A provision of the Affordable Care Act (ACA) has allowed millions of 20-somethings to remain covered by their parents’ health insurance until the child’s 26th birthday. But once young adults turn 26, their health insurance options change.
once you turn 26, you are no longer allowed to stay on your parent’s health insurance plan, unless you live in one of the seven states that allow people to stay on their parent’s plan until the age of 26. 30 or 31 years old. But there are still options for getting coverage, like employer-sponsored health insurance or a plan through the health insurance marketplace.
Keep reading to learn everything you need to know about your parent’s health plan expiration age.
can you stay on your parents’ insurance after age 26?
For the most part, no. young adults can stay on their parents’ health insurance policy until they turn 26. This generally applies even if you are not a dependent, are married, have dependents of your own, or have another job that offers health insurance. This coverage generally ends the day before your 26th birthday if you are on a parent’s employer-sponsored health insurance plan. if the plan is through the market, you can stay until December 31 of the year you turn 26.
If you turn 26 and are dropped from your parent’s health insurance plan, you qualify for a special enrollment period and can get your own policy.
how to stay on parent’s insurance until 30
If you need to stay on your parents’ coverage after age 26, you may be lucky depending on where you live. a handful of states allow young adults to stay on their parents’ coverage until age 30 or 31. there are seven states in the us uu. that will allow you to stay on your parents’ insurance until you’re 30 or 31:
- new jersey
- new york
- south dakota
- bronze: lower premiums; higher out-of-pocket costs
- silver: premiums higher than bronze but lower than gold; lower out-of-pocket costs than bronze
- gold: premiums lower than platinum but higher than silver; lower out-of-pocket costs than silver
- platinum: highest premiums; lower out-of-pocket costs
There are some caveats to staying in the plan that will vary by state. For example, New York residents can stay on their parents’ policies until age 30, but only if they’re not married.
Should you skip health insurance if you’re 20?
Health insurance is not required in most states. now only five states (california, massachusetts, new jersey, rhode island, vermont, and the district of columbia) require residents to have health insurance. While Americans in most states are not required to have health insurance, it’s still a good idea to get coverage, even if you’re young and healthy.
Accidents or serious illness can happen unexpectedly, and not having health insurance can lead to huge out-of-pocket costs when you need care. some people delay care and don’t get needed preventive care because they don’t have health insurance; this can be costly and seriously harm your health and long-term financial future.
If you don’t want to pay a lot for health insurance, you can look for a high deductible health plan that has lower premiums, but also higher out-of-pocket costs if you need medical care.
what are the best health insurance options available after 26?
the aca created easier ways for people to find an individual or small group policy through the health insurance marketplace, allowing them to shop for and compare health plans in one place.
However, there are other ways to get coverage. These are alternatives when you lose your parents’ health insurance:
your employer’s health insurance
Probably the easiest and cheapest way to get health insurance is to get it through your job. Employers pay a large portion of health care costs, making it a cheaper option than most alternatives for a young adult. It’s less expensive than other options and usually has great benefits, but you’re limited to one or two employer-offered plans.
spouse health plan
If you’re married or getting married, you can be added to your spouse’s health plan. adding another person to the plan will likely increase premiums. however, you will get medical coverage and it is usually more affordable than the options below. it’s less expensive than other options and usually has extensive benefits.
cobra requires employers with 20 or more employees to extend health coverage to people who lose their employer-sponsored group health insurance. Before the ACA, cobra insurance was the way most Americans got health insurance after they were laid off.
Although cobra is often an avenue for people who are laid off, it is also available for a child whose age exceeds their parents’ plan.
You have 60 days after losing coverage to elect cobra coverage. You can stay in a paid plan for between 18 and 36 months, depending on the reason for losing health coverage.
there is a drawback. cobra is expensive. How expensive? You have to pay all health plan costs plus an administrative fee of up to 2%, without any help from your former employer.
The average annual family premium for an employer-sponsored health plan is more than $20,000, and the employer bears most of those costs. however, in a cobra plan, the person pays all those health insurance costs.
While Cobra provides the familiarity and protection of a previous employer’s health plan, it does not rely on financial assistance from an employer to pay for the policy.
individual health plan
An individual plan through the Health Insurance Marketplace here may be an affordable option, depending on your income. But while the plans here offer comprehensive benefits, if you don’t qualify for the subsidies, the individual plans can be expensive.
Generally, only people whose income is below 400% of the federal poverty level (about $50,000 or less for a single person in 2021) can receive subsidies to lower premiums or get tax credits to help to pay for medical care. California has even more generous benefits (600% of the federal poverty level).
When you compare plans on the ACA Marketplace, the site will tell you if you’re eligible for subsidies and provide premium estimates when you provide your income data.
If you don’t qualify for subsidies, an individual plan can be expensive. It’s probably not as expensive as a chargeable plan, but it’s more expensive than signing up for an employer’s plan. people who don’t qualify for the subsidies can also get an individual plan outside of the exchanges. These plans are directly through a health insurer and are more expensive than subsidized plans on the exchanges.
Individual plans through the exchanges are divided into four categories based on premiums and out-of-pocket costs:
Over three-quarters of members on the exchange have a bronze or silver plan. not many insurers offer platinum plans.
People shopping for an individual health insurance plan should consider the plan’s overall price, the amount you pay for your care, and the flexibility you’ll have in seeing specialists and doctors in your network. compare plans from at least three insurers, if possible.
To make sure you’re choosing from the best insurance companies, check out insure.com’s ranking of the best health insurance companies, based on a survey of 3,160 policyholders on customer service, price, claims handling, website or app. and renewal.
You may be eligible for Medicaid if you are considered low income.
Income requirements differ by state. thirty-eight states and a.d. Medicaid expanded eligibility so that people up to 138% of the federal poverty level are eligible. other states have stricter guidelines.
Medicaid offers the same level of comprehensive health insurance as a private insurer, but the coverage has much lower costs based on your income. check with your state’s medicaid program to see if you qualify.
Medicaid offers affordable coverage with benefits similar to those found in an employer-sponsored health plan, but despite expansion to 38 states, most Americans still don’t qualify for it.
catastrophic health plan
catastrophic health plans are available for people under the age of 30 or those facing specific hardships, such as homelessness.
These plans have low premiums and comprehensive benefits that are similar to those found in a standard health insurance plan. however, they also have high deductibles, so you pay more out of pocket when you need care than in another plan.
While catastrophic health plans offer low premiums and comprehensive coverage, they also have high deductibles and out-of-pocket costs, so you pay more when you need care.
short-term health plan
Short-term health insurance is a low-cost plan that can provide a safety net for catastrophic emergencies, but it has limited benefits and can lead to significant out-of-pocket costs.
A short-term health plan is available for one year and can be renewed twice. so, in effect, you can stick to a short-term plan for three years.
Some states prohibit companies from offering such plans. critics say they don’t provide the comprehensive coverage found in an aca plan. For example, you may have trouble finding a short-term plan that covers maternity, mental health, and prescription drugs. in that case, you may end up paying for that care yourself.
If you’re considering a short-term plan, be sure to read the fine print to see what is and isn’t covered.
– les masterson contributed to this story.