This article was last updated Sept 6, 2022.
Since the Affordable Care Act (ACA) External Site passed into law in 2010, adults under age 26 can be added to their parent's plan, as long as their health insurance plan covers dependents and regardless of whether their child has access to other coverage. This part of the ACA helps young adults stay covered External Site and protects their health and finances.
If your 26th birthday is approaching and you’re still covered by your parent's plan, you may have lots of questions about when and how to look for a new health insurance plan. Let us help you get started.
Health insurance questions when you turn 26
Know the answers to these commonly asked questions so you don’t lose your health insurance when you turn 26.
What are my health insurance options when I turn 26?
If you’re about to lose coverage due to aging off your parent's plan, don’t worry. Depending on your personal situation, you may have a few different options for coverage. Read on to learn about the different types of health coverage and details about health insurance.
Individual coverage
Individual health insurance is purchased through the Health Insurance Marketplace External Site. If you buy a plan through the Marketplace, you may be eligible for subsidies External Site. These subsidies help you pay your monthly premium and are based on your annual income, among other factors.
Compare individual health plans
Wellmark Blue Cross and Blue Shield has a variety of health insurance plans for individuals to fit your unique needs. Open enrollment for 2023 hasn't opened up yet, but you can enroll now if you qualify for a special enrollment period.
To learn more about the individual coverage option, contact your agent. If you’d like to find a Wellmark Blue Cross and Blue Shield representative near you, you can find an agent here Opens New Window.
Employer-sponsored (Group) coverage
When an employer offers health insurance to its employees, it’s called employer-sponsored — or group — coverage. With group coverage, the employer typically shares the cost of the monthly premium with its employees. You have a set time of the year to enroll, add dependents or make changes to your plan. Reach out to your employer for information about your eligibility and coverage options.
Government-sponsored coverage, like Medicaid or TRICARE
Based on your income and family size, you may qualify for free or low-cost health coverage through Medicaid. To find out if you’re eligible, visit the U.S. Department of Health and Human Services website External Site.
TRICARE is a health care program for service members, retirees and their families. To find out if you’re eligible, visit the TRICARE website External Site.
Do I lose health insurance the day I turn 26 or is there a grace period?
Different health insurance carriers have different rules for when you lose coverage after turning age 26, so it's important to check your parent's benefits document or talk to their employer to know for sure.
Is turning 26 a qualifying life event?
If you're still on your parent's health insurance plan, turning 26 may cause you to lose minimum essential coverage, which is a qualifying life event Opens New Window and kicks off a special enrollment period. This means you can sign up for coverage, even if it’s not during an Open Enrollment Period.
Keep in mind, your special enrollment period is 60 days before and after you lose coverage. If you don’t enroll during this time, you’ll need to wait for the next Open Enrollment Period. The Open Enrollment Period for individual coverage runs Nov. 1–Jan. 15 each year. If you plan to enroll in an employer-sponsored health plan, the Open Enrollment Period varies, depending on the company.
What if I’m under 26 and experience a life event? Can I stay on my parent's plan?
Even if you’ve experienced another life event, such as marriage, birth of a child, adoption of a child or have employer-sponsored coverage available to you, you can stay on your parent's plan until you turn 26.
Is there a penalty for not enrolling in health insurance when I turn 26?
No, there is no longer a federal tax penalty for not having health coverage. However, some states have their own individual health insurance mandates.
While you may not be charged a penalty for not having health insurance, having continuous coverage can help you save money in the future. Even if you’re relatively healthy right now, health insurance provides financial protection. Accidents happen, and a health plan protects you from high, unexpected medical costs.
Wellmark is here to help you with your health insurance questions
Choosing a new health insurance plan can feel overwhelming and everyone's needs are different. For more help determining the plans available to you and the best ones to fit your budget and lifestyle, contact your authorized Wellmark agent Opens New Window. If health insurance is available to you through your job, talk to your HR benefits administrator.
