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Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.

Stepchild Part of Our Household?

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Question: My wife’s child with her previous husband lives with us, yet is claimed as dependent on her father’s taxes. Can my wife’s daughter be covered under our family plan (whether we take a Covered California plan or not), or must she be covered under her father’s health plan?

Answer: While Covered California is still wrestling with regulations for families that will specify issues like this, I will go out on a limb and say that your step-daughter will be included as part of your household is she lives with you for over half the year regardless of IRS issues.


A custodial parent can permit the non-custodial parent to claim the dependency exemption (tax benefit) by executing and filing a waiver - Form 8832 with the IRS.

The Covered California enrollment application asks the question, Will this person be claimed as a dependent on another taxpayer’s income tax return (or words to that effect). If the answer is yes, then I assume Covered California will base the tax credit eligibility for that dependent in that taxpayer’s household.

How is it that you have physical custody but do not receive the tax benefit? If this is a private arrangement between you and your ex-spouse, then you might consider working out some other kind of agreement that offsets the tax benefit one dependent makes in your ex’s income tax so that you can claim the child, provide the insurance and obtain any tax credit for which you qualify.

Or make it his/her responsibility to provide the child with the insurance as required by law.

One or the other it seems to me should prevail.

However, if neither you nor your ex- are qualified to receive a tax credit, the whole issue is moot. You just have to decide who’s providing the child’s insurance and pay for it.

According to the “child to age 26” nonsense created by the ACA, there is neither (a) an IRS dependency requirement, (b) a residency requirement, (c) a student requirement, or (c) an unmarried requirement. It doesn’t matter who the child lives with or where, whether the “child” is married or not, or even if they could be covered under another parent’s policy.

What the child cannot do is enroll his or her spouse or own child under the grandparent’s (in-law’s) plan.

However, if the parent’s plan is an HMO, the child needs to reside in the plan’s service area, because only IN-NETWORK services (other than bona fide medical emergencies) are covered. If the plan is a PPO or POS, then it doesn’t matter where the child lives, because OUT-OF-NETWORK services are covered (generally with higher cost sharing, including preventive care which would have no cost sharing in-network).

Finally, when the child turns age 26, and would be dropped by an employer-sponsored group plan, the child may invoke the COBRA continuation privilege and continue the group plan by paying the full cost — for up to three additional years (to age 29) or until the child is eligible for coverage under another employer-sponsored plan, in which case HIPAA regulations permit immediate enrollment into that employer-sponsored plan (either the child’s employer or the child’s spouse’s employer).

So much for “personal responsibility”.

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