Definitions
Who Can You Cover?
When you enroll in benefits through OEBB, you can only cover people who meet OEBB’s rules. Read the definitions below to make sure each dependent you enroll is eligible.
Who Counts as a Dependent?
Child
You can cover a child who is 25 or younger on the first day of the month if they meet one of these criteria:
- Your biological child
- Your spouse’s or domestic partner’s biological child
- Your legally adopted child or a child placed for adoption
- A child placed in your custody by the court (must provide legal documents)
- Your stepchild
Special cases:
- You can only cover a grandchild if you are their legal guardian or adoptive parent
- OEBB no longer accepts affidavits or notarized letters to prove child eligibility—you must provide legal documentation (e.g., court order)
Covering a Disabled Dependent Child
- You must act before they turn 26
If your child has a qualifying disability and you want to continue their coverage, you must apply before the child reaches age 26. Coverage does not continue automatically, even if the carrier (Moda, Kaiser, etc.) knows about the disability.
Who Qualifies?
All the following must be true:
- Your child can’t support them self due to a developmental disability, physical disability, or mental illness
- A medical provider confirmed the disability before your child turned 26
- Your child had continuous health coverage (no breaks), and
One of these applies:
- You claim your child on your federal tax return
- You have legal guardianship ordered by a court
- Your child files their own tax return and earns less than 150% of the federal poverty level (FPL)
Note:
- You may owe extra taxes (called “imputed income”) for covering someone who isn’t a tax dependent.
What You Need to Do
- Contact OEBB up to 60 days before your child turns 26:
- Submit the required paperwork to OEBB
- Provide a birth certificate and proof of guardianship or tax status
- Send your documents (copies only, not originals) to OEBB
- Ask your doctor to submit proof of disability to your carrier
- Use your carrier’s Disabled Dependent form, which you can request from your carrier or from OEBB
- Get approval from the carrier
- They will review and may recheck eligibility in the future.
Once your child is enrolled as a Disabled Dependent, you must continue covering the child for them to stay eligible. If you drop the child from your OEBB coverage for any reason, you cannot re-enroll them in the future.
Need help?
Call OEBB Member Services at: