An adult child who is incapable of self-sustaining employment may be eligible to continue coverage beyond the age where coverage would otherwise terminate. One of the following conditions must cause the incapacity:
- Mental illness
- Developmental disability as defined in the NYS Mental Hygiene Law
- Physical handicap
- The child must also meet all of the following conditions:
- The condition occurred before the dependent reached the maximum age under the certificate
The child was covered at the time he or she would have otherwise reached the maximum age under the certificate:
- The condition continues to exist
- The child remains unmarried
- The child remains dependent upon the subscriber for support
- The application for coverage as a disabled dependent is also dependent upon the review by and approval of, the Medical Director at Excellus BCBS.
Documentation requirements include both of the following:
A completed Disabled Dependent Form must be completed and signed by both the subscriber and the medical doctor. This application must be received prior to the dependent age limitation.