FEHB and disabled dependent

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Q. My 21-year-old daughter is disabled (diagnosed with osteosarcoma at age 14, limb salvage and metastatic). My husband retired from the Postal Service a few years ago, and she has been continued on our insurance plan through Federal Employees Health Benefits as she is under age 26.

1. At age 26, will she be allowed to remain on our FEHB insurance, which is her current primary coverage. She is on SSI and also has state Medicaid, which is her current secondary insurance coverage.

2. When my husband turns 65 and is Medicare eligible, will we be able to keep her as a child adult daughter on FEHB?

A. Yes to all of your questions.

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Reg Jones was head of retirement and insurance policy at the Office of Personnel Management. Email your retirement-related questions to fedexperts@federaltimes.com.

2 Comments

  1. Family lives in Southern California. Dad is retired with FEHB coverage through Kaiser. Adult daughter now 34 has significant developmental disabilities and is permanently disabled and has always been covered by family Kaiser plan . Daughter resides with her parents in their home. Daughter received SSI from age 18 and Medi-Cal. SSDI kicked in once the Mom starting to receive SSA. Parents opted NOT to go with Kaiser Medicare, just stayed with Kaiser coverage as it was more financially beneficial to parents. Daughter was enrolled in Medicare about the same time the SSDI kicked in, although parents are NOT on Medicare. Parents did not fill in any paper work or were they notified of the Medicare enrollment. Now daughter is Medi/Medi . Parents were told Medicare is first payee according to a FEHB handbook from mid-2000’s. Before Medicare kicked in the Medi-Cal picked up prescription co-payments. Parents were told because daughter is Medi/Medi, co-payments for prescriptions will only be paid if Medicare is assigned to Kaiser or if the parents take prescriptions to a non-Kaiser Pharmacy and use the Part D coverage. Do not want to assign Medicare and Medi-Cal to Kaiser as the parents want the option to get 2nd opinions (if needed) outside of the Kaiser system.

    QUESTION: (1)who is the first payee? (2) Is the information about the prescription co-payment correct?

    Thanks

    • Your question falls outside boundaries of this forum. You’ll have to call OPM’s Retirement Information Office at 1-888-767-6738.

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