Eligibility

In general, to be eligible for a UVA Health Plan, you must be employed by UVA full- or part-time, and regularly scheduled to work at least 20 hours per week. To be eligible for the UVA Health Plan, your job must be one of the following types: 

• Faculty
• Classified Staff
• Medical Center Team Member
• Postdoctoral Research Associate
• Senior Professional Research Staff
• University Staff
• Grant-funded Postdoctoral Fellow (Value or Choice Health only)
• Housestaff (Value or Choice Health only)
• Academic Division and Medical Center Temporary and Wage Employee (if eligible under ACA). 

J visa holders are only eligible for the UVA J Visa Health Plan option. Federal government regulations prohibit J visa holders from enrolling in the Basic, Value or Choice Health options.

Two UVA spouses may choose who covers and who waives, or they may have separate plans.

For the UVA Health Plan:

• Must be legally recognized as spouse in the Commonwealth of Virginia and have no access to Affordable Healthcare Coverage of minimum value (as defined by the Affordable Care Act) through their non-UVA employer; OR
• Spouses whose remote employer offers affordable health care that provides minimum value, but ALL of their health options are HMOs and the spouse lives outside the HMOs' defined service areas, are eligible to be a dependent on the UVA employee's health coverage.

For UVA Dental and Davis Vision: Must be legally recognized as spouses in the Commonwealth of Virginia.

Must be your biological, step, adopted, or foster child, or any child declared a dependent on your federal tax return for whom you are the legal guardian with permanent custody. Children are eligible to the end of the birth month in which they turn 26.

If children are incapable of self-support due to mental or physical disability, they can remain on your health option beyond age 26 as long as the following requirements are met:

• Required documentation is approved in advance by the Aetna Claims Administrator before the dependent’s 26th birthday
• They are unmarried
• They live with you 100% of the time
• They are declared a dependent on your federal tax return

For further details and additional assistance, contact Aetna Member Services at 800.987.9072 or askhr@virginia.edu 

Eligibility Definition

• Marriage must be legally recognized in Commonwealth of Virginia
• Ex-spouses are not eligible, even with court order

Required Documentation

• Copy of state-issued marriage certificate received after the date of the ceremony with recorded file date, and 
• Copy of the first page of the employee’s most recent federal tax return that shows the dependent listed as “Spouse”. “Mark out” all financial information and the first five digits of all Social Security numbers.

Eligibility Definition

• A child may be covered to the end of the month in which he or she turns age 26.

Required Documentation

• Copy of birth certificate (or proof of birth for newborn) showing employee as parent

Eligibility Definition

• A child may be covered to the end of the month in which he or she turns age 26.

Required Documentation

• Copy of birth certificate or court approved adoption order showing employee’s name. If this is a legal pre-adoptive agreement, it must be reviewed and approved by the UVA HR.

Eligibility Definition

• A stepchild may be covered to the end of the month in which he or she turns age 26.

Required Documentation

• Copy of birth certificate (or adoption agreement) showing the  employee’s spouse as parent, and
• Copy of state-issued marriage certificate received after the date of the ceremony with recorded file date showing the employee and dependent parent’s name, and one form of proof of joint ownership, and 
• Copy of the first page of the employee’s most recent federal tax return that shows the dependent’s parent listed as “Spouse”. Redact or mark out  financial information and the first five digits of all Social Security numbers.

Eligibility Definition

• A foster child may be covered to the end of the month in which he or she turns age 26.

Required Documentation

• Copy of birth certificate, and
• Copy of the Final Court Order granting permanent custody with name of employee as responsible party, name of minor children, and presiding judge’s signature, support order number, and seal.

Eligibility Definition

A child for which a court has ordered the employee (and/or the employee’s legal spouse) to assume permanent custody may be covered to the end of the month in which he or she turns age 26 if:

• They are unmarried,
• Reside full-time with the employee in a regular parent-child relationships
• Is declared as a dependent on the employee’s federal income tax return, and
• Custody was awarded prior to the child’s 18^th birthday. 

Required Documentation

• Copy of birth certificate, and
• Copy of the Final Court Order granting permanent custody with name of employee or spouse as responsible party, name of minor children, and presiding judge’s signature, support order number, and seal

Eligibility Definition

If the employee (or the employee’s spouse) shares permanent custody of an “other child” with their minor child who is the parent of the “other child – exception”, then that “other child” may also be covered if the other child, the minor child (who is the parent) and the employee’s spouse (if applicable):

• All live in the same household as the employee, 
• Both children are unmarried,
• Both children are declared as dependents on the employee’s federal tax return, and
• A court has ordered the employee or the employee’s spouse to assume joint permanent custody.

Required Documentation

• Copy of the other child’s birth certificate showing the name of the minor child as the parent of the other child, and
• Copy of the birth certificate (or adoptive agreement) for the minor child showing the name of the employee, and
• Copy of the Final Court Order granting custody with names of employee or spouse and their minor child as the responsible parties, name of “other child”, and presiding judge’s signature, support order number, and seal.

Eligibility Definition:

The employee’s adult children who are incapacitated due to a physical or mental health condition may be covered beyond the end of the month in which they turn age 26 if:

• They are permanently and totally disabled, 
• They are unmarried,
• Reside full-time with the employee (or the other natural/adoptive parent),
• Is declared as a dependent on the employee’s federal income tax return,
• They are deemed incapacitated prior to the end of the month in which they reach age 26, and
• They have maintained continuous coverage under an employer-sponsored plan of the employee (or the other natural/adoptive parent).

Required Documentation

• Copy of birth certificate or legal adoptive agreement showing employee’s name, and
• Other medical certification and eligibility documentation as needed.
• In the case of a new employee, copy of the HIPAA Certificate showing prior employer-sponsored coverage.