Individual and Family

Who Can Be Added as a Dependent on My Health Insurance Plan?

BY Carly Plemons Published on May 14, 2024

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When you purchase a health insurance plan for yourself, you can get coverage that extends to your dependents; likewise, if you’re an employer covering your workers, you can provide coverage for any dependents they have. If you’re planning on purchasing a family health insurance plan to cover your dependents, it’s important to make sure you know they’re eligible to join your family health insurance plan before you make your final purchase.

What is a dependent in health insurance?

A dependent refers to someone who is eligible to become an additional person on your health insurance plan. Your dependents can receive the benefits of your health insurance plan and use it in much the same way as you.

However, policies do not all read the same or have the same criteria for dependents, so it’s important to look into the details of your specific plan. It’s also important to note that if you’re an employer covering your workers, then some different rules can apply when it comes to dependents.

Who can I add to my medical insurance as a dependent?

Who you can add to your medical insurance as a dependent will depend on the terms of your policy and the type of policy you have. But for the most part, you can add:

  • Your current spouse
  • All biological children and stepchildren
  • Adopted children
  • Foster children
  • Children under your care who financially depend on you
  • Children who can receive your benefits because of a court order

You can cover adult children up to the age of 26, but some caveats exist if your child is a college student. Some special circumstances can lead to dependent health care coverage, such as taking care of someone with a disability. Domestic partnerships can also lead to dependent coverage, but not always.

Dependents for taxes & health insurance

According to healthcare.gov, if you can count someone as a dependent on your taxes, they’re also a dependent on your health insurance plan. What’s more, you are required to provide health insurance for anyone whom you claim as a tax dependent. So, if you intend to include a child or other relative as a tax dependent, you should also make sure they’re included in your health insurance plan.

Requirements for adding your children as dependents

If you have children, they’re probably the first people that come to mind when talking about dependents. Generally speaking, you can include any child who fits the following criteria:

  • Age: Your child must be under the age of 26.
  • Relationship to You: For a child to qualify as your dependent, he or she needs to be your biological child, your stepchild, your adopted child, or a foster child you are taking care of. If your child has other sisters, brothers, half-sisters, half-brothers, or children of their own, you can also include them on your health insurance plan.
  • Length of Residency: A child only qualifies as your dependent if they have lived with you for at least six months.
  • Income Contribution: Although your child can be your tax dependent while working and contributing to their own expenses, they cannot be their own primary source of support. This means a child’s income must be less than half of the cost of their support expenses to qualify as your dependent.
  • Tax Filing: A child cannot be your dependent if they file a joint tax return that year.
  • Other Claims: A child cannot be claimed as a dependent by more than one household. So, regardless of your relationship, if someone else claims your child as a dependent, you cannot.

What’s not required to add your children as dependents

Besides keeping track of what’s required to claim your child as a dependent, you should also remember what isn’t required to claim a child as a dependent:

  • Living with parents: Your child doesn’t have to be living with you at the time you enroll them in your health insurance plan, provided they’ve lived with you long enough to meet the residency requirement.
  • Marital status: your child is still eligible for coverage if he or she is married or has children.
  • Enrolled in school: it doesn’t matter if your child is enrolled or not enrolled in school.
  • Eligible for employer-based coverage: you can still add your child to your health plan even if they chose to not enroll in their employer’s health insurance plan.
  • Tax status: you can add your child to your plan even if you don’t claim them as a tax dependent.

As long as your children meet these other requirements, you can usually still include them in your coverage.

Adding your spouse as a dependent

In most cases, adding a spouse to your health insurance plan is acceptable. After getting married, you usually have up to 60 days to enroll in a new plan or add your spouse as a dependent.

Keep in mind that if you or your spouse have access to employer-sponsored health insurance but choose to buy your own family plan on a health insurance exchange, you likely will not qualify for Obamacare subsidies. Check out eHealth’s other resources to learn more about how health insurance works with marriage. If you have questions, you can also talk to one of eHealth’s licensed insurance agents to discuss coverage options that might fit your family’s needs.

Additional Dependents

Besides your child and spouse, you can include other relatives as dependents under certain conditions, namely:

  • If no one else has named them as a dependent
  • If their gross annual income is less than $3,000
  • If you are responsible for providing more than half of the financial support they rely on

In addition to relatives, you can include others who have lived in your house for at least a year, provided they meet all the aforementioned criteria.

Can you add your parents to your health insurance?

While the Affordable Care Act mandates that children be eligible for coverage under their parents’ insurance till 26, there isn’t a similar protection for parents. Health plans typically count spouses and children as dependents, but generally don’t include parents. However, the rules vary by plan and location, so always double check with your plan.

If you’re interested in getting health coverage for your parents, contact your health plan to find out if you can add them to your plan. Your parents must, generally, be claimed as tax dependents.

If your health insurance won’t allow you to add your parents, you can enroll them in a separate health plan, either through the Marketplace or Medicare (if they’re 65 or older). If you have questions about their eligibility or would like help finding coverage for your parents, eHealth’s team of trusted health insurance experts can go over your options.

Changes from the ACA

The Affordable Care Act (ACA) brought significant changes to healthcare coverage, particularly for dependents. Here’s how the ACA revolutionized dependent coverage:

  1. Coverage for Dependents up to 26: One of the most notable changes introduced by the ACA was the extension of dependent coverage up to age 26. This provision allows young adults to remain on their parents’ health insurance plans, providing them with access to essential healthcare services during a critical period of transition, such as graduating from college or starting their careers.
  2. Protection for Pre-existing Conditions: The ACA prohibits health insurance plans from denying coverage or charging higher premiums based on pre-existing conditions, including those of dependents. This ensures that individuals with pre-existing conditions, such as asthma or diabetes, cannot be discriminated against when seeking health insurance coverage under a family plan.
  3. Impact on Dependent Coverage: The ACA’s provisions regarding dependent coverage have had a significant impact on families across the country. Parents can now rest assured knowing that their adult children have access to comprehensive healthcare coverage, regardless of their employment status or health history. This has provided peace of mind to millions of families and helped bridge the gap in coverage for young adults transitioning into adulthood.
  4. Specific Exceptions: While the ACA expanded dependent coverage for many individuals, there are specific exceptions to the rules. For example, dependent coverage under a parent’s plan may end if the dependent gets married, gains access to employer-sponsored coverage, or turns 26. It’s essential for families to understand these exceptions and plan accordingly to ensure continuous healthcare coverage for dependents.

Overall, the changes introduced by the ACA have transformed the landscape of dependent coverage, ensuring that young adults have access to quality healthcare and providing families with greater financial security and peace of mind.

Why should you add someone as a dependent for health insurance?

Healthcare is of the utmost importance to all people. However, health insurance offers other benefits as well. For example, health insurance offers you tax deductions and credits. So, who can I add to my health insurance plan for tax benefits? The same people you would add to your health insurance plan for health benefits.

Those same dependents recognized by your health insurance policy are usually also dependents in the eyes of the government. So, you can claim them when filing taxes and get tax benefits. Some of these tax benefits can include:

  • Head of Household status
  • Child Tax Credit and Additional Child Tax Credit
  • Other Dependent Credit
  • An increased Earned Income Tax Credit
  • Deductions for medical and dental expenses for you and all dependents

You can also enjoy some tax exemptions. Credits reduce the amount of taxes you owe. Deductions reduce how much of your income is subject to taxes. Exemptions exclude certain amounts of your income from being taxed.

Also, the laws do change periodically, so it’s best to do some research and speak with a professional about the tax dependent aspects.

Health insurance for dependents: FAQs

Can you add someone who is not your spouse to your health insurance?

It depends on where you live. For example, some states allow you to add a domestic partner and the children of that domestic partner to your health insurance policies. In another state, that’s just not possible.

However, most times, you can claim someone as a dependent if you provide over half of the financial support for them, have a court order to do so, or take care of them in a substantial way. A dependent has to meet the qualifications as set out by the healthcare provider, state law, and federal law. The IRS Code supersedes other laws and plan rules.

Who can I add to my insurance as a qualified dependent?

  • Policyholder’s child under the age of 26
  • A child you have a defined relationship with and provide over half of the financial support for
  • A relative you have a defined relationship with and provide over half of the financial support for
  • Someone you must include in your plan because of a court order or exceptional circumstances

State laws and policy rules can modify the dependent criteria, but they can only really add to the IRS Code, not take away from it.

Can you put friends on your health insurance?

Except where common law marriages and domestic partnerships are allowed, you cannot add dependents that aren’t relatives to you. A family health insurance plan will not allow you to add a friend unless that friend can fit the relationship criteria for a dependent.

Do I need to pay extra premiums to include dependents in my health insurance coverage?

Yes, typically, you will need to pay extra premiums to include dependents in your health insurance coverage. The cost of adding dependents, such as a spouse or children, to a health insurance plan generally increases the overall premium. However, the specific amount of the increase depends on the insurance plan and provider. Family plans are structured to cover additional members, but they come at a higher cost compared to individual plans.

Are there limitations to the number of dependents I can include in my health insurance plan?

Most health insurance plans do not have a limit on the number of dependents you can include. However, the definition of eligible dependents can vary by plan. Typically, dependents can include your spouse, children under a certain age (often up to 26), and sometimes other relatives like stepchildren or legally adopted children. It’s important to check your specific plan’s rules regarding dependent eligibility.

How does divorce affect health insurance coverage for ex-spouses and children as dependents?

In the event of a divorce, an ex-spouse is generally no longer eligible to be covered as a dependent under the other’s health insurance plan. They may need to obtain their own coverage, potentially through options like COBRA or the health insurance marketplace. However, children can still be covered as dependents by either parent’s plan, regardless of the divorce. The specifics of child coverage post-divorce can be outlined in the custody agreement or divorce decree, and both parents should coordinate to ensure continuous coverage for their children.

Coverage Considerations

Once you have named someone as your dependent, he or she will generally have access to the same plan or set of plans that you use. Depending on where you get your health insurance, he may also be able to choose among plans that you rely on, including the health plan, dental insurance, vision, or more.

Protecting the health of your loved ones with quality health coverage is one of the most important things you can do for them. eHealth is committed to helping you understand all the nuances of health coverage. Our trusted and knowledgeable licensed insurance agents are here to help you find coverage that fits your needs and budget. For more information, visit eHealth.com, where you can tap into our information on health insurance or start looking at family health insurance plans. We make it easy to browse and compare plan benefits and costs in one place.