Eligible dependents

Most dental plans can cover dependents until they reach age 19. But if a dependent is a student or is disabled and unable to work, some plans provide coverage past age 19.

Student 

If you're covered under an Aetna dental benefits and dental insurance plan, your unmarried dependent may be eligible for coverage after age 19 if he or she:

• Is not working full time*, and
• Goes to school regularly on a full-time or part-time basis

This can include dependents enrolled in classes preparing for a GED exam. It does not include a home-schooling program.

Eligible student dependents may be covered:

• During the school year
• During summer vacation
• While working in a temporary summer cooperative job training program

Please contact us with proof of eligibility

If your dependent is an eligible student, please call Member Services. We will give you the address or fax number to send one of the following:

• A letter from the school's registrar's office
• A copy of the current tuition statement
• A copy of the student schedule
• A copy of a current report card
• A dental claim form with complete student verification information

Rather contact us by e-mail? Log on to Aetna Navigator®, our secure, self-service member website.

Disabled dependents

If your dependent is disabled and your dental plan has an incapacitated dependent provision, you can apply to continue coverage. To be eligible, your dependent:

• Must be incapable of self-support because of mental retardation or any mental or physical disability
• Became disabled before reaching the age limit for coverage
• Depends on you for financial support and maintenance**
• Does not have coverage under a medical expense conversion policy***

Here are examples of some conditions that may prevent a dependent from being self-supporting:

• Autism
• Cerebral palsy
• Cystic fibrosis
• Quadriplegia
• Down syndrome
• Schizophrenia

Please call member services

Member Services will send you the following forms:

• Handicapped Child Attending Physician's Statement/Behavioral Health Attending Physician's Statement, form GC-464 (10-07)
• Request for Continuation of Medical Coverage for Disabled Student† or Handicapped Child, form GC-463 (7-07), if required

Complete and send us your form(s) no later than:

• 31 days from the date the dependent reaches the maximum age under your dental plan
• Or within the timeframe stated in you dental plan documents

You can contact us by e-mail, too. Just visit Aetna Navigator®.

*Full-time is defined as working at least a seven- to eight-hour job, five days a week.
**Must meet Internal Revenue Service dependent requirements for federal income tax purposes.
***Federal and some state laws allow employees who leave their jobs, voluntarily or involuntarily, the right to continue their group coverage under an individual plan.
†Applies to eligible dependents of subscribers in MD, ME, MI, NH, NY, VA and VT.