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| WHO IS ELIGIBLE FOR COVERAGE? |
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You, and your Eligible Dependents, as defined below, are eligible. 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 and grandchildren from birth up to age 25 provided they are chiefly dependent on you for support.
Children include natural children, stepchildren, adopted children, foster children, grandchildren and children of a Domestic Partner if they are dependent on you for support. Grandchildren must live with you to be eligible. Newborn children (including newborn adopted children) are covered from and after the moment of birth. Notification of birth must be received within 31 days after the date of birth for coverage to continue beyond 31 days. Foster children are eligible from and after the moment they are placed in your physical custody. Adopted children (other than newborns) are eligible from and after the moment you file suit for adoption. Dependents in military service are not eligible.
An unmarried child over the age of 25 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.
To be eligible, you must live or work in ALPHA's Service Area and the permanent legal residence of any enrolled dependent must be the same as yours. If any of your enrolled dependents do not live with you, they must reside in ALPHA's Service Area in order to maintain eligibility (except as described in #4 below).
If the legal residence of any enrolled dependent is not the same as yours, the dependent's legal address must be:
- in ALPHA's Service Area with the person having temporary or permanent conservatorship or guardianship of such dependents where you have legal responsibility for the health care of such dependents; or
- in ALPHA's Service Area under other circumstances where you are legally responsible for the health care of such dependents; or
- in ALPHA's Service Area with your spouse or Domestic Partner; or
- anywhere in the United States for a child whose coverage under the Program is required by a medical support order.
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