FEDweek

FEHB Coverage for Your Children

Last week I went over the basics of the FEHB program, focusing on enrollment options and costs to you of participating in the program. This time I want to spell out the variables involved in covering a child.

Many of you are covered under the self and family option, which includes your spouse – if any – and your child or children. Others are covered under the self plus one option, which may consist of yourself and a child (or you and your spouse if you have no children). In either case, your child is automatically covered until his or her 26th birthday.

Due to a change in the law several years back, there is no longer a requirement that your child be financially dependent on you, be a student or live with you.

You may also cover a foster child if you certify in writing that he or she meets the following requirements:

•  is under age 26,

•  lives with you,

• you are be the primary source of financial support for the child,

• the parent-child relationship is with you, not the child’s biological parent, and

• you expect to raise the child to adulthood.

How your enrollment is handled when your child turns 26 differs depending on whether you are covered under self and family of self plus one. If you are enrolled in self and family, you’ll have to contact your health benefits carrier directly to have your child removed from coverage.

If you are enrolled in self plus one, you can go to your personnel office and change your enrollment from self plus one to self only. If you are a retiree, you’ll need to call OPM’s Retirement Service Office at 1-888-767-6738. You can make the enrollment change from 31 days before the event to 60 days after it.

Note: If you have a child who is incapable of self-support because of a mental or physical disability that existed before age 26, he or she can continue to be covered after age 26 under either your self and family or self plus one enrollment.