support and reside with you within your home, while being either an American national, legal resident, or citizen (but not your child) at the time they move in with you. Furthermore, paying out-of-pocket will incur taxes (though this could be discussed with your insurer).
Employers that provide health insurance plans that extend coverage to domestic partners differs from that provided for spouses or children in that it typically grants the domestic partner all of the same benefits, including hospital visitation rights. They would need to be an employee at the same company and in a legal, committed relationship for at least 12 months prior to being covered under such plans.
If you are in a domestic partnership and your employer offers this type of insurance plan, adding your partner can often be accomplished seamlessly during initial enrollment or open enrollment with special enrollment periods due to life events or qualifying life changes. Contact HR representatives or insurance providers directly for details about their policy in your company.
Addition of family members to your health insurance is one of the easiest and cheapest ways to cut costs, since health insurers typically offer discounts to families as an incentive to sign up more people for coverage. Before making decisions about who qualifies as dependents or eligible for discounts, however, it is crucial that you understand exactly who qualifies and understand what constitutes a dependent relationship and eligibility before making decisions regarding coverage decisions. Also keep in mind that once married or ending domestic partnerships occur you’ll have to remove them from the plan (unless waiting until finalization of divorce proceedings before re-enrolling again).
Young Adults
As young adults transition out of parental care, many face the daunting task of finding suitable health insurance options. Options could range from employer plans, individual and family policies purchased on the ACA marketplace or directly through insurers, to Medicaid. Understanding all available policies as well as setting personal healthcare priorities – such as affordability, coverage limits, preferred network providers access, mental health coverage benefits etc – is paramount in narrowing down available policies until individuals find those that best meet their needs.
Young adults worried that they will lose their parents’ insurance after leaving home or graduating college will find some comfort in knowing that the Affordable Care Act mandates plans and insurers provide coverage until age 26. Parents can arrange a system whereby their adult child pays their portion of premium, co-pays and contributions towards family deductible.
Young adults looking for additional health support could sign up for their school or university’s student health plan, which are often affordable options that provide vital support in transitioning towards living healthier. These plans also offer valuable health information and resources as they transition toward leading healthier lifestyles.
Young adults living with pre-existing conditions will now benefit from protections provided under the Affordable Care Act, which prohibit insurance companies from denying coverage or charging higher premiums due to these pre-existing conditions. While this will bring relief, it doesn’t provide sufficient coverage.
Young adults living on low incomes should keep in mind that the Affordable Care Act offers financial assistance in the form of premium subsidies for qualifying applicants purchasing health insurance through its marketplace. A young adult’s ability to receive these subsidies may depend on factors like filing status and household income as well as whether or not they are listed as dependents on their tax returns. Working with an insurance agent will assist young adults navigate these complexities effectively.