Family members eligible for coverage under your Self +1 or Self and Family enrollment include:
Your spouse, including a common law spouse only if the marriage was initiated in a state that recognizes such marriages,
Child under age 26 including
biological child,
stepchild,
adopted child, or
foster child; and
Child age 26 or older incapable of self-support, if disabling condition began before age 26.
Family Member Eligibility Circle
Biological Child
Stepchild
Married Child (excluding their spouse and kid)
Placed for adoption
Financial responsibility exists
Parent-child relationship exists
Common residence
Expect to raise the child to adulthood
Primary source of financial support
Legally married
Initiated in a State that recognizes common law marriages
Incabale of self-support because of a physical or mental disability that existed before age 26 and will last for at least a year
Click on a category in the circle to learn more.
Note: This infographic is for the purpose of providing general information about FEHB rules. It does not replace official guidance.
Your employing office will review the evidence you provide to determine whether your family member is eligible for coverage.
The FEHB Handbook and FAQs provide additional information about family members' eligibility for coverage.
Spouse
Your spouse is an eligible family member.
You must provide proof that you are legally married to your spouse.
If you are married less than 12 months, provide a copy of your government-issued marriage certificate.
If you are married 12 months or more, provide a copy of your government-issued marriage certificate and any one of the following sets of documents listing your spouse:
Front page of most recent tax year’s Federal or State tax return; or
Proof of common residency (e.g., utility bill, other household bill, auto registration); and proof of financial interdependency (e.g., shared bank statement, credit card statement, life or auto insurance policy).
The FEHB Family Member Eligibility Factsheet for Spouse summarizes the eligibility requirements.
Common Law Spouse
You may cover your common law spouse under the FEHB Program only if your marriage was initiated within a State that recognizes such a marriage. The National Conference of State Legislatures lists the states that recognize common law marriages. You must provide all of the following information:
A court order or judgment recognizing the marriage; or
Your declaration indicating:
The date on which and the state in which you and your spouse mutually agreed to become married.
The length of time you and your spouse have lived together.
All address or addresses at which you and your spouse have lived together.
Whether you and your spouse have been regarded among neighbors, friends, and relatives as being married spouses.
If you or your spouse were previously married, the declaration must indicate date and place of each previous marriage as well as the date, place, and manner of termination (i.e., death, divorce, or annulment).
Your signature underneath the following statement:
WARNING: Any intentionally false statement or willful misrepresentation relative thereto is a violation of the law punishable by a >fine of not more than $10,000 or imprisonment of not more than 5 years, or both. (18 U.S.C. 1001)
In addition to the above, you must provide any one of the following documents listing you and your spouse:
Front page of most recent tax year’s Federal or State tax return; or
Proof of common residency (e.g., utility bill, other household bill, auto registration); and proof of financial interdependency (e.g., shared bank statement, credit card statement, life or auto insurance policy).
The FEHB Family Member Eligibility Factsheet for Common Law Spouse summarizes the eligibility requirements.
Child under age 26
Child under age 26 includes your biological child, stepchild, legally adopted child, and foster child.
Your biological child meets the eligibility requirements when you provide a copy of any one of the following documents listing you and your child:
Government-issued birth certificate; or
Certificate of live birth; or
Front page of the most recent tax year’s Federal or State tax return; or
Consular Report of Birth Abroad; or
Official paternity test; or
Voluntary affidavit of paternity or similar document; or
Court or administrative order (e.g., National Medical Support Notice).
You can establish your relationship with your stepchild by providing a copy of any one of the following documents:
Birth certificate, or final adoption certificate/decree, listing current spouse as parent; or
Front page of most recent tax year’s Federal or State tax return with child’s name; or
Court or administrative order (e.g., National Medical Support Notice).
Note: If enrolling a stepchild, you must also verify your spouse’s eligibility (see above for required documents), even if you are not enrolling your spouse on your FEHB plan.
The FEHB Family Member Eligibility Factsheet for Child Under Age 26 summarizes the eligibility requirements.
Adopted Child
A child is considered adopted when the child is placed for adoption with you. In other words, you have assumed legal responsibility for total or partial support of the child in anticipation of adoption.
You must provide a copy of any one of the following documents listing you and your child:
Final adoption certificate or decree; or
Authorized letter from a placement agency for the purpose of adoption; or
Front page of most recent tax year’s Federal or State tax return with child’s name; or
Court or administrative order (e.g., National Medical Support Notice).
The FEHB Family Member Eligibility Factsheet for Adopted Child summarizes the eligibility requirements.
Foster Child
Your foster child is eligible for coverage if they meet the following requirements:
the child must be under age 26 (if the child is age 26 or over, he/she must be incapable of self-support on account of a disabling condition that began 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.
You must submit all of the following documents:
Certification of foster child status that is available in the FEHB Handbook .
Government-issued birth certificate or other document verifying child’s date of birth
Documentation of regular and substantial support for the child such as:
Evidence of eligibility as a dependent child for benefits under other State or Federal programs
Proof of inclusion of the child as a dependent on the front page of the enrollee’s most recent tax year’s Federal or State income tax returns
Canceled checks, money orders, or receipts for periodic payments from the enrollee for or on behalf of the child
Evidence of goods or services which show regular and substantial contributions of considerable value
Any other evidence which OPM, in guidance, deems to be sufficient proof of support
If applicable, include copy of court order naming employee or spouse as child’s legal guardian
The FEHB Family Member Eligibility Factsheet for Foster Child summarizes the eligibility requirements.
Child Incapable of Self-Support
Your child age 26 or over who is incapable of self-support because of a mental or physical disability that existed before age 26 is also an eligible family member. You must submit a medical certificate stating the child is incapable of self-support because of a physical or mental disability that existed before they became age 26 and is expected to continue for more than one year. Additional information required to be included in the certification can be found in the FEHB Handbook .
The FEHB Family Member Eligibility Factsheet for Child Incapable of Self-Support summarizes the eligibility requirements.