Health insurance after 26: What you need to know
If your 26th birthday is approaching and you’re still covered by your parents' health plan, you’ll need to start thinking about your options for health insurance. Here’s what you need to know about this qualifying life event.
Common health insurance questions about turning 26
Knowing the answers to these commonly asked questions can help you avoid a gap in your health insurance coverage once you're 26.
When do you lose your parent’s health insurance coverage?
The Affordable Care Act (ACA) allows dependents to remain on their parents’ health insurance coverage until age 26. Once you turn 26, you only have a short period of time to enroll in new coverage.
Is turning 26 a qualifying life event?
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).
Special Enrollment Period eligibility and deadlines vary by health plan. Check your current 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.
Don’t wait until you turn 26 to figure out your health insurance coverage. Use this checklist to prepare ahead of time and avoid a gap in coverage.
A health insurance checklist for turning 26
- Reference your parents’ insurance documents to determine when you will lose coverage.
- Contact your employer to see if they offer group coverage.
- Learn a few health insurance basics.
- Make a list of your current health providers and medications.
- Explore available plans through your employer or ACA Health Insurance Marketplace®.
- Enroll before the deadline.
The information below can help you complete this check list and make sure you’re covered by your birthday.
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 what to ask
1.
Individual coverage from the ACA Health Insurance Marketplace
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 federal premium tax credits (subsidies), which help you pay your monthly premium. Tax credits are based on your annual income, among other factors, and you can estimate your tax credit amounts when you use Wellmark's online shopping platform to find a plan.
Shop for a new plan with confidence
Shopping for a health insurance plan on your own can be overwhelming. Read this article to learn everything you need to know about individual health plans and how Wellmark tools and resources can help you feel confident in your plan choice.
2.
Employer-sponsored (group) coverage
Many employers offer employer-sponsored — or group — coverage to their employees. With this coverage, the employer typically shares the cost of the monthly premium with its employees. Each employer will have a set time of the year for you to enroll, add dependents or make changes to your plan. Reach out to your employer for information about 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 dependents can stay on their parents' health plan after turning 26. Check your parents' benefits document or talk to their employer ahead of time to know when you'll lose coverage.
What if I’m under 26 and experience a life event? Can I stay on my parents’ 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?
There is no longer a federal tax penalty for not having health coverage. However, some states, such as California, Massachusetts, New Jersey, Rhode Island and Vermont, 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.
Use Wellmark’s shopping tools to find a plan
Wellmark is here to make finding your own coverage as easy as possible. That’s why Wellmark offers multiple shopping support options, from self-service tools to agent guidance. Compare and shop for plans using our online shopping platform.
Or, 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 human resources benefits administrator.