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Medical Insurance or Benefits Plan Coverage for a Disabled Child over 26 years of Age - Request Continuation

Summary

An unmarried, disabled child may continue his/her enrollment as a covered eligible family member for medical plans in the medical insurance plan after s/he turns 26 if the:

  • staff member/retiree continues to provide principal support for the child.
  • insurance administrator approves the child's handicapped status.

The request for handicap status must be submitted to the insurance administrator for determination of eligibility and approved by the insurance administrator before the child's 26th birthday.

If the child is not approved for handicapped status by the insurance administrator, his/her coverage under the MIP will end at the end of the month in which the child reaches age 26 and s/he will be eligible to apply for coverage under the Continuation Medical Insurance Plan (CMIP) or Continuation Medical Benefits Plan (CMBP).

Step

Action

 

Action by Staff

01

For Country Office Staff:

Complete and send form Cigna Request for Continuation of Coverage for Handicapped Children to the address listed in the form.

For HQ Staff:

Complete and send form Aetna Request for Continuation of Medical Coverage for Handicapped Child to the following address:

PO Box 14199 Lexington,
KY 40512-4199.

Ask the physician who treats your child's disabling condition to complete the Aetna Handicapped Child Attending Physician's Statement.

02

Receive an email notification acknowledging the receipt of your request.

03

Receive a written decision at your home address from the insurance administrator within 30 days of your application being received.

If the decision is positive, your medical insurance records will be updated to continue your child for the period approved.

If the decision is negative, the letter from the insurance administrator will provide appeal information. During the appeal process, if the child's coverage will end, you will need to enroll your child in MIP continuation and pay the unsubsidized premium. If the appeal is successful, any unsubsidized premium you have paid will be refunded.

Check the status of the medical insurance benefits enrollment on myHR Self-Service (accessible by active staff only).