Do My Children or Dependents Have Coverage?

When you have children or dependents, knowing whether they’re covered by your dental insurance can make a huge difference when it comes to planning for their oral health. And knowing how much coverage they have or what procedures are covered can help you plan for potential costs down the road.

To put it simply, a dependent is a child or individual that a parent, relative, or caregiver can claim a personal exemption for on their taxes. Basically, if this person depends on you to provide shelter, food, or for most of their day-to-day care and expenses, then that person is considered a dependent. This can include:

• Spouses and domestic partners
• Anyone you include on your federal income tax return (even if they do not live with you)
• Dependent children through age 18
• Dependent children 19 to 26 – when your child turns 19, they no longer qualify for pediatric benefits. However, they can stay on your plan as a dependent until their 26 years old.

The quickest, easiest, and most accurate way to check if your dependents or children are covered is by logging in to your MySmile® account.

From there, you can get cost estimates for a variety of different procedures, for all the individuals included on your plan. This way, you’ll know what you expect whenever one of your loved ones needs dental care.

If you want to add a dependent to or make changes to your plan, talk to your HR representative to determine when you are eligible to do so. Typically, though, this happens during open enrollment, but some situations will allow you to enroll,  or make changes to your plan outside the open enrollment window – these are called qualifying events.

They can include:

1. Your family getting bigger i.e., having a baby, adopting or fostering a child
2. A change in the status of your family
• Getting married or entering a domestic partnership
• Divorce or dissolution of a domestic partnership
• Your child turns 19 (as stated above, your child can remain on your plan once they turn 19 but can no longer qualify for pediatric coverage. They would have to be recognized as a dependent child receiving adult coverage until they turn 26)
• Your child loses coverage
• Your child becomes a US citizen
3. You or your child’s parent/guardian are no longer receiving dental coverage through work
4. You or your child’s parent/guardian no longer qualifies for COBRA coverage