Young Adults Staying On Parents' Insurance Plans

In the United States, young adults can typically stay on their parents' health insurance plans until they turn 26. This is made possible by the Affordable Care Act (ACA), which allows young adults to remain on their parents' insurance policies even if they are married, have children, are not claimed as tax dependents, or live outside of their parents' home. However, there are some exceptions to this rule, and the specific laws vary from state to state. For example, in some states like New York and Florida, young adults can stay on their parents' health insurance until the age of 30, and in many states, disabled dependents can remain on their parents' health insurance indefinitely.

Coverage until age 26

According to the Patient Protection and Affordable Care Act (PPACA), an adult child can be covered by a parent's health care plan until the age of 26. This provision allows young adults to stay on their parents' insurance plans even if they are no longer dependents, are married, have children of their own, or are eligible for employer-sponsored coverage. This extension of coverage was implemented to provide young adults with more options for health insurance and to ensure continuous coverage during the transition to adulthood.

Most states allow children to remain on their parent's health insurance plan until they turn 26. However, this is only possible if the parent's insurance plan covers dependents. In the case of job-based plans, parents can typically add their children to their insurance during the plan's yearly Open Enrollment Period or during a Special Enrollment Period after certain life events, such as losing health coverage or having a baby. For plans bought through the Health Insurance Marketplace, parents can include their children on their application when applying for a new plan or during the yearly Open Enrollment Period.

It is important to note that once a young adult turns 26, they will need to find their own insurance coverage. There are several options available, including employer-sponsored health insurance, school-sponsored health insurance, the Health Insurance Marketplace, and Medicaid.

Additionally, there are some unique circumstances where the age limit for coverage under a parent's plan can be extended. For example, in some states, children with disabilities can remain on their parent's health insurance indefinitely. Furthermore, each state has its own requirements for children over the age of 26 who want to stay on their parent's health insurance, with some states allowing coverage until the age of 30.

Coverage beyond 26

In most cases, young adults can remain on their parent's health insurance plan until they turn 26. However, there are a few exceptions where individuals can stay on their parent's plan beyond the age of 26.

While losing parental health insurance at 26 is common, some states and health plans may extend coverage beyond this age. For instance, in some states, young adults can remain on their parent's plan until the age of 30 or even 31. These states include Florida, Illinois, New Jersey, New York, Pennsylvania, South Dakota, and Wisconsin. However, there are certain conditions that must be met to qualify for extended coverage. For example, in New York, individuals must be unmarried to remain on their parent's plan until the age of 30.

Other factors affecting coverage beyond 26

In addition to state-specific regulations, other factors can influence an individual's ability to stay on their parent's insurance beyond the age of 26. These include:

• Type of insurance plan: The type of insurance plan your parents have can impact your coverage options. If your parents have an employer-sponsored health insurance plan, your coverage will likely end before your 26th birthday. On the other hand, if their plan is through the Marketplace, you may be able to stay on until December 31 of the year you turn 26.
• Disability status: In many states, individuals with disabilities can remain on their parent's health insurance plan indefinitely, regardless of their age.
• Marital status: In some states, individuals must be unmarried to remain on their parent's plan beyond the age of 26.
• Veteran status: In certain states, veteran status may allow individuals to stay on their parent's plan beyond the age of 26.
• Student status: Some states allow full-time students to remain on their parent's health insurance plan indefinitely.

It's important to note that the specific requirements and eligibility criteria may vary from state to state, so it's recommended to research the laws and regulations in your specific state.

Special Enrollment Period

A Special Enrollment Period (SEP) is a time outside the yearly Open Enrollment Period when you can sign up for health insurance. You qualify for a Special Enrollment Period if you've had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child, or if your household income is below a certain amount.

Losing Health Coverage

You may qualify for a Special Enrollment Period if you or anyone in your household lost qualifying health coverage in the past 60 days or expects to lose coverage in the next 60 days. This includes losing health coverage through a parent or guardian because you're no longer a dependent.

Changes in Household

You may qualify for a Special Enrollment Period if, in the past 60 days, you or anyone in your household:

• Got married
• Had a baby, adopted a child, or placed a child for foster care
• Got divorced or legally separated and lost health insurance (divorce or legal separation without losing coverage doesn't qualify)
• Died

Changes in Residence

You may qualify for a Special Enrollment Period if you move to:

• A new home in a new ZIP code or county
• The U.S. from a foreign country or U.S. territory
• A place you attend school (if you're a student)
• A place you both live and work (if you're a seasonal worker)
• A shelter or other transitional housing

An Offer of Employer-Sponsored Coverage

You may qualify for a Special Enrollment Period if you or anyone in your household was offered an individual coverage HRA (Health Reimbursement Arrangement) or a Qualified Small Employer Health Reimbursement Arrangement (QSEHRA) in the past 60 days or expects to in the next 60 days.

It's important to note that the timeframe for enrolling in a plan during a Special Enrollment Period may vary depending on the type of event and the state you live in. In some cases, you may have 60 days before or after the event to enroll, while job-based plans must provide a minimum of 30 days for Special Enrollment.

Getting your own insurance

In most states, individuals can stay on their parent's health insurance plan until the age of 26. However, once you turn 26, you will need to get your own insurance coverage. Here are some options for getting your own insurance:

Employer-Sponsored Health Insurance

If you have a full-time job, your employer may offer health insurance benefits. You can sign up for these benefits during open enrollment, which is an annual opportunity to enrol in benefits provided by your employer. Turning 26 is also considered a "qualifying life event", which means you can enrol outside of the standard open enrollment period, but you usually only have 60 days to do so.

School-Sponsored Health Insurance

If you are a student, your educational institution may offer school-sponsored health insurance with low copays. Check with an advisor at your school to see if this is an option for you.

Health Insurance Marketplace

If you can't get coverage through your employer or school, you can apply for insurance coverage through the health insurance marketplace. You can explore your options based on your state's individual marketplace.

Medicaid

Medicaid is a type of health insurance offered by federal and state governments to help low-income adults, families, people with disabilities, elderly adults, children, and pregnant women. Eligibility is based on income, and you typically must be a resident of the state that you apply to.

Consolidated Omnibus Budget Reconciliation Act (COBRA)

If you lose your job, you can continue your existing coverage for a limited amount of time through COBRA. However, this option can be very expensive, as you usually have to pay the full monthly premium yourself.

Catastrophic Health Insurance

If you are under 30, you may be eligible for a catastrophic health insurance plan, which has low premiums but extremely high deductibles. This means you will have to pay for most of your medical care out-of-pocket.

Short-Term Health Insurance

Short-term health insurance can provide temporary coverage during transitional periods, such as turning 26 and losing coverage through your parents. However, this option may not cover pre-existing conditions, and deductibles are usually high.

Car Insurance

Unlike health insurance, there is no age at which you are required to purchase your own car insurance policy. As long as you live at home, you can remain on your parents' car insurance. If you move out, you will need to get your own policy.

Dual coverage

In the United States, it is common for young adults to remain on their parents' health insurance plans until they turn 26. This is known as "dual coverage" or "dual health insurance coverage". This is allowed by the Affordable Care Act (ACA) and applies to most health insurance plans, including job-based plans and those bought through the Health Insurance Marketplace.

However, it is important to note that dual coverage does not always mean double the benefits. The primary insurance, which is usually the parent's plan, will cover the bill up to its coverage limits. The secondary insurance, which can be the young adult's own plan or the other parent's plan, will then cover part or all of the remaining costs. The coordination of benefits (COB) provision ensures that there is an order to which the insurance policies payout and prevents individuals from receiving multiple reimbursements for the same visit or medication.

In some states, such as New York and Florida, young adults are allowed to stay on their parents' health insurance plans even beyond the age of 26, with certain conditions applying. These variations depend on factors such as the age of the child, their marital status, disability status, and veteran status.

Frequently asked questions