Getting Health Insurance After Turning 26
If you’re aging out of your parents’ plan, you’ll need to find your own coverage. Luckily, the ACA requires that health plans and issuers offer dependent coverage up to age 26.
To make sure you’re covered, be sure to research full-coverage ACA plans and lower-cost short-term options. Also, consider working with a broker or agent who can help you understand your options.
What is a Qualifying Life Event?
A qualifying life event is a major change that allows you to sign up for or make changes to your health insurance outside of the annual open enrollment period. These events typically trigger what’s known as a special enrollment period, giving you 30 or 60 days (depending on the type of life event) to find and buy a new plan.
Many common life events qualify, like getting married or divorced, moving to a different city, adding a child to your family through birth or adoption, and even graduating college. The rules are a bit more complex for some situations, such as when you quit your job or are fired. Generally speaking, any involuntary loss of coverage qualifies for a special enrollment period but leaving your job voluntarily does not.
Other complicated circumstances, such as natural disasters and technical errors during the application process, may also trigger a special enrollment period. Contact your insurance provider to see if your situation qualifies.
How Long Can I Stay On My Parent’s Plan?
Many young adults are confused about when they can no longer remain on their parents’ health insurance. The general rule is that you must get your own insurance after turning 26 unless you have a qualifying life event. However, this varies by state.
If your parent’s plan is through an employer, they usually decide when you lose coverage. However, if they have private insurance through the Marketplace, you may stay on their plan until December 31 of the year that you turn 26.
If you move out of your parents’ home, it is important to know when their coverage ends. This is because the provider network for their plan may not extend to your new area. In this case, a special enrollment period is available to allow you to buy your own individual plan through the Marketplace. This is a great way to find affordable insurance and avoid a lapse in coverage. You can use our website to find and compare affordable options in your area.
Can I Get a Health Insurance Rider?
Adding riders is a way to customize coverage, especially if you are concerned about specific medical conditions or treatments. They can be costly, but they are also affordable, especially when compared to traditional health insurance plans. They are usually low in cost because they require minimal underwriting.
A few popular health insurance riders include maternity cover and critical illness coverage. Typically, these are designed to pay for treatment costs incurred when the insured suffers from an expensive medical condition like cancer or heart attack.
Other riders include the daily hospital cash rider, which pays a fixed amount of money for each day spent in hospital. This can help with out-of-pocket expenses and reduce financial stress for the policyholder and their family members. Riders and add-on covers are usually priced differently, with riders providing greater flexibility and customization compared to add-on covers. Moreover, riders generally amend the terms and conditions of the base health insurance plan while add-on covers do not.
What If I Need My Own Healthcare Before 26?
If you are enrolled in your parent’s healthcare plan and will be turning 26, you should take action to ensure that you don’t wind up without any health insurance coverage. The good news is that turning 26 triggers a Special Enrollment Period, which allows you to enroll in new coverage outside of your employer’s yearly Open Enrollment Period. Contact your HR representative before your birthday to learn more about the next steps.
If your parent’s healthcare plan does not offer a rider, you can enroll in marketplace coverage or purchase an individual health insurance plan directly from an insurer. If your income is low, you may qualify for premium tax credits and other savings based on your income when purchasing marketplace plans.
Young adults often think that they don’t need health insurance, but having it can prevent expensive medical emergencies from occurring. If you are uninsured for three months following your 26th birthday, you will have to pay a fine.