Benefits for family members & dependents
These Frequently Asked Questions provide general information, but do not contain a full description of your benefits. Please refer to your Certificate of Coverage for a full benefit explanation or call Member Services at the number on your ID card.
Family members eligible for coverage under your family enrollment are your spouse (including a valid common law marriage and legally married same-sex spouses) and children who are under age 26, including legally adopted children, stepchildren, recognized natural (born out of wedlock) children and children of same-sex marriages. Your employing office will look at the child’s relationship to you as the enrollee to determine whether the child is a covered family member.
- Your foster children are included if they live with you in a regular parent-child relationship.
- An unmarried dependent 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.
Under the Affordable Health Care Act:
- Children do not have to live with the enrolled parent, be financially dependent on the enrolled parent, or be students to remain covered until age 26.
- Children are covered under the enrolled parent's Self + One and Self and Family enrollment even if they are eligible for or have their own employer-provided health insurance coverage.
- Children are not required to have any form of continuous health insurance, such as Temporary Continuation of Coverage, leading up to the effective date of their eligibility.
- If your child has a spouse and/or children, the spouse and/or children are not eligible family members under your Self + One and Self and Family enrollment.
- For children who converted to an Individual policy, they may no longer need that policy once they resume coverage under your Self and Family enrollment.
If you have a Self Only policy, you will follow the procedures to change to Self + One and Self and Family coverage during Open Enrollment.
Children with a TCC FEHB enrollment will receive notice in their Open Season mailing. We advise them that they are again eligible for coverage under your Self + One and Self and Family enrollment. You may add them to your Self and Family policy by completing the Add a Dependent to a Family Membership (PDF) form.
If your child loses their personal or employer-based coverage, this would be a qualifying life event, and coverage can be extended. Procedures are the same as during Open Enrollment.