Dependent
A dependent is a person, usually a family member, who qualifies for coverage under someone else’s insurance plan. Dependents are typically the spouse or children of the primary insured person, also known as the plan member or policyholder. Some plans may also cover other individuals who rely on the plan member for financial support, such as a common-law partner or a child with a permanent disability.
How It Works
In private health insurance, a dependent relies on the main policyholder for financial support and can be added to the plan to receive coverage, with eligibility criteria set by the insurance provider. In Canada, dependents are generally limited to your spouse or common-law partner and your children, including stepchildren. Dependent children are typically covered up to age 18 or 21, or up to age 25 if they are studying full-time at a recognized educational institution. A child who is physically or mentally incapable of self-support, and who became incapable while dependent on the insured, may continue to qualify beyond the normal age limit. Dependents are not added automatically; you must add them when you buy the policy or when a qualifying life event such as a birth, marriage, or adoption occurs. On a workplace group plan, adding a dependent is usually only possible at certain times, such as on marriage or entering a common-law relationship, the birth or adoption of a child, or a spouse losing their own workplace coverage.
Example:
If you have a family health and dental plan through your employer in Canada, your spouse or common-law partner and your children under 21, or up to 25 if studying full-time, can be added as dependents and claim eligible expenses such as prescription drugs, dental cleanings, or physiotherapy that provincial health care does not cover. If your child turns 22 and stops attending school full-time, they age out, and you would notify your insurer to remove them.
What to Watch For:
Many people generally cannot be added as dependents, including parents, in-laws, ex-spouses, siblings, grandparents, and adult children over the age limit who are not financially dependent or disabled. Coverage can also overlap. When a person is covered as a dependent under one plan and as an employee under another, coordination of benefits generally treats the plan where they are the active employee as primary and the plan covering them as a dependent as secondary. When dependent children are covered under two parents' plans, the birthday rule is used to decide which parent's plan is primary.
