This article was last updated on Dec. 29, 2021.
Ever 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 that health insurance plan covers dependents. This part of the ACA helps young adults stay covered External Site and protects their health and finances, no matter if they have access to other coverage or not.
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.
Individual health insurance is purchased yourself — not through an employer. It can be 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 and a couple other factors.
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.
When an employer offers health insurance to its employees, it’s called employer-sponsored coverage. This is also known as a group plan. With group coverage, the employer typically shares the cost of the monthly premium with its employees, and you have a set time of the year to enroll, add dependents or make changes to your plan.
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 uniformed services 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?
When you lose coverage after turning 26 depends on your parent's health insurance coverage. Different health insurance carriers have different rules for when you lose coverage after turning age 26, so it's important to check the benefits document or talk to their employer.
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. 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 2022 Open Enrollment Period for Individual coverage runs Nov. 1–Jan. 15, 2021. 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 a life event, like marriage, having or adopting a child, or have job-based 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 fee for not having health coverage. However, some states have their own individual health insurance mandates.
While you may not be charged a fee 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.