Dependent Eligibility Change                                                         
  
Background

The 2007 Legislature passed legislation extending coverage for dependent children up to 25 years of age for fully insured group and individual plans and some self-insured business (see below).  The change is effective January 1, 2008.  BCBSMT will issue amendments for all Group and Individual Contracts and Member Guides to reflect the change.

The legislation also applies to self-insured groups that are governmental groups such as cities, counties, towns, and school districts.   However, the law does not apply to

• The State of Montana Employee Health Plan
• The University System Employee Health Plan (MUS)
• Self-Insured groups who are not governmental groups

Criteria for Coverage up to Age 25

An unmarried dependent is eligible until the end of the month in which the dependent turns age 25.  The dependent may be employed and eligible for insurance with his/her employer.

The dependent does not need to:

• Reside with the subscriber
• Be a full or part time student*
• Be financially dependent on the policyholder or claimed as a dependent on the policyholder's income tax return

*Currently some groups require dependents (beyond a specific age) to be full-time students. As of January 1, 2008, this requirement will no longer be allowed for fully insured groups.

Well-Child Care

Background

The 2007 Legislature enacted legislation for the well-child benefit to extend from birth through seven years of age, i.e. until the 8^th birthday.  BCBSMT will issue amendments to all Groups and their subscribers and all members.   

Well-Child Benefit Definition

The well-child benefit extends from birth through seven years of age. Note that this change impacts the standard preventive benefit. For groups and/or products that have the Standard Preventive Benefit, the preventive benefit coverage is for members 8 years of age and older.