Who Qualifies as an Eligible Dependent?

Eligible dependents

Please check with your plan administrator or Guide to Benefits to determine who is an eligible dependent under your HMSA plan. Generally, a subscriber’s spouse and children are eligible dependents.

If you are enrolling your eligible dependent outside the initial enrollment or open enrollment period, you must apply for enrollment within 31 days of an event, such as the birth of a child or marriage that makes your dependent eligible for coverage under your HMSA plan.


A spouse is an eligible dependent if the marriage to the subscriber is legally recognized in the state of Hawaii. Please contact your employer to inquire whether civil union partners are eligible to enroll as a dependent under your employer’s rules of eligibility.

The state of Hawaii doesn’t recognize common-law marriages.


For most plans, subscribers may enroll a child who meets all the requirements listed below:

  • Children up to the age of your plan’s specified maximum age. If your plan has implemented provisions under the Affordable Care Act, your plan will cover children up to age 26 regardless of marital status, financial dependency, or residency. Please contact your employer or group for more information on whether your plan has implemented provisions under the Affordable Care Act.
  • The child must be one of the following:
    • Your natural child.
    • Your stepchild.
    • Your legally adopted child with valid documentation.
    • A child placed with you for adoption. Placement occurs when you assume a legal obligation for total or partial support of the child in anticipation of adoption.
    • A child for whom you’re the court-appointed guardian.
    • Your eligible foster child (defined as an child placed with you by an authorized placement agency or by judgment, decree, or other court order).

You may also enroll children who meet all of the criteria in the following article:

Children with Special Needs