How Long Can You Stay on Your Parent’s Health Insurance?

Under current laws, you can stay on your parent’s health insurance policy until you turn 26 years old.

In some states, it’s even longer.

When the time comes for you to get your own insurance, it’s important to know what your health insurance choices are and how to choose the right plan.

It can be a confusing topic, and sometimes it is difficult to know what your best options are.

This article breaks down what you need to know about your health insurance options, how to choose a plan that’s right for you, and if you even need insurance.

When You Lose Health Insurance Through Your Parents

Currently, the Affordable Care Act (ACA) requires your parent’s insurance plan to cover you until your 26^th birthday.

You qualify for coverage under your parents even if you are:

• Married
• Attending school
• Not living with your parents
• Not financially dependent on your parents
• Eligible to enroll in your employer’s plan

If your parents have their insurance plan through an employer, you usually have coverage until the end of your birthday month.

Check with your individual plan to know for sure, as some states and plans have different rules.

If your parents have a Marketplace insurance plan, you have until December 31 of the year you turn 26 to get your coverage.

States with an extended age limit

Some states have an extended age limit to remain on your parent’s policy if you meet specific criteria. 

To be eligible for extended dependent coverage, you typically can’t be eligible for any other form of comprehensive health coverage.

For example, if you are eligible for your own employer’s health insurance, you may not be able to extend your parent’s coverage. (This does not apply to individuals who have a disability.)

Following are the states that offer exceptions; however, laws are always subject to change, so check with your own state’s laws.

Health Insurance Options

If you are about to age out of your parent’s insurance policy, you have a few options to choose from.

Employer-sponsored insurance

If you or your spouse are currently employed full-time, you may be able to get health insurance coverage through an employer.

You must request special enrollment within 30 days of your loss of coverage.

Health insurance marketplace

For individual coverage, you may qualify for special enrollment through the Health Insurance Marketplace.

To purchase a Marketplace plan, you must special enroll within 60 days of aging out of your plan. You can find more information here.

You may even qualify for subsidies that can make your coverage more affordable.

COBRA

If your parent’s employer sponsors 20 or more employees on its plan, you may be eligible to purchase a temporary extension of health coverage for up to 36 months under the Consolidated Omnibus Budget Reconciliation Act (COBRA).

Be sure to notify your parent’s employer in writing within 60 days before you turn 26 if you want to elect COBRA coverage.

Medicaid

If you apply for insurance through your state health insurance marketplace, you will be asked to enter your income amount.

Depending on how much you make per year, you may qualify for your state’s Medicaid program.

School-sponsored health insurance

If you are currently attending a university as a full-time student, you may be able to get health coverage through your school’s insurance policy.

This is a great option for graduate students who are getting older and aging out of their parent’s plan.

Choosing the Right Health Insurance

The health insurance plan you choose depends somewhat on your health status.

If you are in good health and don’t require monthly prescriptions or need to have a procedure done, you will want a different plan than someone who does.

Types of plans

Here are the most common types of health insurance plans.

Exclusive provider organizations (EPO): An EPO plan requires you to seek healthcare services from doctors and hospitals within their defined network if you want your costs to be covered, with exceptions for emergency care.

Health maintenance organizations (HMO): HMO plans typically contract with doctors within a specific area to provide services, including preventative measures. Except for an emergency, this type of plan only covers the cost of services provided by in-network healthcare providers.

Point of Service (POS): POS plans offer reduced-cost physician and hospital care when you seek care from their in-network providers. If you need an appointment with a specialist, you’ll need to get a referral from your primary care physician.

Preferred provider organization (PPO): With a PPO, you pay less for healthcare services when you only use in-network providers. This plan does not require a referral to see a specialist.

Marketplace: The health insurance Marketplace offers a few different levels of coverage plans. The plans are broken down by tier:

• Gold and Platinum: These plans have the most expensive premiums (monthly payments), but they also have the lowest deductibles (the amount you need to pay out of pocket). This means you will have access to coinsurance benefits quickly. If you are in great health, this policy might end up costing more compared to the benefits you will receive. However, if you require monthly medications, this plan would be a great money-saving plan for you.
• Silver: These plans have average premiums, deductibles, and out-of-pocket maximums. It is more expensive than the cheapest plan, but it’s a great plan if you are preparing to start a family. In addition, Silver plans offers cost-sharing discounts if your income is below 250% of the federal poverty level.
• Bronze: These plans have low premiums and high deductibles but are only available for people under 30. If you are eligible for subsidies, you can apply them to get a Bronze plan for a low monthly rate. This type of plan is good if you don’t think you’ll have many medical expenses throughout the year.
• Catastrophic: These plans are also only available for people under 30. They are the cheapest plans available on the Marketplace, but they have the highest deductibles and out-of-pocket maximums. This type of cheap plan is great if you are healthy and don’t expect to have substantial medical costs. You cannot apply subsidies to Catastrophic plans.

Costs

Whatever plan you choose, there is a required monthly premium (how much you pay for the plan each month).

If you don’t require any medical care, your premium is the only payment you can expect.

However, if you do require healthcare services, you will have to pay other costs as well.

• Deductible: This is the amount of money you pay out of pocket before the benefits of the policy start covering costs. For example, if you have a deductible of $2,000, you will need to pay the first $2,000 of any healthcare bills yourself before your insurance starts to pay.
• Copayment: Also called a copay, the copayment is typically a fixed cost for a service (e.g., $25 to see your primary care physician). Once the deductible has been met, you will only be asked to pay your copay when you visit your doctor.
• Out-of-pocket maximum: This is the maximum amount of money you will pay out of your own pocket for healthcare services in a single year. Until you reach this maximum, you are responsible for all of the out-of-pocket costs.

Do I Need Health Insurance?

If you are healthy, you might think that you don’t need health insurance coverage.

But consider that accidents happen all the time, and healthcare services can be expensive without the help of insurance.

According to the U.S. Centers for Medicare and Medicaid Services, the average hospital stay can cost $10,000 per day.

While that may be an extreme case, injury and illness can come as a surprise, and signing up for health insurance is one simple way to help avoid high medical bills if an issue does arise.

It’s always best to plan ahead—you’ll be happy you did.

How K Health Can Help

Need to go to urgent care but don’t have insurance? 

Check your symptoms, explore conditions and treatments, and if needed, text with a healthcare provider in minutes all through K Health. 

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