Family members eligible for coverage under your self and family enrollment are your spouse (including a valid common law marriage)
and children younger than age 26. Children include a child born within marriage, an adopted child, a stepchild, a foster child who lives with you in a regular parent-child relationship, or a recognized natural child. A child age 26 or older who is incapable of self-support because of a mental or physical disability that existed before age 26 is also an eligible family member.
You cannot include a former spouse as a family member under your health insurance enrollment once you are divorced, even if the divorce decree specifies that you provide health insurance coverage for your former spouse. A former spouse can elect FEHB coverage under the provisions of Temporary Continuation of Coverage and/or the Spouse Equity Act.
You may be required by a court or administrative order to provide health benefits to your children. If you are subject to such an order, you must be enrolled in a self and family plan that provides full benefits to your children in the area where they live, or provide documentation that you have other health coverage for the children. If you are eligible for FEHB but do not have the appropriate coverage, the Civilian Benefits Center will notify you that it has received a court order requiring you to provide health benefits for your children.
To include a foster child as a family member, you must certify that:
- The child is younger than age 26 (if the child is older than age 26, he or she must be incapable of self-support);
- The child lives with you;
- The parent-child relationship is with you, not solely the child's biological parent;
- You are the primary source of financial support for the child; and
- You expect to raise the child to adulthood.
To continue coverage for a child older than age 26 on your health insurance enrollment, you will be required to provide documentation that the child is incapable of working at a self-supporting job because of a physical or mental disability that existed before age 26 and is expected to continue for at least 1 year.