Who Can You Put on Your Health Insurance?

Health insurance provides financial protection and access to medical care. Understanding who can be covered under a policy is important for many individuals and families. A policyholder can extend coverage to eligible dependents, ensuring multiple individuals receive benefits under a single plan. Eligibility criteria vary by provider and plan, but general guidelines exist.

Qualifying Family Relationships

A legally married spouse is eligible to be added to a health insurance plan. This requires documentation, such as a marriage certificate, to verify the legal union. Once a divorce is finalized, an ex-spouse loses eligibility for coverage under the former spouse’s plan.

Children are recognized as eligible dependents, including biological, adopted, stepchildren, and foster children. The Affordable Care Act (ACA) mandates plans allow children to remain on a parent’s policy until age 26. This applies regardless of the child’s student status, marital status, financial dependency, or residency. For adopted children, federal law ensures coverage without pre-existing condition restrictions, and adoption is a qualifying life event for enrollment.

In some cases, coverage for children may extend beyond age 26. If a child has a disability that began before age 21 or 25 and remains financially dependent, they may qualify for continued coverage. This requires documentation of the disability and financial reliance. Plans may also cover children under permanent legal guardianship or for whom the policyholder has court-assigned financial responsibility.

Adding Other Dependents

Beyond spouses and children, adding other relatives or non-relatives to a health insurance plan is more restricted. Other relatives, such as grandchildren, siblings, or parents, may qualify under limited conditions. These conditions require the relative to be financially dependent on the policyholder, meaning the policyholder provides over half their financial support. Proof of co-residency may also be required.

Adding parents to a health insurance plan is generally not permitted. Exceptions may exist if the policyholder has legal guardianship of their parent or if specific plan terms or state regulations allow it, often contingent on the parent being claimed as a tax dependent. Non-relative dependents are rarely eligible for coverage, with strict criteria requiring proof of financial dependency and cohabitation. Domestic partners may be covered by some plans if they meet specific requirements, such as cohabitation for a certain period and sharing household expenses, and are not married to anyone else.

Eligibility rules for other dependents are more stringent than for spouses or children and vary among health insurance plans and providers. Individuals seeking to add these dependents should consult their plan documents or contact their insurer to understand the requirements and limitations.

Enrollment and Documentation

Adding eligible individuals to a health insurance plan involves specific steps and documentation. Enrollment for new or existing dependents occurs during designated periods. The main opportunity is the annual Open Enrollment Period, when individuals can make changes to their health coverage or enroll in a new plan. This period takes place annually.

Outside of Open Enrollment, individuals may qualify for a Special Enrollment Period (SEP) if they experience a qualifying life event. Common qualifying life events include marriage, birth or adoption of a child, loss of other health coverage, or a permanent move. For most SEPs, a limited window, typically 30 or 60 days, exists from the qualifying event date to enroll or make changes. For newborns and adopted children, coverage can be retroactive to the date of birth or placement if enrollment occurs within the SEP timeframe.

To verify eligibility and process a dependent’s addition, documents are required. For a spouse, a marriage certificate is needed. To add a child, a birth certificate, adoption papers, or legal guardianship documents are requested. In some cases, a Social Security number for a newborn may be required within 90 days after initial enrollment. For other dependents, proof of financial dependency, such as tax returns showing them as a dependent, or shared financial records, and identification documents may be required.

The application process involves reviewing the health plan’s rules, gathering required documentation, and submitting the request to the health insurance provider. This can be done through an employer’s human resources department, a Health Insurance Marketplace, or directly with the insurer. Submitting accurate and complete information within specified timeframes ensures uninterrupted coverage for the added dependent.