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Aetna Will Extend Dependent Coverage Up to Age 26

Apr 27, 2010


Aetna to extend dependent coverage up to age 26

Aetna knows many families are worried about their dependents losing medical coverage when they graduate from high school or college or otherwise age out of coverage. Health care reform will address this issue nationwide later this year, when new regulations will go into effect. However, some plan sponsors may want to make changes earlier, to help these dependents remain insured without a gap in coverage.

In keeping with the spirit of health care reform, Aetna will work with their customers to extend coverage to their medical plans’ current dependents ahead of schedule. This means current dependents under the age of 26 would not have to leave their plans when they would otherwise age out or are no longer full-time students (including those who would have lost eligibility effective May 31, 2010). Note that this would not include reinstatement of dependents who previously aged out of their plan. It also does not affect dental, vision, standalone pharmacy or other benefits.

  • For individual and small group medical plans (as defined in state law), Aetna will continue coverage effective June 1, 2010 for dependents under age 26 currently covered on a parent’s medical plan. Aetna will not change the plan’s premium until renewal.
  • For fully insured larger groups, and for all self-funded medical plans, Aetna will offer the option of expanding medical coverage for dependents under the age of 26 currently covered on a parent’s medical plan, effective on or after June 1, 2010. This would include dependents who would have aged out on May 31, 2010. We will provide pricing for this plan design change, as appropriate, for plans that choose this option.

Regardless of whether a plan makes this change ahead of schedule, health care reform is bringing changes to all plans soon. On the next renewal date on or after September 23, 2010, all medical plans must cover all dependents up to age 26 (and older for insured plans in states that mandate coverage above age 26). This may include dependents who are not currently enrolled in the plan, in accordance with regulations. Aetna will be able to tell you more when the federal government issues regulations telling insurers and employers how this must be administered.

Aetna is pleased to offer their plan members the ability to keep their dependents insured. This is one step toward the goal of health care coverage for all Americans.

If you have questions about how this will affect individual and small group plans, or have a larger customer who is interested in making this change ahead of the health care reform law, please contact your b&p representative as soon as possible.

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