When a Dependent Turns 26: What You Need to Know

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Questions?

Sofia, your virtual benefits assistant, is available 24/7 on the enrollment site or the MyChoice Benefits App^TM. You can also call the T-Mobile Benefits Center at 1-855-TMO-BENS (1-855-866-2367), Monday through Friday, from 5 a.m. to 5 p.m. PT.

Once your dependent turns 26, they are no longer eligible for coverage under a T-Mobile medical plan. Coverage ends on the last day of the month in which your dependent turns 26, unless they qualify as legally disabled.

Coverage Options

Losing dependent coverage at age 26 is a qualifying life event, allowing enrollment in other coverage outside standard enrollment periods.

Your dependent may be able to enroll in:

Their employer sponsored health plan
State or federal Marketplace coverage, with possible financial assistance
A student health plan, if they are enrolled in school
COBRA continuation coverage to temporarily extend current medical coverage

Legally Disabled Dependents

You may enroll a dependent child over age 26 if they meet the following criteria:

They are incapable of self-support due to mental or physical disability and became disabled prior to age 26
They rely on you for primary financial support and maintenance

Disabled Dependent Process (Age 26+)

The employee contacts the Benefits Center to initiate the request and is then directed to their medical insurance carrier to obtain the disabled dependent form.

Important

UHC enrollees call (877) 259-1527 to request the form.
Premera enrollees call (866) 358-2300 to request the form.

If approved:

Vendor certifies dependent through the next plan year (or as indicated).
Vendor emails approval to The Benefits Center.
The Benefits Center updates the case, enrolls the dependent in selected health plans, and triggers Dependent Verification (if applicable).
Coverage will be applied retroactively, so there are no gaps in coverage. If coverage was dropped before approval, retroactive premiums will be deducted from a future paycheck.

If denied:

Vendor notifies employee and emails denial to The Benefits Center.
The Benefits Center updates the case.

COBRA Coverage

Your dependent will be automatically removed from coverage after the end of the month in which they turn 26. You will receive a COBRA election notice with information about continuing coverage for up to 36 months by paying the full cost of the monthly premiums, including a 2% administration fee.

Prescription Plans	Surest Copay Only	PPO Plan with Health Reimbursement Account (HRA Plan)	Exclusive Provider Organization (EPO Plan)	High Deductible Health Plan with Health Savings Account (HSA Plan)
Tier 1 (30 days)	$10 copay	10% ($5 copay min.-$20 copay max.)	$10 copay	Plan pays 80% after deductible
Tier 2 (30 days)	$75 copay	20% ($25 copay min.-$55 copay max.)	$35 copay	Plan pays 80% after deductible
Tier 3 (30 days)	$200 copay	30% ($45 copay min.-$80 copay max.)	$60 copay	Plan pays 80% after deductible
Mail Order/Retail (90 days)	2x monthly rate	2x monthly rate	2x monthly rate	Plan pays 80% after deductible
Preventive Medications	Subject to normal copay	Many are free	Subject to normal copay	Many are free
Weight loss Medications (anti-obesity and anorexiants)	2027: $100 copay max 2026: $55 copay max	2027: $100 copay max 2026: $55 copay max	2027: $100 copay max 2026: $55 copay max	Plan pays 80% after deductible
*The other differences are that in the HRA and HSA Plans, a robust list of preventive medications are FREE. You can review the covered preventive prescriptions and others, as well as costs at info.caremark.com/oe/t-mobile.

Coverage Election	Dental				Vision
	PPO Network		Open Network		Vision
	Employee	Employer	Employee	Employer	Employee	Employer
Employee Only	$6.00	$7.31	$17.00	$6.95	$3.50	$0.00
Employee plus Spouse	$12.00	$12.62	$31.00	$13.31	$6.00	$0.00
Employee plus Children	$14.00	$15.28	$37.00	$15.69	$6.00	$0.00
Employee plus Family	$20.00	$20.59	$52.00	$21.05	$9.50	$0.00
Domestic Partner¹	$6.00	$5.31	$14.00	$6.36	$2.50	$0.00
Domestic Partner Child¹	$8.00	$7.97	$20.00	$8.74	$2.50	$0.00
¹Domestic Partner deductions are taken on a post-tax basis, and employee pays tax on the employer portion of the contribution.

Coverage Election	Surest Copay Only Plan	PPO Plan with Health Reimbursement Account	Exclusive Provider Organization (EPO) Plan	High Deductible Health Plan with Health Savings Account (HSA)
Employee	$10.25	$52.88-$100	$108.39-$162	$44.97-$91
Employee + Spouse	$36	$121.28-$216	$232.28-$340	$105.45-$198
Employee + Children	$26	$104.12-$189	$202.64-$300	$90.21-$174
Employee + Family	$42	$163.05-$304	$336.39-$498	$137.53-$275
Additional Working Partner Premium	$46.15	$46.15	$46.15	$46.15

Coverage Election	Surest Copay Only Plan	PPO Plan with Health Reimbursement Account	Exclusive Provider Organization (EPO) Plan	High Deductible Health Plan with Health Savings Account (HSA)
Employee	$10.25	$48.62-$91	$98.57-$147	$41.50-$83
Employee + Spouse	$36	$112.75-$198	$212.65-$310	$98.50-$182
Employee + Children	$26	$96.31-$173	$184.97-$272	$83.78-$159
Employee + Family	$42	$150.94-$278	$306.94-$453	$127.97-$252
Additional Working Partner Premium	$46.15	$46.15	$46.15	$46.15
If you have a domestic partner or child of your domestic partner enrolled on the medical plan, the amount T-Mobile pays for your domestic partner/child of domestic partner coverage is added to your paycheck as taxable income because the IRS does not consider either to be a tax dependent. For additional information, please log in to your account at www.t-mobilebenefits.com/login.

Medical Plans	Surest Copay Only	PPO Plan with Health Reimbursement Account (HRA Plan)	High Deductible Health Plan with Health Savings Account (HSA Plan)	Exclusive Provider Organization (EPO Plan)
Calendar Year Deductible
Individual	$0	$2,250	$2,250	$750
Enrolled dependents	$0	$4,500	$4,500	$1,500
T-Mobile Account Funding (coverage on Jan 1)
Individual	N/A	$500*	$500**	N/A
Enrolled dependents	N/A	$1,000*	$1,000**	N/A
T-Mobile Account Funding (coverage Feb 1 or after)
Individual	N/A	$41.66/month*	$19.23/pay period**	N/A
Enrolled dependents	N/A	$83.33/month*	$38.46/pay period***	N/A
Out-of-Pocket Max (includes the deductibles)
Individual	$6,500	$4,250	$4,250	$3,750
Enrolled dependents	$13,000	$8,500	$8,500***	$7,500
Coinsurance (starts after deductible is met)	N/A	80% in-network, 60% out-of-network up to R&C	80% in-network, 60% out-of-network up to R&C	80% in-network only, NO coverage out-of-network
Office Visits
Preventive	FREE	FREE	FREE	FREE
In-person primary care physician (or a virtual care physician, if available)	$25-$130	$35	Deductible + coinsurance	$20
24/7 virtual medical care with a designated provider in the following networks: Premera Blue Cross enrollees: Doctor on Demand and 98point6 UHC enrollees: Teladoc, Optum Virtual Care, Walmart Health Virtual Care, Amwell, Doctor on Demand Surest enrollees: Amwell, Doctor on Demand, Alma, Talkspace	FREE	FREE	Deductible + coinsurance	FREE
In-person specialist	$25-$130	$50	Deductible + coinsurance	$30
In-person behavioral health visit with a licensed therapist	$25-$130	$35 (in or out of network)	Deductible + coinsurance	$20
Virtual behavioral health care with licensed psychiatrists or therapists in the following networks: Premera Blue Cross enrollees: Doctor on Demand and Talkspace UHC enrollees: Amwell, Doctor on Demand and Talkspace	$0-$130	$35	Deductible + coinsurance	$20
Emergency room	$600 copay	$200 copay, then 80% after deductible (copay waived if admitted)	80% after deductible	$200 copay, then 80% after deductible (copay waived if admitted)
To view cost estimate comparisons for how much you might spend out of pocket for certain services under each plan, click here. Entire T-Mobile funding is available first day of coverage. Any balance rolls over to the next year, up to $6,000 as long as you remain in the plan. T-Mobile contributions are prorated and funded by the Friday following each pay date. Any funds in your HSA are yours to keep, even if you leave T-Mobile. **The High Deductible Health Plan with HSA Plan features a true family deductible. The family deductible is two times the individual deductible and requires that the entire family deductible is met before paying 80% of covered charges. Please note that the out-of-pocket maximum works the same way.

Prescription Plans	Surest Copay Only	PPO Plan with Health Reimbursement Account (HRA Plan)	High Deductible Health Plan with Health Savings Account (HSA Plan)	Exclusive Provider Organization (EPO Plan)
Prescription Drugs
Tier 1 (30 days)	$10 copay	10% ($5 copay min.-$20 copay max.)	Plan pays 80% after deductible	$10 copay
Tier 2 (30 days)	$75 copay	20% ($25 copay min.-$55 copay max.)	Plan pays 80% after deductible	$35 copay
Tier 3 (30 days)	$200 copay	30% ($45 copay min.-$80 copay max.)	Plan pays 80% after deductible	$60 copay
Mail Order/Retail (90 days)	2x monthly rate	2x monthly rate	Plan pays 80% after deductible	2x monthly rate
Preventive Medications	Subject to normal copay	Many are free	Many are free	Subject to normal copay
Weight loss Medications (anti-obesity and anorexiants)	$55 copay max	$55 copay max	Plan pays 80% after deductible	$55 copay max
Preventive Prescription Drugs*
Tier 1 (30 days)	$10	FREE	FREE	$10
Tier 2 (30 days)	$75	FREE	FREE	$35
Tier 3 (30 days)	$200	FREE	FREE	$60
Mail Order/Retail (90 days)	Copay x 2	FREE	FREE	Copay x 2
Lifetime Maximum	n/a	Unlimited	Unlimited	Unlimited
*The other differences are that in the HRA and HSA Plans, a robust list of preventive medications are FREE. You can review the covered preventive prescriptions and others, as well as costs at info.caremark.com/oe/t-mobile.

When a Dependent Turns 26: What You Need to Know

Coverage Options

Legally Disabled Dependents

COBRA Coverage

Money on the Table

Buffet of Services

Don't Wait for a Breakdown

The Umbrella Effect

Virtual Care Delivers

Surest

PPO with Health Reimbursement Account

High Deductible Health Plan with HSA

EPO Plan

Supplemental Health Plans

HMSA HMO and PPO:

HMSA Health Plan Hawaii Plus (HMO):

HMSA Preferred Provider Plan (PPO):

New Lyra Support for You and Your Family

Enhancements to all Aflac Plans

Enhanced Virtual Musculoskeletal Care Benefit

Enhanced Decision-Making Tool

Expanded Family-Building and Maternity Support

New LightCare Vision Benefit

Cost Per Pay Period Is Changing

Weight Loss Medication Cost Increase

Select Voluntary Benefits Now Available Through the Enrollment Experience

New Health Savings Account (HSA) Limits Are Increasing

Hawaii Medical Plan Changes