Updated April 10, 2014
HANDICAPPED DEPENDENT COVERAGE
Insureds who have an unmarried child who is physically disabled and incapable of earning his/her own living as of the age of 19 may apply for Handicapped Dependent Coverage for their child. Family coverage is required.
- Give the employee the Handicapped Dependent Application.
- The employee and dependent’s physician must complete the application and send it to the GIC.
- The GIC will review the application for eligibility and will notify the insured of its decision.
- The GIC sends periodic re-certification forms for continuation of handicapped dependent coverage to the employee.
If the child is not eligible for Handicapped Dependent coverage and is under age 26 and over age 18, he/she will be covered as a dependent age 19 to 26.
DEPENDENT TURNING AGE 19
Under the dependent age 19 to 26 Expansion as the result of federal health care reform, an insured’s child, stepchild, adopted child and eligible foster child will automatically continue health and dental coverage up to the last month the dependent turns age 26 as long as the insured has family coverage. All members of the GIC family plan must reside in the health plan’s service area, unless the dependent is a full-time student. The GIC sends a questionnaire to insureds who have a covered dependent turning age 19. The insured only needs to complete and return the questionnaire if the dependent lives outside of the health plan’s service area or is a full-time student living outside of the health plan’s service area.
If the dependent is not the child, stepchild, adopted child or eligible foster child, he or she may be eligible for coverage under Massachusetts Health Reform up to age 26 or two years after the losing dependent status under IRS rules, whichever occurs first. The insured must contact the GIC at extension 5 for a Massachusetts Health Care Reform Dependent Application in order to apply.
If the insured wishes to cover the child of a dependent who is age 19 to 26, the insured may only cover both the dependent age 19 and over and the dependent’s child under Massachusetts Health Care Reform. This will provide coverage for both the child and dependent age 19 to 26 up to when the dependent turns age 26 or two years after loss of IRS dependent status, whichever occurs first. Instruct the insured to contact the GIC at extension 5 for the Massachusetts Health Care Reform Dependent Application. Attach a copy of the IDF form and the birth certificate for the child of the dependent and send with the application to the GIC.
This information provided by the Group Insurance Commission .