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Family Coverage Expansion Act

The change outlined below does not apply to Maryland regulated small employer groups.  Please contact your employer or benefits manager to determine if this change applies to you.

Members enrolled in Maryland Risk medical health insurance accounts that offer dependent coverage will have the opportunity as their accounts renew to provide health care coverage for their qualifying child dependents until the dependent turns age 25.  A student certification is not required for continued health care coverage until age 25.  If your group has requested domestic partner coverage, then the dependent child of a domestic partner that is not currently on the policy may be eligible.  Please check with your group regarding adding an eligible dependent to your policy.

If you are enrolled in an individual market, direct bill, non-group Maryland CareFirst medical health care product and your dependent child is over the age of 18 and under the age of 25 and no longer on your policy they may be eligible to enroll as a dependent on your policy.  The individual will have to meet specific eligibility criteria and pass medical underwriting.  The addition of a dependent may impact your health care premium.  If you have requested domestic partner coverage then the dependent child of a domestic partner that is not currently on the policy may be eligible.  Please contact the Individual Sales Department at (410) 356-8000 or 1 (800) 544-8703 to request an application to add your eligible dependent onto your policy.  Please call the Customer Service Department at the telephone number listed on your member ID card to confirm if your eligible dependent is already on your policy.

Eligibility Criteria

• The policy is in effect,
• Dependent coverage is still available,
• The child is a dependent of the insured, as that term is used in the IRS code-U.S.C. 104,  105 and 106 and regulations adopted under those sections,
• The child dependent is unmarried, and
• The child dependent is a member of a policy that is issued in the State of Maryland.

A qualifying child has the following relationship to the subscriber:

• A natural child,
• Stepchild,
• Adopted child, or child placed with the insured for legal adoption,
• Grandchild,
• A child placed in a court ordered guardianship or a guardianship appointment of more than  12 months as a result of a will decree.

There may be Federal tax consequences to continuing health care coverage for a non student after the end of the year in which the dependent turns 19 or a student after the end of the year in which the student turns 24.  CareFirst cannot provide tax advice regarding this matter.

If a child dependent will no longer be covered under your policy, it is important that you contact CareFirst immediately.  Please call the Customer Service Department at the telephone number listed on your member ID card.