COVERING YOUR CHILDREN
Q: How long will my dependent children be eligible for health benefits coverage?
A: Your dependent children will be eligible until the end of the month in which they turn 26 years old. A dependent child’s military service may extend coverage beyond age 26 if upon returning from serving, the child enrolls as fulltime student. Military discharge confirmation letter must be provided along with the request. Contact your department personnel officer or, if you are a retiree Contact Us at Comptroller's Health Benefits Unit.
Eligible dependents include your natural children, stepchildren, children of domestic partners and legally adopted children, including children in a waiting period prior to finalization of adoption. Other children who are chiefly dependent on you and for whom you have assumed legal responsibility in place of the parent may also be eligible; you must verify eligibility and provide documentation upon enrollment and every two years thereafter
Q: What coverage is available for dependent children after age 26?
A: Extended coverage to Young Adults up to age 30 is required by State legislation. The Young Adult Option allows your unmarried, adult children, up to age 30 to purchase their own medical coverage. To be eligible, the parent must be a current enrollee (includes retirees and COBRA), and the young adult must work or reside in New York State or the insurer’s service area and not be eligible for coverage through their own employer-sponsored insurance plan. Eligible adult children will be able to enroll in the Young Adult Option during the open enrollment period. They may also enroll if/when eligibility is lost due to age or when they are newly eligible because of a change in circumstance, such as a loss of coverage through another plan. Under the Young Adult Option, you or your young adult child will pay a separate premium for coverage. The premium is the full cost for individual coverage. For example, during 2020, individual coverage under NYSHIP costs $1031.85 per month. There is no employer contribution. For more information, please contact your department’s Human Resources Representative.
Q: I have a disabled child. Are there any special provisions that would extend my child’s coverage as a dependent after turning age 26?
A: Unmarried children age 26 or over who are incapable of supporting themselves because of a mental or physical disability acquired before termination of their eligibility for health insurance may be eligible for continued dependent coverage. You must complete and file a NYSHIP Disability Form. Disabled Dependent Form is available on this website in the Forms section. You may Contact Us to request the form or call (516) 571-2369. (If your child was not enrolled in NYSHIP because the child had other health insurance, but has lost the other coverage involuntarily, you may apply for disabled dependent child coverage. You must submit a NYSHIP Disability Form, along with proof that (a) the disability occurred prior to NYSHIP’s standard age disqualification date in accordance with the eligibility rules in effect at the time the disability commenced and (b) that the loss of the other coverage was involuntary. Contact your department Human Resource Representative, if retired the Comptroller’s Health Benefits Unit prior to your child’s 26th birthday.)