Instructions for submitting dependent verification documentation
How do I submit my documentation?
Read the Eligibility Documentation Required section below for each dependent to see what documents you have to submit.
• Make sure the documents you are sending are clear and legible.
• If you are mailing the documents, mail copies and not the originals. Any original documents will not be returned to you.
• Please include student name, student ID #, school name, and confirmation # on all documentation submitted. (The confirmation # is referenced on the enrollment confirmation email you received titled “Your Student Health Insurance Enrollment”; please see below for an example.)
• Send your documents to us by any of the following ways:
Fax:
859-425-5200
Email:
StudentHealthEnrollmentVerification@AETNA.com
Mail:
Aetna Student Health
PO Box 14388
Lexington, KY 40512
Important Note about Vital Records (birth certificates, etc.)
Don’t delay requesting vital records - it can take 4-8 weeks for vital records to be processed in some states and counties. Also, some states and county clerk offices prohibit the copying of vital records (e.g. Florida, Pennsylvania, Wisconsin, etc.). If you are getting records from one of those offices, ask for a non-certified record.
Eligibility Documentation Required
Below is a list of eligibility rules and documents required to verify your dependent(s).
Note: In lieu of the documentation below, international students may submit dependent’s Form I-20 or DS-2019.
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Dependent Type
|
Age
|
Eligibility Requirements
|
Document Options for Verifying Eligibility
|
|
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|
|
Legal Spouse
|
N/A
|
The covered employee's husband or wife under Federal Law
|
Marriage Certificate
|
|
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|
|
Common Law
Spouse
|
N/A
|
Only allowable in the following states, according
to the criteria listed below:
• Alabama
• Colorado
• Georgia (if created before 1/1/97)
• Idaho (if created before 1/1/96)
• Iowa
• Kansas
• Montana
• Ohio (if created before 10/10/91)
• Oklahoma (if created before 11/1/98)
• Pennsylvania (if created before 1/1/05)
• Rhode Island
• South Carolina
• Texas
• Utah
• Washington, D.C
|
Affidavit of Common Law Marriage
|
|
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|
|
Domestic Partner
|
Age 18
and
over
|
Your dependent is eligible for coverage as a partner if
you and your partner are:
• At least age 18
• Not legally married to another person or part of
another domestic partner relationship
• Intending to remain each other's sole domestic
partner indefinitely
• Intending to reside together in the same
principal residence indefinitely
• Emotionally committed to one another and
share joint responsibilities for common welfare
and financial obligations
• Not related by blood closer than what your
resident state prohibits
|
Declaration of Domestic Partnership
|
|
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|
|
Civil Union
Partner
|
N/A
|
Must have Certificate of Civil Union Partnership as
allowable by the state.
|
Civil Union Partner Certificate
|
|
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|
|
Biological Child
|
Up to
age 26
|
Must be your biological child
|
Government Issued Birth Certificate
|
|
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|
|
Disabled
Biological
Child
|
Age 26
and
over
|
Dependent must be listed as medically disabled
with Aetna
|
Government Issued Birth Certificate
|
|
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|
|
Step-Child
|
Up to
age 26
|
Must be your step-child
|
Government Issued Birth Certificate and Marriage Certificate /
Affidavit of Common Law Marriage
|
|
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|
|
Disabled
Step-Child
|
Age 26
and
over
|
Dependent must be listed as medically disabled with Aetna
|
Government Issued Birth Certificate and Marriage Certificate /
Affidavit of Common Law Marriage
|
|
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|
|
Adopted
Child
|
Up to
age 26
|
Must be your adopted child
|
Adoption Certificate
OR
Adoption Placement Agreement and Petition for Adoption
|
|
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|
|
Disabled
Adopted
Child
|
Age 26
and
over
|
Dependent must be listed as medically disabled with
Aetna
|
Adoption Certificate
|
|
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|
|
Partner Child
|
Up to
age 26
eligible
|
Your children and/or children of your partner
Partner must be enrolled for the child to be eligible
|
Government Issued Birth Certificate and Declaration of Domestic Partnership
|
|
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|
|
Partner
Disabled Child
|
Age 26
and
Over
|
Dependent must be listed as medically disabled
with Aetna Partner must be enrolled for the child to be Eligible
|
Government Issued Birth Certificate and Declaration of Domestic Partnership
|
|
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|
|
Foster Child
|
Up to
age 26
|
Must have Foster Care Placement Letter
|
Foster Care Letter of Placement
|
|
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|
|
Legal Ward
|
Up to
age 26
|
Must have court ordered document of legal
guardianship
|
Government Issued Birth Certificate and Court Ordered
Documentation of Legal Guardianship
|
|
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|
|
Disabled
Legal Ward
|
Age 26
and
Over
|
Must have court ordered document of legal
guardianship
Dependent must be listed as medically disabled
with Aetna
|
Government Issued Birth Certificate and Court Ordered
Documentation of Legal Guardianship
|
|
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|
|
Civil Union
Partner
Child
|
Up to
age 26
|
Civil Union Partner must be enrolled for the
child to be eligible
|
Government Issued Birth Certificate and Civil Union Partner
Certificate
(Proof of Civil Union Partnership must be a Certificate including the date of the union.)
|
|
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|
|
Civil Union
Partner
Disabled Child
|
Age 26
and
over
|
Civil Union Partner must be enrolled for the
child to be eligible
Dependent must be listed as medically disabled
with Aetna
|
Government Issued Birth Certificate and Civil Union Partner
Certificate
(Proof of Civil Union Partnership must be a Certificate including the date of the union.)
|
|
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|
The above benefit descriptions describe the plan(s) generally, and in summary form only. In the event of a conflict between what is stated in this document and the governing plan document(s), the plan document(s) will control.
Non‐Discrimination Notice
Aetna complies with applicable Federal civil rights laws and does not discriminate, exclude or treat people differently based on their race, color, national origin, sex, age, or disability.
Aetna provides free aids/services to people with disabilities and to people who need language assistance.
If you need a qualified interpreter, written information in other formats, translation or other services, call 1-877-480-4161.
If you believe we have failed to provide these services or otherwise discriminated based on a protected class noted above, you can also file a grievance with the Civil Rights Coordinator by contacting:
Civil Rights Coordinator,
P.O. Box 14462, Lexington, KY 40512 (CA HMO customers: PO Box 24030 Fresno, CA 93779),
1-800-648-7817, TTY: 711,
Fax: 859-425-3379 (CA HMO customers: 860-262-7705), CRCoordinator@aetna.com.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or at: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201, or at 1-800-368-1019, 800-537-7697 (TDD).
Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company, Coventry Health Care plans and their affiliates (Aetna).
Availability of Language Assistance Services
TTY: 711
|
To access language services at no cost to you, call 1-877-480-4161.
|
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Para acceder a los servicios de idiomas sin costo, llame al 1-877-480-4161. (Spanish)
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