Qualifying Life Events
Legislation allows for the continuation of HCTC benefits for Qualifying Family Members (QFM) for up to 24 months after the eligible primary individual reaches certain life events: Medicare eligibility, divorce, or death.
In most cases, an individual becomes eligible for Medicare the first day of their birth month the year they turn 65. An individual will remain HCTC eligible their entire birth month in which they turn 65.
A Medicare enrollment letter, Medicare card, or other documentation of Medicare eligibility is required.
In the case a divorce between an eligible participant and spouse, the spouse is treated as an eligible individual beginning:
- In the month of the divorce, if the spouse was a qualifying family member immediately before the divorce and had a separate coverage
- In the month after the divorce, if the spouse was a QFM immediately before the divorce and did not have separate coverage
- The enrollment form must be completed and signed by the QFM and will be enrolled in their name
- A divorce certiﬁcate (or similar legal documentation) is required, and, must include the date of the divorce
After the death of an eligible participant, the following are treated as eligible individuals:
- Any spouse of the participant (determined at the time of death)
- Any individual who was a QFM immediately before such death
- In the month of the date of death, for individuals with separate coverage
- In the month after the date of death, for individuals who did not have separate coverage
The enrollment form must be completed and signed by the QFM and will be enrolled in their name.
A death certiﬁcate (or similar documentation) is required, and must include the date of the death.