What Are The Dependent Eligibility Requirements For Marketplace Family Health Coverage?
Who can be considered a dependent?
Your dependents can include spouses, children, and partners. Eligibility requirements for children include:
- Age: Your child must be under the age of 26.
- Relationship to you: Your biological children, stepchildren, and adopted children in your care are eligible dependents.
What Is Covered In A Marketplace Health Insurance Plan?
A Marketplace family health insurance plan covers you and your family, including your spouse and your children. All Marketplace plans cover 10 essential health benefits:
- Ambulatory patient services (outpatient care you get without being admitted to a hospital)
- Emergency services
- Hospitalization (surgery and overnight stays)
- Pregnancy, maternity, and newborn care
- Mental health and substance use disorder services, including behavioral health treatment (includes counseling and psychotherapy)
- Prescription drugs
- Rehabilitative services and devices (used to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision for children
When Can You Add Dependents To Your Insurance Plan?
You may also add dependents outside the Open Enrollment Period if they have a qualifying life event.
You can add dependents to your health insurance plan during the annual Open Enrollment Period. Open Enrollment typically runs from November 1 to January 15 annually, but actual dates can vary by state.
How Long Can Children Stay On A Parent’s Marketplace Plan?
Children can stay on a parent’s health insurance plan until they turn 26 years old, even if they are:
- Getting married
- Having or adopting a child
- Starting or leaving school
- Living in or out of a parent’s home
- Eligible for employer-based coverage but declined it
Can You Add Your Parents To Your Marketplace Health Insurance Plan?
Health plans typically count spouses and children as dependents, but generally do not include parents. However, the rules vary by state.
Your parents have other options. They can sign up for their own Marketplace plan or may qualify for Medicare if they are turning 65 or older. And, depending on their income or disability status, they may qualify for Medicaid.
Can I Buy Family Health Insurance On The Health Insurance Marketplace?
Family health insurance plans are available on the Marketplace. The Health Insurance Marketplace was established by the Affordable Care Act (ACA) to help individuals access health insurance for themselves and their family. Also, you may be eligible for free or lower-cost coverage through premium tax credits, also known as health insurance subsidies.
The Marketplace offers plans in four “metal” levels: Bronze, Silver, Gold, and Platinum. Metal levels differ only in how you and your insurance provider share the overall cost. Check for availability, as not all metal level plans are available in all areas.
Metal level plans include:
- Lowest monthly premiums
- Higher deductibles
- For individuals and families who only need routine checkups, preventive care, and emergency care coverage
- Average monthly premiums
- Lower deductibles
- Additional cost-sharing subsidies may reduce out-of-pocket costs for eligible enrollees based on income
- For individuals and families who need routine preventive care along with coverage for a condition or upcoming procedure
- Higher monthly premiums
- Lower deductibles
- For individuals and families who need routine preventive care and have ongoing healthcare needs
- Highest monthly premiums
- Lowest deductibles
- For individuals and families who frequently use care and need coverage for nearly all related costs
Learn more about Marketplace health plans.
Get Help Navigating Your Health Insurance Options
Count on our experience and support to enroll in health coverage. We can help you choose a Marketplace health insurance plan with Anthem and guide you through the process.