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| WHO IS ELIGIBLE FOR COVERAGE? |
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You and your eligible dependents, as defined below, are eligible provided you live or work in the DeltaCare USA service area. You and your eligible dependents become eligible:
- on the first day of the month following our receipt of timely Premium and complete enrollment information;
- as soon as they become your dependent, or at any time subject to a change in legal custody or lawful order to provide Benefits.
Your Eligible Dependents include:
- spouse (unless legally separated or divorced) or Domestic Partner (until such partnership is terminated by either or both parties);
- unmarried children from birth up to age 19; and dependent grandchildren until age 18 months;
- unmarried, dependent children from age 19 until the end of the calendar year in which they turn 25 if they are wholly dependent on you for support AND are either full or part-time students in an accredited school or are living in your household.
Children include natural children, children of a covered family member, stepchildren, adopted children, foster children and children of a Domestic Partner if they are dependent on you for support. Newborn children (including newborn children of a covered family member and newborn adopted children) are covered from and after the moment of birth. With the exception of newborn adopted children, notice of birth must be received within 31 days after the date of birth for coverage to continue beyond 31 days. Foster children and legally adopted children (other than newborns) are covered from and after the moment they are placed in your physical custody. Dependents in military service are not eligible.
An unmarried child over the age of 19 may remain eligible if that child is incapable of self-support because of a physical disability or mental incapacity and is chiefly dependent on you for support and maintenance. See Renewal, Cancellation and Termination of Benefits. |
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