Eligible Dependents

You may enroll eligible dependents in the Plan as long as you are also enrolled. “Eligible dependents” include:

• Your spouse, unless he/she is covered through MCHCP where he/she works,
  • If you and your spouse are both State employees, you must each enroll under your own coverage.
• Newborn of a member,
• Your unemancipated dependent children through the end of the month in which they turn age 25, including:
  • Natural children
  • Adopted children from the date you assume the legal obligation for total or partial support of the child
  • Those children who live with you and are either:
    • Stepchildren
    • Foster children
    • Children for whom you or your spouse are the court-appointed legal guardian
• Children for whom you are required to provide coverage under a Qualified Medical Child Support Order (QMCSO)
• Your unemancipated stepchildren not residing with you provided the natural parent who is legally responsible for providing coverage is also covered by the Plan.
• Your unemancipated dependent (disabled) children who are over age 25, but only when first eligible or when covered before age 25.

Coverage may continue beyond age 25 for unemancipated dependent children who are permanently disabled before age 25. In these cases, medical coverage may continue for as long as the child is disabled (and you remain a covered subscriber). Before the child’s 25th birthday, you must provide MCHCP with written documentation of the medical condition and a doctor’s statement verifying the child’s condition. Proof of continuing disability must be provided at the request of MCHCP but not more than once annually.

Children must be under age 25 and unmarried to qualify as dependents. Dependent children must live with a parent, adult family member, or someone appointed by an agency with legal jurisdiction unless they are students in an accredited school or institution of higher learning. Appropriate documentation may be required.

You must terminate coverage on dependents who no longer qualify, such as a divorced spouse or a dependent child who becomes emancipated. Coverage ends on the last day of the month of the occurrence. Note the reason for terminating your dependent, along with the date of loss of eligibility, on the Change/Cancellation (M-2) form.