To add a stepchild or stepchildren to a new or existing health insurance plan, you must follow the specific requirements outlined in each plan's policy statement. Review the eligibility requirements as a first step because stepchildren do not always qualify as eligible dependents. If your stepchild is eligible, further steps depend on whether you're making the addition during the open enrollment period or as a special enrollment exception.
Check Eligibility Rules
Whether a stepchild is eligible for employer-provided health insurance depends on whom the plan includes in family coverage. Employer group health insurance plans do not have to cover stepchildren. As a result, some plans only include biological and legally adopted children, while others cover stepchildren in both marriage and domestic partnership arrangements.
The rules are different if you purchase a health insurance policy through the Health Insurance Marketplace. According to the rules outlined in the Affordable Care Act, if you don't include the child on your tax return as a dependent you can't add the child to your health insurance.
Adding an Eligible Stepchild
Open Enrollment Procedures
Enrolling an eligible stepchild during the annual open enrollment period is a relatively simple process. Because insurers are required to accept all eligible applicants during open enrollment, adding a stepchild is a simple matter of filling out an application and providing the child's full name, birth date and Social Security number. Coverage will become effective on January 1 of the coming year.
Special Enrollment Procedures
When you get married, a special enrollment period allows you time to change your health coverage. However, when you add an eligible stepchild during a special enrollment period, you'll need to provide supporting documentation along with the insurance application. Depending on the insurer's rules, you must submit the application and supporting information within 30 to 60 days from the time the child becomes eligible. Documentation requirements usually include a marriage certificate and a copy of the child's birth certificate. Coverage will become effective on the first day of the next month.
- FreeAdvice: Employer Medical and Health Coverage of Stepchildren
- Healthcare.gov: Who’s Included in Your Household
- National Association of Insurance Commissioners: Health Insurance Open Enrollment: Choosing The Best Option For You And Your Family
- U.S. Department of Labor: Life Changes Require Health Choices...Know Your Benefit Options
- Steptoe and Johnson, LLP: HIPAA’s Special Enrollment Rights: Today’s Rules