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Frequently Asked Questions Insurance

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Coverage for Family Members

  • Can my grandchild be covered by my FEHB Self Plus One or Self and Family enrollment? View more
     Your grandchild may be eligible for FEHB coverage if he/she meets the eligibility requirements for foster children. These requirements are:
    • the child must be under age 26 (if the child is over age 26, he/she must be incapable of self support due to a disability that existed before age 26);
    • the child must currently live with you;
    • the parent-child relationship must be with you, not the child's biological parent;
    • you must currently be the primary source of financial support for the child; and
    • you must expect to raise the child to adulthood.

    For your grandchild to be covered under your FEHB enrollment, you must sign a certification stating that your grandchild meets all the requirements and that you will notify your employing office if the child moves out of the home or stops being financially dependent on you. You submit this certification to your employing office for their determination that your grandchild meets these requirements. Your employing office will then notify your FEHB plan that your grandchild should be added to your enrollment.

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  • I'm a single parent. Will my children be eligible for FEHB coverage if I should die? View more
    As long as you have a Self Plus One enrollment and your designated eligible family member is entitled to a survivor annuity or you have a Self and Family enrollment and one of the family members is entitled to a survivor annuity, the child(ren) are eligible for FEHB coverage until they reach age 26 or until no survivor is eligible for a survivor annuity. Children age 26 or over are eligible to continue FEHB coverage if they are incapable of self-support because of a mental or physical disability that existed before age 26.
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  • My ex-spouse is a Federal employee. I have a court order stating that he or she has to provide health insurance coverage for our children. How can I make sure his or her health plan covers the children? View more

    The "Federal Employees Health Benefits Children's Equity Act of 2000" requires mandatory Self Plus One or Self and Family enrollment coverage for FEHB-eligible employees who do not comply with a court or administrative order to provide health insurance coverage for their child(ren). You should send a copy of the court order to your ex-spouse's Human Resources Office. They will ensure that your ex-spouse has an FEHB Self Plus One or Self and Family enrollment that provides coverage for the children. If your ex-spouse does not have a Self Plus One or Self and Family enrollment, his or her Human Resources Office will enroll him or her in the Self Plus One or Self and Family option of his or her current FEHB plan. If his or her current plan is an HMO and the child(ren) don't live within the service area of this plan, they will enroll him in the Basic Option of the Blue Cross and Blue Shield Service Benefit Plan. If he or she is enrolled in Self Plus One but does not have the child listed in the court order designated as his or her covered famiy member, the Human Resources Office will increase his or her enrollment to Self and Family.
     
    Please be sure to include your home address in your notification so that the Human Resources Office can make this determination. The Human Resources Office will send you a copy of the SF 2809, Health Benefits Election Form. They will also send a copy to the FEHB plan so the plan can update their records and send ID cards to you. The Human Resources Office will flag your ex-spouse's health insurance records to prevent him or her from decreasing his or her enrollment or switching his or her covered family member under a Self Plus One enrollment for as long as the court order requires him or her to provide health insurance coverage to your child(ren) or until the youngest child reaches age 26, whichever occurs first.

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  • My child is in college. How long can my child stay covered under my FEHB enrollment? View more
    Your child can be covered under your Self Plus One enrollment  (if he or she is listed as your designated covered family member) or  your Self and Family enrollment until he/she turns age 26. There is no requirement that your child attend college to be covered under your Self and Family enrollment.
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  • Can I cover my common-law spouse under my Self and Family or Self Plus One enrollment? View more
    If the State in which you reside recognizes common-law marriages, yes.
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  • When will FEHB cover children until age 26? View more

    As a result of health care reform, beginning January 1, 2011, children of Federal enrollees will be covered by their parent’s FEHB Self Plus One enrollment (if the child is listed as the designated covered family member) or the parent’s FEHB Self and Family enrollment until their 26th birthday (plus a 31-day temporary extension of coverage), even if the child previously lost coverage because he/she turned 22.

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  • My ex-wife and I are both Federal employees who each have a Self and Family enrollment. Can our children be covered by both of our plans? View more
    No, the children are entitled to receive benefits under only one enrollment.  Generally, when divorce occurs, one parent will enroll in Self Only coverage and the other parent will enroll in Self and Family coverage to provide benefits for the children.  If there is a reason for both parents to enroll in Self and Family coverage (i.e., both parents have remarried and need Self and Family enrollments to cover their new spouses and stepchildren), each enrollee must notify his or her insurance carrier of the name(s) of the child(ren) to be covered under his/her enrollment to prevent ant child from receiving dual coverage under FEHB (which is prohibited by Federal law). In cases where there are only two children, each parent could enroll in Self Plus One where they can each designate an eligible child.
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  • I heard that a Self Plus One enrollment type was added to the FEHB enrollment types. When will the Self Plus One enrollment type be available? View more

    All FEHB plans offer a Self Plus One enrollment type.

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  • Is my family covered under my Spouse Equity Self Plus One enrollment? View more

    Only you or a child born to or adopted by you and your former spouse (the Federal employee or annuitant) are covered under a Self Plus One enrollment. Your child must be under age 26 or be incapable of self-support because of a mental or physical disability that existed before age 26. If you have more than one eligible child, only one child can be covered under a Self Plus One enrollment.

    Your children cannot be covered under more than one FEHB enrollment. If your former spouse (the Federal employee or annuitant) covers the children under his/her FEHB enrollment, your Spouse Equity enrollment should be for Self Only coverage.

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  • My child will turn age 26 this year but she is disabled and incapable of self support. Can I continue to cover her under my FEHB enrollment? View more

    Your child age 26 or over who is incapable of self-support because of a disability that existed before age 26 may be eligible for coverage under your FEHB enrollment. For more information, please see the FEHB Handbook for Enrollees and Employing Offices.

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