Prior to the Affordable Care Act, insurance companies often dropped dependents from their parents’ plans once they turned 26. That is no longer an issue.
Under COBRA or New Jersey’s Small Group Continuation law, young adults can stay on their parent’s plan up to age 29 without being subject to penalties for doing so; however there may be certain restrictions.
Age Limits for Dental Plans
Under the Affordable Care Act (ACA), dependents can stay on their parents’ dental plan up until the age of 19, but this doesn’t always happen depending on a variety of factors including plan specifics and state law.
Some plans limit coverage to those between a certain age and 70; others allow young adults to extend their coverage so long as they are full-time students or certified by their physician as disabled. It is wise to check with both your employer and plan details in order to determine what your limits may be.
Consider your future dental needs when choosing a plan, such as procedures or major services like implants or oral surgery, the costs involved and any copays or deductibles you might owe; additionally it would be wise to find one which allows you to stay with the same dentist of choice.
Delta Dental recently raised the age limit on its plans from 7-13, giving kids more time to visit their chosen dentist. This is great news for parents whose children are already covered under Delta Dental, while also helping RF provide more competitive employee benefits.
Other than age limits, some plans impose additional restrictions. For instance, family dental plans only cover full-time students as members; or there may be restrictions regarding who can join such as spouses and domestic partners.
If someone no longer qualifies for their parent’s dental plan due to age or payroll status changes, they can apply for a special enrollment period through the Health Insurance Marketplace to purchase an individual plan from trusted insurers. While some employers also provide dental and vision plans of their own – these could provide another source of coverage which may be more affordable depending on individual situations.
Age Limits for Vision Plans
Vision-specific insurance plans can be an excellent way to cover the expenses associated with eye care, such as exams and part of lens and frame purchases. Such policies often make an excellent addition to medical plans that do not offer vision coverage such as Medicare.
Most vision plans do not impose age restrictions on covered dependents; however, their definition of what qualifies as “children” varies between plans. Generally, children include any biological, adopted or stepchild who lives with you for at least six months each year and is under 26. Additionally, they must not earn more than 50% of household expenses, file their own joint tax return that year and not claim someone else as their dependent – providing they fulfill these criteria they can be added to your vision plan.
Many group plans, like those provided by RF’s Regular and Vision Plus plans, provide coverage to spouses/domestic partners and children up to the month they turn 25; additionally, coverage extends to disabled dependent children as well.
Your vision plan’s benefit booklet will detail all aspects of its coverage, including an explanation of your frame allowance – this amount represents what insurance will pay towards eyeglasses or contacts within one plan year. Some plans place limits on the number of glasses or contacts they cover each year while other only cover one specific lens type annually.
If you are an employee in the RF and have inquiries regarding your coverage, it is advisable to reach out to HR. They can inform whether or not your current insurance plan offers vision coverage; and, if not, how you can add family members like children or other relatives.
Age Limits for Disabled Dependents
Children typically remain dependents of their parent’s health insurance until the age of 26 – this applies both for private plans as well as employer-sponsored coverage such as COBRA. If, however, they have an incapacitating condition which prevents them from working and supporting themselves financially they can continue on their parent’s policy indefinitely.
Developmental disability refers to conditions like Down syndrome, autism spectrum disorder and cerebral palsy that impact a child’s physical or intellectual abilities. If your disabled child has been diagnosed with developmental disability, contact the Social Security Administration (SSA) so they can apply for SSDI benefits – this federal program pays people who meet its definition of disabled based on earnings history – including dependent benefits of $600 each month if you enroll them into your disability plan and are awarded SSDI yourself.
Law requires plans and issuers offering dependent child coverage to allow their dependent to remain on their plan until age 26 regardless of their financial independence or marital status. In order to qualify for this extension, a physician must sign a statement attesting that their dependent suffers from a debilitating condition that requires their parents’ support in order to remain covered.
Once a child reaches age 26, they can sign up for their own employer-sponsored or individual health insurance plan, Marketplace coverage or temporary extended health coverage under COBRA. Young adults with disabilities may also qualify for assistance through state or local disability services offices.
Families should take steps to safeguard a disabled child’s income and resources before enrolling them in government disability programs. Some ways of doing this include setting up a special needs trust or updating estate planning documents so an inheritance doesn’t terminate government benefits, representative payee, and an ABLE account – it’s best to consult a qualified attorney about what options may work and to put protections into action as quickly as possible.
Age Limits for Young Adults
Young adults turning 26 can find themselves overwhelmed with questions regarding their health insurance options when covered under their parent’s plan, but the Affordable Care Act offers rules which can assist them.
Under this new policy, most group health plans will continue to cover dependent children up until their 26th birthday. This applies to employer plans as well as individual market and state and local government-sponsored plans; for more specifics please reach out directly to either plan as some states and plans have different rules regarding coverage for dependent children at this age.
Additionally, under this new policy, when young adults leave parentally sponsored plans they’re eligible for a special enrollment period in the Marketplace and any premium subsidies received can be applied toward purchasing either their own Marketplace policy or other qualified plans outside the Exchange – making this an attractive option for low income individuals without access to employer coverage who want health coverage but don’t wish to pay privately for it.
To qualify for special enrollment, young adults must not be covered under an employer-based health plan or other type of coverage (such as COBRA) and must not have taken steps to discontinue it with their parents. The special enrollment period will run through to December 26th of their 26th birthday year; young adults can either continue on their parent’s plan or obtain coverage independently.
Under the Affordable Care Act, plans and insurers that offer dependent coverage must offer it until an adult child turns 26 even if they no longer live with or financially depend on their parents, no longer meet plan definition of dependent, or no longer enroll as students. Furthermore, any adult with changes in status must receive same benefit packages available to any similar individuals.
Are You Exploring Health Insurance Coverage (or Have any Additional Inquiries About Insurance Policies?) Those interested in learning more about Aflac Coverage or have any queries or needing help understanding health insurance options should reach out to an Aflac Agent near them – Our highly trained agents will be there when needed and help make obtaining coverage easier for our members.