Download expanding the definition of dependent coverage

 EXPANDING THE DEFINITION OF DEPENDENT COVERAGE PRELIMINARY SHARE FINDING: Dependent coverage expansions do not appear to reduce uninsurance among young adults. Ö SHARE grantee Joel Cantor, Sc.D., of Rutgers University, is studying the impact of state dependent coverage expansions on insurance coverage rates in 20 states. Ö One of Dr. Cantor’s key preliminary findings is that young adult coverage expansions do not appear to be expanding coverage as anticipated. Rather, expanded dependent coverage appears to substitute for other coverage (i.e., own‐name employer‐sponsored coverage), resulting in zero net change in overall coverage rates. Ö Click here to see more of Dr. Cantor’s preliminary results. Ö Click here for more details about Dr. Cantor’s SHARE‐sponsored research project, “Evaluation of Extending Dependent Coverage to Young Adults.” Young adults are more likely to be medically uninsured than any other age group, with an estimated 29.3 percent of Americans age 19 to 29 lacking coverage in 2008. 1 Several factors contribute to this coverage deficit, one of which is the common practice of insurers to drop children from their parents’ plans when the children turn 18 and are no longer considered “eligible dependents” by insurer definitions. Currently, there is no federal statute that defines “dependent,” (although the issue has arisen in the current federal reform discussion). In the absence of federal action to define and expand dependent coverage, 24 states have taken measures to do so on their own. These states have mandated the expansion of dependent coverage (in some form) to adults in their mid‐twenties and beyond. In some cases, states have expanded the definition of dependent coverage to include older children up to 25 or 30 years old, along with elderly/impaired parents being cared for by their children. The varied approaches of these states can provide lessons for those considering such expansions at both the state and federal level. Please continue reading to learn about specific state definitions of dependent coverage. 1
Compiled by the State Health Access Data Assistance Center (SHADAC), University of Minnesota School of Public Health, using data from the U.S. Census Bureau’s Current Population Survey‐March Supplement, 2009 August 2009
STATE STATE DEFINITION OF DEPENDENT COVERAGE Alabama No state definition of dependent coverage Alaska No state definition of dependent coverage Arizona No state definition of dependent coverage Arkansas No state definition of dependent coverage Dependents are not defined in California statutes. California California health plans, however, are required to provide dependent children with coverage if they are incapable of self‐sustaining employement; this requirement has no age cap. Individuals are considered dependents in Colorado if they are either: Colorado •
Under 19 and unmarried, or •
Between ages 19 and 25, unmarried, and living with or financially dependent on parents Connecticut Dependents in Connecticut must be under 26 years old, unmarried, not covered under their own employer‐sponsored insurance, and being a Connecticut resident or full‐time student. Delaware Dependents in Delaware are are under 24 years old, unmarried, have no dependents of their own, not covered under other insurance, and are Delaware residents or full‐time students out‐of‐state. If parents choose to cover dependents, there is an additional premium charge for the continued coverage. District of Columbia No state definition of dependent coverage Dependents in Florida can maintain insurance coverage if they are either: Florida •
Under 25 years old, and living with parents or are a full or part‐time student, or
•
Between 25 and 30 years old, unmarried, with no dependents, not covered under other insurance, and are a Florida resident or a full or part‐time student Georgia Individuals are considered dependents in Georgia if they are under age 25 and dependent themselves, or enrolled as a full‐time student (or are eligible to be a full‐time student but prevented from doing so by illness or injury). Hawaii No state definition of dependent coverage August 2009 STATE STATE DEFINITION OF DEPENDENT COVERAGE Idaho dependents are defined as being: Idaho Illinois Indiana •
Under 21 years old and unmarried, or •
Between 21 and 25 years old, unmarried, a full‐time student, and financially dependent on parents, or •
Disabled, at any age Illinois dependents must be under 26 years old and unmarried. Dependent veterans may keep coverage until age 30. Indiana dependents must be under 24 years old, with no other requirements. To qualify as dependents, Iowans must: Iowa Kansas •
Be under 25, unmarried, and an Iowa resident, or •
Be an unmarried, full‐time student, or •
Have a disability No state definition of dependent coverage Kentucky dependents must be either: Kentucky Louisiana •
Under 19 and unmarried, or •
Between 19 and 25, unmarried, a full‐time student, and primarily dependent upon parents Louisiana dependents are defined in group coverage only; dependents must be under 24 years old, unmarried, dependent on the primary insurance holder, and a full‐time student. Dependents in Maine must be either: •
Under 25, unmarried, have no dependents of their own, and be either a Maine resident or a full‐time student, or •
Under 25, and have a disability that prevents full‐time enrollment in school Maine Same‐sex partners must also be eligible for the same coverage as a spouse. Maryland Individuals are considered dependents in Maryland if they are under 25, unmarried, dependent on parents, and live at their parents’ residence. Massachusetts Dependents in Massachusetts must be either under 25 years old, or two years past their parents’ plan’s age of dependency, whichever comes first. August 2009 STATE STATE DEFINITION OF DEPENDENT COVERAGE Michigan No state definition of dependent coverage Minnesota defines dependents as being either: Minnesota •
A spouse, or •
An unmarried child under 25, or •
A child of any age with a disability Mississippi No state definition of dependent coverage Missouri No state definition of dependent coverage Montana Montana dependents must be under 25, unmarried, and not eligible for employer‐
sponsored insurance where the dependent’s share of the premium would be the same or less than for the dependent coverage premium under the parents’ plan. Nebraska No state definition of dependent coverage Dependents in Nevada must be either: Nevada •
Under 19 and unmarried, or •
Between 19 and 24, unmarried, a full‐time student, and financially dependent on parents New Hampshire New Hampshire dependents must be under 26 years old and unmarried. New Jersey New Jersey dependents are defined for the group market only, and must be under 30 years old, unmarried with no dependents of their own, ineligible for Medicare or covered under another policy, and be either a New Jersey resident or a full‐time student; enrollees must indicate dependent status within 30 days of aging out of a policy, or in open enrollment. New Mexico Dependents in New Mexico must be under 25 years old and unmarried. New York No state definition of dependent coverage North Carolina No state definition of dependent coverage August 2009 STATE STATE DEFINITION OF DEPENDENT COVERAGE Dependents are defined in North Dakota for the group market only; North Dakota dependents must be either: North Dakota Ohio •
Under 22 years old, unmarried, and live with or be financially dependent on parents, or •
Between 22 and 26 years old, unmarried, a full‐time student, and financially dependent on parents No state definition of dependent coverage Oklahoma defines dependents for the group market only; dependents must be either: Oklahoma •
Under 19 and unmarried, or •
Between 19 and 23, unmarried, a full‐time student, and financially dependent on the primary insurance holder Oregon dependents may remain under a parent’s coverage up to age 23. Oregon Pennsylvania Elderly parents and adult children with disabilities also qualify as dependents eligible for coverage. Legislation signed by the governor in June 2009 requires group policies to cover dependents up through 28 years old. Full‐time students whose education is interrupted by military service must also receive benefits as a dependent until they finish school, regardless of age. Rhode Island dependents must be either: Rhode Island •
Under 19 and unmarried, or •
Between 19 and 25, unmarried, and finanacially dependent on parents Rhode Island mandates coverage of dependent children with disabilities beyond these age limits. Dependents are defined in South Carolina only for the group market; dependents must be either: South Carolina •
Under 19 and unmarried, or •
Between 19 and 22, unmarried, a full‐time student, and financially dependent on parents August 2009 STATE STATE DEFINITION OF DEPENDENT COVERAGE Dependents in South Dakota must be either: South Dakota •
Under 19 years old, or •
Between 19 and 29 and a full‐time student Tennessee To qualify as a dependent in Tennessee, individuals must be under the age of 24, unmarried, and dependent on parents. Texas Texas dependents must be under 25; Texans may be considered dependents at age 25 and older if they are full‐time students. Utah Utah dependents must be under 26 and unmarried. Vermont If an insurance company covers dependents past age 18, Vermont mandates it must also cover the dependent for up to 24 months through a medical leave of absence from school. Dependents unable to maintain self‐sustaining employment and who are chiefly dependent on the main policyholder may not be dropped from a plan after aging out of the plan’s dependent coverage. To qualify as a dependent in Virginia, an individual must be under 25, and either: Virginia •
Living at home, or •
A full‐time student Washington dependents must be under 25 and unmarried. Washington Dependents with disabilities may continue to receive coverage under a parent’s plan, regardless of age, at the same premium rate for dependents under age 20. West Virginia West Virginia defines dependents in the small‐group market only; dependents must be under 25, unmarried, and dependent on parents. West Virginia dependents may be children or stepchildren. Wisconsin No state definition of dependent coverage Wyoming dependents must be either: Wyoming •
Under 19 and unmarried, or •
Between 19 and 23, unmarried, and a full‐time student Unless noted otherwise, dependent coverage applies in both the individual and group markets in the states listed. Sources: National Conference of State Legislatures (www.ncsl.org), Kaiser Family Foundation (www.kff.org), and State Coverage Initiatives (www.statecoverage.org) August 2009