Alyssa Lane
Turning 26 means you can no longer stay on your parent's health insurance plan and you need to take action to ensure you have health coverage. There are several options for getting health insurance as a 26-year-old, including enrolling in your job's health insurance plan, signing up for a Health Insurance Marketplace Plan, or purchasing coverage through your college or university if you are a student. You may also be able to keep your parent's coverage through COBRA, but this option can be expensive. This paragraph will explore the different ways to get medical insurance after turning 26 and provide information on choosing the right plan.
| Characteristics | Values |
|---|---|
| When does coverage on a parent's plan end? | Coverage on a parent's plan ends on December 31 of the year you turn 26, no matter the birthdate. |
| When to enroll in a new plan | Enroll during the open enrollment period (November 1 – January 15 every year). |
| What if I'm claimed as a tax dependent? | If someone claims you as a tax dependent, you can buy a plan through the federal or state marketplace, but you won't qualify for savings based on your income. |
| What if I have a low income? | You may qualify for Medicaid. |
| What if I'm a student? | You may have the option of buying coverage through your college or university. |
| What if I have an employer? | You can enroll in your job's health insurance plan. Your birthday does not need to fall inside the usual enrollment period. |
| What if I don't have an employer? | You can enroll in a Health Insurance Marketplace Plan. |
| What if I have a qualifying disability? | Many states let you stay on your parent's health insurance indefinitely. |
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What You'll Learn
Job-based health insurance plans
If you are on your parent's health insurance plan, you can usually stay on the plan until you turn 26. After that, you will need to take action to avoid losing coverage. If your employer offers health insurance, you can qualify to enroll outside of the yearly Open Enrollment Period. You can contact your job's human resources representative to learn more about your options.
If you leave your job or are fired and lose your job-based health insurance, you can enroll in a Marketplace plan. You will qualify for a Special Enrollment Period to get coverage for the rest of the year. You will need to apply for Marketplace coverage within 60 days of losing your job-based coverage. You may also be able to keep your job-based health plan through COBRA continuation coverage, which lets you pay to stay on your previous health insurance for a limited time after your job ends (usually 18 months).
If you have a Marketplace plan and get an offer of health insurance through a job, you may no longer qualify for savings on your Marketplace plan even if you do not accept the job-based coverage. You can update your Marketplace application to see how the offer impacts your savings.
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Health Insurance Marketplace plans
If you are about to turn 26 and are currently on your parent's health insurance plan, you should know that your coverage will usually end during or shortly after the month of your birthday. If you are on your parent's Marketplace plan, your coverage will end on December 31 in the year you turn 26, regardless of your birth date.
To avoid a lapse in coverage, you can enroll in a Health Insurance Marketplace Plan. The federal government operates the Health Insurance Marketplace, but some states also run their own marketplaces. You can apply at HealthCare.gov or your state's marketplace website. During the application process, you will find out if you are eligible for Medicaid or the Children's Health Insurance Program (CHIP). If you have limited income or are pregnant, you may qualify. These plans are independent of your employer, so you will have to pay the premium on your own. When you apply, you may qualify for subsidies. If someone claims you as a tax dependent, you can buy a plan through the federal or state marketplace, but you won't qualify for savings based on your income.
If your parent will claim you as a tax dependent for the year after you turn 26, you may qualify for savings based on your parent's income and anyone else on their federal tax return. You can stay on your parent's application for Marketplace coverage; don't create a separate account. Your parent can enroll you in your own marketplace plan during Open Enrollment (November 1 to January 15 every year). Your new marketplace plan can start as soon as the first day of the month after you lose coverage.
If your employer offers health insurance, you'll qualify to enroll outside of their yearly Open Enrollment if you didn't enroll in the employer coverage when it was offered to you and you lost your parent's coverage because you turned 26. You may have a limited time to enroll in job-based coverage, so contact your job's human resources representative before turning 26 to learn your next steps.
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Special Enrollment Periods
If you are about to turn 26 and are on your parent's health insurance plan, you should take action to ensure you have health coverage after your birthday. In most cases, your coverage under your parent's plan will end when you turn 26.
If you lose your health coverage because you are no longer a dependent on your parent's plan after turning 26, you will qualify for a Special Enrollment Period. You can use this period to enroll in a Marketplace plan. You can apply at HealthCare.gov or your state's Marketplace website. You may also be able to sign up for your job's health insurance plan outside of the usual enrollment period if your employer offers coverage.
If you are claimed as a tax dependent by your parent for the year after you turn 26, you can remain on your parent's application for Marketplace coverage. Your parent can enroll you in your own Marketplace plan during Open Enrollment, and your coverage will usually end during or shortly after the month you turn 26.
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Maintaining coverage through COBRA
If you've been on your parent's job-based health insurance plan, you can usually stay on it until you turn 26. However, once you turn 26, you will need to take action to ensure you have health coverage. One option to maintain coverage is through the Consolidated Omnibus Budget Reconciliation Act, or COBRA.
COBRA is a way to temporarily maintain your health coverage if you've lost your job, had your hours reduced, or experienced other qualifying events. It allows you to keep your employer-provided health insurance for a period of time, even if you're no longer working for that employer. This can be helpful if you want to continue seeing the same doctors and receiving the same health plan benefits. Your dependents, such as your spouse, former spouse, or children, are also eligible for COBRA coverage, even if you do not sign up for it yourself.
There are a few things to consider when exploring COBRA as a health coverage option. Firstly, you may be required to pay the entire group rate premium out of pocket, plus a 2% administrative fee. This can be a significant cost, so it's important to compare the price of COBRA coverage with other plans available through the Health Insurance Marketplace before making a decision. The Health Insurance Marketplace is operated by the federal government, and some states also have their own Marketplaces. You can apply at HealthCare.gov or your state's Marketplace website.
If you're ending your COBRA coverage, the open enrollment period from November 1 to January 15 allows you to enroll in a Marketplace plan, regardless of the reason for ending COBRA. Additionally, if you're eligible for Medicaid or the Children's Health Insurance Program (CHIP), you can enroll at any time, and coverage can start immediately. However, it's recommended to wait until you receive a final decision about your Medicaid/CHIP eligibility before ending your COBRA coverage.
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Eligibility for Medicaid
Medicaid is a joint federal and state program that provides health coverage to Americans, including children, pregnant women, parents, seniors, and individuals with disabilities. Each state runs its own Medicaid program, and so eligibility rules differ across states. However, there are some general rules that apply in most states. Firstly, Medicaid is typically available to individuals with low incomes, with or without a disability. Some states have expanded their Medicaid programs to cover other adults below a certain income level.
Modified Adjusted Gross Income (MAGI) is used to determine financial eligibility for Medicaid, and it considers taxable income and tax filing relationships. However, some individuals are exempt from the MAGI-based income counting rules, including those whose eligibility is based on blindness, disability, or age (65 and older). For those aged 65 and above, or who are blind or have a disability, eligibility is generally determined using the income methodologies of the SSI program.
Medicaid Buy-In programs are available in most states, offering coverage to people with disabilities who are working and earning more than the allowable limits for regular Medicaid. There are also special provisions for young adults formerly in foster care, with Medicaid available until age 26 for those who meet certain criteria.
To enrol in a Marketplace plan, you can visit HealthCare.gov to create an account and complete an application. If it appears that someone in your household might qualify for Medicaid, the application will be forwarded to your state for a final eligibility decision.
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Frequently asked questions
You can get medical insurance through your employer or through a state health care marketplace. You can also buy coverage through your college or university if you are a student.
Contact your job's human resources representative before turning 26 to learn about your options and next steps.
You can apply at HealthCare.gov or your state’s marketplace website. During the application process, you will find out if you are eligible for Medicaid or the Children’s Health Insurance Program (CHIP).
You can stay on your parent's insurance plan until the end of the year in which you turn 26. If your parents' insurance 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).
