Who can be included as a dependent in the Health Plan

Who can be included as a dependent on the Health Plan

Having a health plan is essential to take care of our health.

Likewise, ensuring this benefit for the people we love most is something we cannot ignore. Including dependents in a health plan is a topic many are unaware of.

For this reason, to help you understand how it works, why it's important, and how to request it, we've prepared this content to ensure the safety and health of your entire family. Keep reading!

Why include dependents?

I'm sure everyone wants their family to be well taken care of in every aspect of life.

And one of them is healthcare. The main advantage of including a dependent in your health plan is that they can enjoy all the benefits you have.

What's more, it's much cheaper than taking out an individual plan.

So, in addition to saving money, you ensure that they are always protected and supported, as they will have the same professionals and all the plan coverage available.

Who can be a dependent on the health plan?

According to the National Supplementary Health Agency (ANS), the body that oversees health plan operators, to be considered dependent, a person must fit into one of the following situations:

• Spouse or partner;
• First-degree consanguineous relative: these are direct relatives, such as parents and children;
• Stepchildren or other persons under judicial guardianship or custody;
• Persons under the guardianship of the holder between the ages of 21 and 24 (if they are students and financially dependent on the holder);
• Relatives up to the 3rd degree of blood relationship: this includes grandparents, parents, children, grandchildren, great-grandchildren, nephews, brothers and uncles (in accordance with the company contract);
• Relatives by affinity (in-laws).

What documentation is required?

To be able to include a dependent, it is necessary to prove their relationship with the holder, so the operator requests the following documents:

• Spouse: Marriage Certificate;
• Same-sex or opposite-sex partner: present a public deed of Declaration of Stable Union, some other document that proves the relationship in a public, stable and lasting manner or Birth Certificate of a child in common;
• Child – Birth certificate or photo ID; adoption document (if applicable);
• Disabled child: recent medical report proving permanent disability;
• Guardian and minor under guardianship: Birth certificate or identity document with photo and guardianship or custody agreement;
• Stepchild – Birth Certificate together with the Marriage Certificate or documents required as proof of the stable union;
• Relative by affinity: official documents that prove the degree of kinship.

Are there rules for inclusion?

The rules for including dependents are:

• Children who turn 21 are no longer considered dependents. However, this age may be extended according to the carrier's policy;
• Newborns must be included within 30 days of birth or adoption. Otherwise, the child will be required to complete the waiting period.
• To include a newborn, the policyholder must have a hospital-type plan with obstetrics. If they don't have one, but the contract includes dependents, they will be included, but the waiting periods stipulated in the plan must be met.
• Inclusion of a spouse must occur within 30 days of the wedding, so that there is no waiting period.
• If there is no contractual provision for including dependents, the policyholder must request a change to the plan contract. If the change is made, only the included dependents will have to meet the waiting periods.

How does the inclusion of dependents in the business plan work?

In the case of corporate plans, the inclusion of the dependent in the health plan will depend on the type of contract with the company and the health plan.

The best thing to do is to contact your company's Human Resources department and ask for clarification on this matter.

This is because some companies allow the inclusion of dependents, while others do not. 

Once the possibility of inclusion has been confirmed, the ideal is to contact the operator to find out about the necessary documentation.

Finally, the inclusion request can be made at any time, but it is important to remember that depending on the case, it may be necessary for the dependent to complete a waiting period.