Under current law, you are eligible to remain on your parents’ health insurance plan up until age 26. This rule generally applies to both employer-sponsored plans and those purchased via the Affordable Care Act Marketplace plans, with some notable exceptions.
As you approach 26 it is vitally important that you have a plan in place for getting coverage of your own.
Age Requirements
As a young adult, you may not have given much consideration to the responsibilities involved with getting your own health insurance policy. But eventually it will come time for you to transition away from your parents’ coverage – whether through employer coverage, individual marketplace plans or government programs like Medicaid. Understanding age requirements and rules will help make this transition less daunting.
Most parental health plans allow their beneficiaries to remain on their policy until their 26th birthday; however, as insurance provider policies and state regulations may differ. If you’re on an employer-sponsored plan provided by one of your parents’ employers, coverage typically ends by either the end of your 26th month or calendar year; similarly if you’re covered under an ACA Marketplace Plan or individual market policy.
There may be exceptions, but they are few and far between. If you require constant medical care, COBRA could allow you to continue with their health insurance plan until 29 under certain conditions – these states include Florida, Illinois, New Jersey, New York and Pennsylvania.
To qualify, individuals must meet certain criteria: the insurance must come through an employer based in Pennsylvania; they must reside permanently within Pennsylvania’s borders and not be married while attending full-time study at an accredited university; finally they cannot be claimed as dependents by another tax return; finally they are under 29 and cannot be claimed as a dependent tax return. If all these requirements are fulfilled, individuals can qualify for special enrollment periods that allow them to sign up for marketplace plans outside the regular open enrollment periods – you can learn more by visiting the Affordable Care Act’s website
Expiration Dates
The Affordable Care Act permits those under 26 to remain on their parents’ health insurance until they gain employment-sponsored or other coverage, making this an attractive option for young adults who are just starting their careers, lack benefits at work, or cannot afford expensive college health plans. Rules vary by state and insurance plan so it’s essential to check with them directly for more details.
Youth typically leave their parent’s insurance when they turn 26 years old as per requirements set by the Affordable Care Act (ACA), typically either near their birthday month end or end of year. Loss of coverage via employment-based coverage or marketplace plans also typically triggers an automatic special enrollment period in the individual market to enable purchase of coverage separately through ACA’s individual market.
Decisions on whether or not to remain on their parents’ plan depend on how their budget looks. If they have other sources of income, enrolling in an individual health insurance policy through an open marketplace during special enrollment period may be more financially advantageous; individual markets often provide more affordable coverage options for people with lower incomes.
Apart from costs, other considerations should also be taken into account when making the decision to remain on a parent’s insurance. For example, some parents may prefer particular doctors and health care providers while some plans offer services unavailable locally.
Most states mandate that young adults leave their parent’s coverage when they reach 26, but New York offers an exception through its health insurance rider which allows young adults to remain on it until turning 30 – although this only applies to medical coverage, not dental or vision coverage.
Special Enrollment Periods
Under certain conditions, special enrollment periods allow individuals to sign up for coverage outside of the Open Enrollment Period. Usually lasting 60 days following a qualifying life event such as getting married, moving into a different coverage area, or losing job-based coverage (you can find a list here), these Special Enrollment Periods enable people to enroll.
In general, you are only eligible to submit one SEP application every year; however, certain plans offer “unwinding” SEPs, meaning if your circumstances change you can reapply without waiting for another SEP period to commence.
Marriage, birth or adoption are common qualifying events for marketplace plans. You can also qualify for an SEP if your current coverage changes due to employment termination or layoff from work; other qualifying events include losing a job-based plan or Medicare or Medicaid coverage as well as ending AmeriCorps service.
Change in household status (such as moving in or out of your parent’s house). Other qualifying events could be an increase or decrease in family size, moving to a different ZIP code, or becoming an American citizen.
If you are applying for an unwinding SEP, it’s important to remember that young adult premiums will likely be higher compared to if your parents were your sole dependents. However, this provides a way for you to gain health insurance you might otherwise not afford.
Additional to qualifying life events, SEPs can also be used when your parent’s insurer violates your rights as an enrollee under the Affordable Care Act (ACA). This could range from contract breaches to more serious actions such as changing provider networks without your permission. When an insurer violates your rights under ACA they are required to notify you in writing of this violation as well as provide an official channel through which to file complaints about it; if that process doesn’t yield satisfactory results you can seek recourse by filing legal cases to recover your money back.
Exceptions
Current legislation (the Affordable Care Act or ACA) permits young adults up until they reach age 26 to remain on their parents’ health insurance plan for health coverage purposes and save money on monthly premiums. Most young people eventually require their own health plan so it is crucial that they understand all their options when selecting an individual plan that meets their specific needs.
Before the Affordable Care Act was implemented, young adults often found it difficult and expensive to secure individual or family health insurance plans on their own. Thanks to this reform, however, young adults can remain on their parent’s policies until their 26th birthday and purchase individual policies through either an ACA marketplace or directly from insurers.
If you are still dependent on your parents’ health insurance plan and it will expire before your 26th birthday, contact their insurer and inquire about a special enrollment period tailored specifically to you. Your parent’s insurer should also inform you about available alternatives such as the Affordable Care Act marketplace or state marketplaces.
Most states allow young adults to enroll in a marketplace plan during their birthday month as long as it meets other eligibility criteria such as income guidelines. As these rules can change at any time, be sure to contact your state for up-to-date information.
Subsidies from the Affordable Care Act Marketplace can often be more cost effective than remaining on your parents’ policy, depending on your income level. Supplementary plans can also be an option to consider and can cover out-of-pocket expenses like copays. Here is more information about shopping for one.
