I have insurance through my employer and my daughter is still covered under the plan, she is 23. She had a child on July 4, 2015. I was first told that my grandson was covered because my daughter is not married, living at home and on my insurance. This week I get a call from my company that he is not covered. I do not understand and feel that they need to cover him since they cover his mother. Does not make sense that we would need a policy for a 2 month old. Is this covered under Obamacare?
A coverage family can include any tax dependent so a grandchild can be covered, but only if the natural parent isn't living in the same household.
If the natural parent is living at home on the grandparents insurance then coverage won't extend to the grandchild.
Here is the good news. Kids, especially babies, are often covered under CHIP based on income. CHIP eligibility levels are typically pretty generous. If CHIP doesn't work then you can get a child only policy from the Marketplace.
In a case where the natural parent is not living at the house or you are trying to get private child only coverage, they must be added to the plan during special enrollment or open enrollment. There is a 60 day window to enroll a child in a plan, with coverage starting as early as the day they are born.
Learn more about special enrollment.
The child must meet certain qualifications to be covered under your health plan. If the child:
- Is under age 26
- Is living in a parent-child relationship with you and economically dependent upon you
- You have legal guardianship of or formally adopted the child,
he or she may be covered under your health plan. The natural parent cannot be living in the same household as the child. If disabled, special rules apply. The dependent must be enrolled within thirty (30) days from the date of legal custody or during open enrollment. You must contact Human Resources, provide proof of custody, and complete the required documents.