Get Declaration Of Age

The Declaration of Age is a crucial document for extending eligibility for dependent children who are disabled due to a physical or mental condition. This guide provides clear, step-by-step instructions on how to complete this document online.

Follow the steps to fill out the Declaration of Age efficiently.

1. Click ‘Get Form’ button to obtain the Declaration of Age and open it in your preferred editing tool.
2. Begin by entering the subscriber’s name as it appears on relevant documents.
3. Input the group number associated with your plan to identify your coverage.
4. Provide the member number linked to the subscriber for accurate processing.
5. Enter the dependent child’s name for whom the declaration is being filled out.
6. In the physician certification section, the physician must state the dependent's name, confirm their inability to engage in self-sustaining employment, and describe the disabling condition.
7. The physician should also include their prognosis and an estimated date by which the dependent might be able to sustain employment, if applicable.
8. The parent or guardian needs to certify that the dependent is unmarried, dependent for support, and incapable of self-sustaining employment due to their condition.
9. Finalize by entering the parent or guardian’s name, their relationship to the dependent, and their date of birth.
10. Review all entered information for accuracy before submitting the form.
11. Once completed, save changes, download, print, or share the document as needed.

Complete your documents online today to ensure timely processing.