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Changes in Health Coverage Changes in Health Coverage FAQs

 

Changes in Health Coverage


Members of Congress and Designated Staff - General



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SHOP - General



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SHOP Eligibility & Enrollment



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SHOP Health Coverage



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Premiums, Taxes & Signing Up for SHOP



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Retirement & Medicare



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Eligibility for Other Benefits Programs



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Disputed Claims



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Turning Age 26



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Former Spouses



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Former Employees



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Ineligible for FEHB

      • A spouse, including a valid common law marriage.
      • Children under age 26 (including adopted children, recognized natural children or stepchildren (including children of same-sex domestic partners in certain states); or foster children living with tribal employee in regular parent-child relationship>
      • Children age 26 or older incapable of self-support, if disabling condition began before age 26
    Which family members are not eligible?   
      • Grandchildren, unless foster child requirements (as defined in the Handbook) are met.
      • Parents
      • Siblings
      • In-laws
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      • Grandchildren, unless foster child requirements (as defined in the Handbook) are met.
      • Parents
      • Siblings
      • In-laws
      Which family members are eligible for Federal Employees Health Benefits?   
      • A spouse, including a valid common law marriage.
      • Children under age 26 (including adopted children, recognized natural children or stepchildren(including children of same-sex domestic partners in certain states); or foster children living with tribal employee in regular parent-child relationship>
      • Children age 26 or older incapable of self-support, if disabling condition began before age 26
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  • If you are ineligible for FEHB, you may purchase insurance on the Marketplace. Please visit www.Healthcare.gov for more information. * Note: Under provisions of the ACA effective January 2014, you must have insurance of some sort or will have to pay a tax penalty. For more information, please visit www.IRS.gov
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  • FEHB law dictates which Federal employees are eligible for FEHB coverage based on the type of appointment you have and your scheduled work hours. For more information, please visit the Eligibility Section of the FEHB Handbook.
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Affordable Care Act

Overview

On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (ACA) also known as Health Care Reform. Highlights of the ACA include the following but are not limited to:

  • The Health Insurance Marketplace
  • Coverage of children to age 26
  • Preventative services with no cost-sharing
  • An opportunity for entitled tribes, tribal organizations and urban Indian organizations to purchase coverage in the Federal Employees Health Benefits (FEHB) Program for their employees


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