There are two main types of health plan policies: individual, which covers you alone, and family, which covers your children, spouse, and, in some instances, domestic partner. Which brings up a question: Just what does the word “family” mean when it comes to health insurance?
The health insurance definition of “family” depends on where you live and who provides your insurance. Health insurance is regulated at the state level, and every state sets different rules for who must be covered as part of a family policy. In addition, large employers who provide their own health insurance, and so are not subject to state regulations, also set their own policies regarding coverage. About one-third of large employers offer benefits to domestic partners.
If you’re looking for the definition of “family” as it relates to your health insurance, check with your state insurance commission and/or your company’s benefits department. You can reach your state insurance department through the National Association of Insurance Commissioners at 866.470.NAIC.
Kids Covered Up to Age 26
Under the Affordable Care Act, children can stay on their parents’ or guardians’ health insurance plans until age 26. Your children can be covered on your family policy up to age 26, even if they’re married, don’t live with you, are not financially dependent on you, and have access to employer-provided health insurance.
In order to qualify for premium tax credits on the electronic health insurance exchanges, you have to meet certain financial criteria based on your “household.” The federal government defines a household as all the individuals for whom a taxpayer claims a deduction for a personal exemption.
That could even include people in your household who file their own tax returns—as long as they don’t claim themselves as dependents. They must also be U.S. citizens or residents of the U.S., Canada or Mexico. Children must live with you longer than half a year, be younger than 19 at the end of the year (or 24 if they are full-time students), and not provide more than half of their own support. Adults qualify as dependents if they are related to you and live in your home all year, you provide more than half of their total support, and they made less than $4,050 in 2017 (not including Social Security).
Last updated: November 2017