Eligible dependents under your insurance plan include: your spouse, your Eligible dependents under your plan can include your spouse, your children, and certain other individuals who meet IRS criteria as a qualifying child or qualifying relative, and they are generally eligible regardless of where they live or whether they have their own income. However, for individual plans purchased for dependents who permanently live in another area, that dependent will typically need a policy based on their own primary zip code and local rating area.
Eligible dependents
Spouse: Your lawful spouse is generally eligible to be covered as a dependent under your plan, subject to your specific plan’s rules.
Child: Your biological, adopted, or stepchild can usually remain on your health coverage until they reach age 26, regardless of marital status, student status, where they live, or whether they have their own job.
Other IRS dependents: Certain individuals can be considered eligible dependents if they meet IRS tests as a qualifying child or qualifying relative (see below), if this is allowed by your specific plan’s eligibility rules.
Qualifying child (legal ward)
For IRS purposes, a qualifying child (often used for legal wards or other children you support) must generally:
Have a specified relationship to you (for example, your child, stepchild, foster child, sibling, or a descendant of any of these).
Share the same primary residence as you for more than half of the tax year, with certain exceptions for temporary absences such as school or medical care.
Be under age 19, or under age 24 if a full‑time student, unless permanently and totally disabled.
Not providing more than half of their own financial support during the tax year.
Qualifying relative
For IRS purposes, a qualifying relative (who may or may not be related by blood) must:
Either have a specified relationship to you (such as parent, sibling, in‑law, or certain other relatives) or live with you as a member of your household for the entire year.
Have gross income for the year below the IRS exemption amount in effect for that tax year.
Receive more than half of their total support from you during that tax year.
Not be treated as a qualifying child of you or of any other taxpayer for that year.
Dependents in another zip code
If a dependent permanently lives and receives most of their medical care in a different rating area or state, they typically need a separate individual plan based on their own primary zip code (for example, a college student who lives out of state full time).
Additionally, you will be unable to shop for them on our platform and will need to shop for their coverage either on the Marketplace or directly from a carrier and then upload the Proof of Coverage to your portal as a Recurring Premium
If that dependent instead receives most of their care in your area (for example, a student who comes home for routine care and prescriptions), you can usually enroll them using your home zip code, subject to the underlying insurance carrier’s network and service‑area rules.