Haris Ashley
If you are an 18-year-old with limited financial resources, you may be eligible for free or low-cost health insurance through government programs like Medicaid. You can apply for Medicaid at any time, and if you are eligible, you can enroll immediately. You may also be able to get on a parent's health insurance plan, or your employer may offer health insurance as a benefit. If you are a student, you may be able to enroll in a student health plan. When choosing a health insurance plan, it is important to compare quotes and consider factors such as your age, health, location, and income to find the best option for your needs and budget.
| Characteristics | Values |
|---|---|
| Age limit to be on a parent's health insurance plan | Under 26 |
| Marketplace enrollment period | November 1 – January 15 |
| Enrollment outside the yearly period | If income is within a certain range or in case of certain life events |
| Special Enrollment Period | Losing health coverage, moving, getting married, having a baby, adopting a child, or if household income is below a certain amount |
| Insurance for children | Children's Health Insurance Program (CHIP) |
| Insurance for low income | Medicaid |
| Insurance through employer | Job-based plans |
| Insurance for students | Student health plan |
| Insurance for single parents | Employer-sponsored health plan, marketplace family plan, or Medicaid |
| Insurance for individuals with chronic illnesses | Higher premium and lower deductible plan |
| Insurance for individuals comfortable with a limited network | HMO plan |
| Insurance for individuals who need specialist care and out-of-network coverage | PPO plan |
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What You'll Learn
Getting on a parent's insurance plan
If you are an 18-year-old who is unable to afford medical insurance, you may be able to get on your parent's health insurance plan. This is because, under the Affordable Care Act, parents can keep their children on their health insurance until they turn 26. This applies to all plans in the individual market and to all employer plans. This means that you can be included in your parents' family coverage.
If your parents' plan is sponsored by an employer with 20 or more employees, you may be eligible to purchase temporary extended health coverage for up to 36 months under the Consolidated Omnibus Budget Reconciliation Act (COBRA). To elect for COBRA coverage, you must notify your parents' employer in writing within 60 days of reaching age 26. You will then have 60 days from the date the notice was sent to elect for COBRA coverage. If your parents' employer has 20 or fewer employees, you may have similar rights under state law. You should ask your parents' employer or your State Insurance Department for more details.
Your parent can add you to their insurance during the plan's yearly Open Enrollment Period, which runs from November 1 to January 15. You may also qualify for a Special Enrollment Period if you have had certain life events, such as losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.
If you are no longer able to stay on your parents' plan, there are multiple ways to get health insurance, such as through an employer, an Affordable Care Act (ACA) marketplace plan, a catastrophic health insurance plan, or Medicaid, if you qualify.
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Enrolling in Medicaid
If you are an 18-year-old with a low income, you may be able to get free or low-cost health insurance through Medicaid. The first step is to check if you qualify. Each state has different rules, but generally, your eligibility will be based on your income, household size, family status, disability, age, and other factors. You can check your eligibility by filling out a Marketplace application.
If you are eligible for Medicaid, you can enroll at any time. Here are the steps to enroll:
- Create an account with the Health Insurance Marketplace: You can do this by visiting the HealthCare.gov website and selecting your state. This will allow you to start a Marketplace application and find out if you qualify for Medicaid.
- Fill out an application: Provide information about your income, household size, and other relevant details. Be sure to include any life events or changes in circumstances that may impact your eligibility.
- Submit your application: Once you have completed the application, submit it for review. Your information will be sent to your state agency, and they will determine your eligibility for Medicaid.
- Wait for a response: After submitting your application, your state agency will review your information and contact you about enrollment. They may request additional information or documentation to complete your application.
- Enroll in a plan: If you are eligible for Medicaid, you will be able to enroll in a plan that meets your needs. Depending on your state and eligibility, you may have the option to choose from different health plans.
- Understand your coverage: Once you have enrolled in a plan, take the time to understand your coverage. Medicaid benefits may vary from state to state, so it is important to know what services are covered and what providers are available in your area.
Remember that if you are under 26, you may also be able to join a parent's health insurance plan or enroll in a student health plan if you are in school. Additionally, if you have children, they may qualify for coverage under the Children's Health Insurance Program (CHIP).
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Getting employer-sponsored healthcare
If you are a poor 18-year-old, you may be able to get on your parent's health insurance plan until you turn 26. Depending on your situation, you may be eligible for savings based on your income. You can also pick a "Catastrophic" health plan, which is a way to protect yourself from the worst-case scenarios. If someone claims you as a dependent, you can buy a plan through the Marketplace but won't qualify for savings based on your income. If you are in school, you may be able to enroll in a student health plan.
If you are employed, you may be able to get employer-sponsored health insurance. This is health insurance offered to you through your job. Your employer may offer a choice of group health plans to eligible workers and cover part of the monthly premium. There are many types of health insurance options offered by employers, such as group insurance, Health Reimbursement Accounts (HRAs), supplemental plans, flex-spending accounts to use with a health plan, and COBRA.
In most cases, your employer's offer is your best bet. If your employer's offer meets the federal affordability and minimum value standards, you will not qualify for financial help to lower the cost of a health plan. A health plan is considered minimum value if it covers at least 60% of the total cost of medical services and provides enough coverage for hospital and doctor services. For 2024, a health plan is considered "affordable" if the plan's premium is not more than 8.39% of the employee's household income.
Large employers are potentially subject to financial penalty under the ACA if they do not offer health insurance coverage that meets certain requirements to their full-time employees. The ACA requires that employers with at least 50 full-time employees offer health benefits that meet minimum standards for value and affordability or pay a penalty. Federal and state laws divide ESI into the small group and large group markets based on the number of full-time equivalent employees working for the employer sponsoring the plan.
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Applying for the Children's Health Insurance Program (CHIP)
The Children's Health Insurance Program (CHIP) provides free or low-cost health coverage to children in families that earn too much to qualify for Medicaid but too little to afford private coverage. Each state offers CHIP coverage, and works closely with its state Medicaid program. Each state program has its own rules about who qualifies for CHIP.
To apply for CHIP, you can fill out a Marketplace application at any time of the year to find out if you qualify. You can also apply for Medicaid coverage to your state agency, and they will let you know if your children qualify for CHIP. If they do, you won't need to buy a separate insurance plan to cover them.
If you have a Marketplace health plan, you may be able to lower your costs with a premium tax credit. The costs are different in each state, but you won't have to pay more than 5% of your family's income for the year.
In Pennsylvania, CHIP is the program that provides health insurance for uninsured children and teens. If your child or teen is uninsured and ineligible for Medicaid, CHIP may be able to help. Depending on household income and other factors, your child will be placed in the appropriate healthcare program, which may be Medicaid, CHIP, or a referral to Pennie, Pennsylvania's health insurance marketplace.
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Picking a Catastrophic health plan
If you are an 18-year-old with a low income, you may be able to get on a parent's health insurance plan. Depending on your situation, you may be eligible for savings based on your income. You can also apply for Medicaid, which offers free or low-cost coverage. If you are in school, you may be able to enroll in a student health plan.
If you are looking for a "Catastrophic" health plan, it is important to note that these plans are designed for people under 30 or those who qualify for financial aid. They are meant to protect you from worst-case scenarios and high emergency medical costs, while also covering some essential health benefits. Catastrophic plans have lower prices than Bronze plans, but they come with very high deductibles. This means that you will have to pay a large amount out-of-pocket before your insurance plan starts to pay. For example, with a $2,000 deductible, you would need to pay the first $2,000 of covered services yourself. Catastrophic plans cannot be purchased with premium subsidies, and they are not HSA-qualified. However, they do cover all of the essential benefits defined by the ACA, including routine health care, screenings, check-ups, and patient counseling.
To qualify for a catastrophic plan, you must meet certain eligibility guidelines. These plans are typically for individuals under 30 or those who qualify for a hardship or affordability exemption. A hardship exemption may apply if you have recently been homeless, declared bankruptcy, or meet other qualifying criteria. An affordability exemption means that your income is not enough to afford regular health care coverage. You can apply for these exemptions by filling out an application and submitting it to the Exchange.
When choosing a catastrophic plan, be sure to compare the benefits and costs of different plans. While these plans offer low monthly premiums, the high deductibles can make them more expensive in the long run if you require frequent medical care. It is important to understand what is and is not covered by your specific plan, as there may be limits on preventive care and the number of covered visits to a Primary Care Provider (PCP).
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Frequently asked questions
An 18-year-old can get medical insurance through their parents' insurance plan, through their employer, or by purchasing health insurance through the Health Insurance Marketplace. If you are poor, you may qualify for free or low-cost coverage through Medicaid.
The average cost of health insurance for 18-year-olds is $324 per month for a mid-range Silver Marketplace plan. However, insurance rates can vary based on factors such as age, location, medical history, and health status.
The Bronze tier is typically the lowest and most affordable option, but some areas offer a Catastrophic tier for healthy 18-year-olds that meet eligibility requirements. Catastrophic plans are cheaper than Bronze plans but often have a higher deductible.
When choosing a health insurance plan, it is important to compare quotes and find coverage that meets your needs and budget. Consider factors such as deductibles, out-of-pocket expenses, and the expected cost of treatment when selecting a plan.
