If you have an individual health insurance Georgia policy, and your family life situation changes, you may wonder who is eligible to be added to your policy. Let’s say, for example, you get married, or have children, or adopt, you may want to know if you can add those new family members to your individual health insurance Georgia policy, which would then be considered a family health insurance Georgia policy.
Please note that these are general summaries, and each particular health insurance Georgia Company and plan has its own specific set of rules and restrictions.
For starters, your lawful spouse, or domestic partner, is typically eligible to apply for enrollment in the same health insurance Georgia plan. A common restriction is that the partner or spouse has to be under the age of 64 ½, and not be eligible for Medicare. Different health insurance Georgia companies define domestic partner in different ways, so you will need to check with your particular carrier for their criteria.
Some health insurance Georgia plans have specific open enrollment times, while others allow you to add members or dependents any time. Typically spouses are eligible to apply for coverage at any time. However, adding anyone to a health insurance Georgia plan is subject to approval by medical underwriting. Medical underwriting is the name given to the process of reviewing a person’s health information in their application to determine whether to approve or deny coverage and to decide what premium rate the health insurance Georgia Company will offer.
Children are eligible to apply as dependents on a family health insurance Georgia plan. They also have to have applications filled out and reviewed by the medical underwriting team. Legally adopted children have equal rights to be enrolled as dependents, and also stepchildren. If an adult has become the legal guardian of a grandchild, then that grandchild can also be eligible for enrollment. One common restriction is that the child must be unmarried. There are other restrictions based on your state of residence, so check with your health insurance Georgia plan certificate of coverage to determine which rules apply to your situation. Some people do choose to purchase a health insurance Georgia plan that will cover children only, instead of adding them to their employer-sponsored group health insurance Georgia policy. This may be more cost-effective for you, so be sure to shop around for child only plans, and compare prices.
Once you have filled out applications for your children or spouse, and they have been approved by the health insurance Georgia plan medical underwriting team, they will give you an effective date of coverage for your family members. Each family member will also receive a health insurance Georgia member identification card, which will include their full names, so it does not matter if there are step-children or children of whom you are guardian and they have different last names.
Some plans do require that people wait until open enrollment to apply for additional family members. However, that requirement may not apply if the family situation changes outside the open enrollment period. Again, check with your administrator and customer service representative on what your specific health insurance Georgia plan requires.
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