Health insurance after 26
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If your 26th birthday is approaching and you’re still covered by your parents' health plan, you may have questions about how to get your own health insurance after you turn 26. We'll help you get started.
Health insurance questions to ask when you turn 26
Know the answers to these commonly asked questions, so you can avoid a gap in your health insurance coverage once you're 26.
Is turning 26 a qualifying life event?
Yes. If you're still on your parent's health insurance plan, turning 26 may cause you to lose coverage. Turning 26 is a qualifying life event, which means you can sign up for health insurance, even if it’s not during the Open Enrollment Period. This is known as a Special Enrollment Period (SEP).
Your Special Enrollment Period differs based on your plan. Make sure to check your coverage documents to confirm what your plan considers a life event and when your Special Enrollment Period begins and ends. If you don’t enroll during your Special Enrollment Period, you’ll need to wait for the next Open Enrollment Period and may have a gap in health insurance coverage.
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 by the company.
What are my health insurance options when I turn 26?
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 other details about health insurance.
1.
Individual coverage
Individual health insurance is ideal for people who need to purchase health insurance on their own, such as freelancers, college students or people who don't receive health insurance from their employer.
All individual and family plans from Wellmark are eligible for subsidies, which help you pay your monthly premium. Subsidies are based on your annual income, among other factors, and you can estimate your subsidy amounts when you shop on Wellmark's online shopping and comparison tool.
Compare individual health plans
Wellmark Blue Cross and Blue Shield has a variety of health insurance plans for individuals to fit your unique needs. You can enroll during the Open Enrollment Period (Nov. 1–Jan. 15 annually) or during your Special Enrollment Period before and after turning 26.
2.
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.
3.
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.
TRICARE is a health care program for service members, retirees and their families. To find out if you’re eligible, visit the TRICARE website.
4.
Student coverage
Some universities offer health plans that students may purchase if being on their parents' plan isn’t an option. The benefits offered by student health plans can vary greatly, so it’s a good idea to check what is covered before signing up.
Do I lose health insurance the day I turn 26, or is there a grace period?
Different health insurance carriers have different rules for how long children can stay on their parents' health plan after turning 26, so it's important to check your parents' benefits document or talk to their employer to know when you'll lose coverage.
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 have the option of staying on your parents' health insurance 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. If your health changes, 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 what will fit your budget and lifestyle, contact an authorized Wellmark agent. If health insurance is available to you through your job, talk to your HR benefits administrator.