Ensuring your children are covered for all medical conditions and mishaps is essential if you don’t want to be forking out for expensive medical bills. While you can add your child from birth, a valid question would be, “how long can children stay on parents’ health insurance?”
When your child reaches their 21st birthday milestone, you may think it’s time for them to leave your health insurance plan. However, current laws do stipulate your child can stay on your insurance until they’re 26 years old.
Let’s walk through the facts about children and your health insurance plan. We’ll also give you some guidelines about what to do as your child approached their 26th birthday.
How Long Can A Child Stay On Their Parents’ Health Insurance?
Before the implementation of the Affordable Care Act (ACA), many states stipulated that insurers should extend coverage to young adults on their parents’ or guardians’ health insurance plans. There was an age limit to staying on their parents’ insurance and this could have been either until the kids were 24 or 25 years old.
Since the implementation of ACA, health insurance providers now have to allow for children to stay on their parents’ health insurance plan until their 26th birthday. This applies to all insurers who include dependent coverage in their policies.
If your concern is that your child will no longer be covered under your plan because they’re leaving home to start college or work, you don’t need to stress. For whatever reason, your child may still remain as part of your plan’s coverage until they turn 26 years old.
Are There Any Restrictions Before Your Child Turns 26?
Before the implementation of ACA, different states allowed insurers to include certain limitations, such as the child being unmarried or living at their parents’ residence.
The ACA now stipulates there may be no restrictions while your child is under your health insurance coverage. This applies not only to parents’ health insurance plans but also to employers’ plans.
Even if your child falls under any of the following categories, they may still remain under your plan’s coverage:
- Their marriage status has changed
- Either parent’s status has changed
- They’ve enrolled into a school or have left school
- They’ve moved residence, which is not their parents’ home
- They’re eligible for an employer’s insurance plan
- They’ve become financially independent
So, if your child’s circumstances do change while younger than the age of 26, they can still benefit from your health insurance plan.
Can You Extend Your Child’s Stay On Your Insurance?
Some states do allow you to apply for an extension of your child’s coverage beyond the age of 26 years old. This is known as a health insurance rider. You’ll need to apply for this rider option during the Open Enrollment period, and certain restrictions do apply.
For example, if you’re residing in the state of New York, you may request an extension of your child’s coverage until they reach their 30th birthday. How long can a child stay on your health insurance during an extension depends on New York’s restrictions. These include that your child:
- May not be married
- Must be under the age of 30 years old
- Isn’t eligible for an employer’s comprehensive insurance plan
- Is a resident of New York
Other states may have different restrictions such as the state of Pennsylvania. Health insurers stipulates you may request an extension as long as your child:
- Is no older than 30 years old
- Is unmarried
- Has no dependents of their own
- Is a resident of Pennsylvania or enrolled as full-time students
If you don’t live in New York or Pennsylvania and still want to find out if your child that’s older than 26 can be covered by your plan, then find out what your state allows. You’ll find a comprehensive list here.
Who Covers The Costs Of Extensions?
For parents who are not on an employer health plan, they’ll (the parents) cover all the costs pertaining to the extension of their child’s coverage. However, if the application was made on the employer’s health plan, then the costs are shared between the parents of the young adult and their employer.
What To Do When Your Child Turns 26
When your child turns 26, they must apply for their own health insurance plan. You may decide to apply for an extension if your state allows it and your child meets all the criteria. Otherwise, your child will need to look for other options.
Apply For A Job-Based Plan
If your child is employed, the first option is to discuss what health benefits their employer offers. Once your child has been removed from your plan, they may opt for their workplace insurance coverage. This is often the most inexpensive route to take. Your child will need to inform their employer’s human resources department of their intentions to apply.
This application may take place outside of the Open Enrollment period once your child has turned 26 years old. Turning down the opportunity to enrol in their job-base plan could mean your child will lose out on qualifying for a premium tax credit.
Get An Individual Marketplace Insurance Plan
Your child may stay on your plan until the end of the calendar year (December 31) even if they turned 26 in the middle of the year. Your child can then get their own health insurance during Open Enrollment. Bear in mind that Open Enrollment ends on the 15th of December.
However, if you’re on your employer’s health insurance plan, your child’s coverage will typically end in the month of their birthdate. Turning 26 is considered as a qualifying life event so Special Enrollment will be triggered. This will give them enough time to register for health insurance if they’re not covered by a job-based plan.
Consider A Student Health Plan
If your child is enrolling for school, speak to them about a student health plan. Some schools do offer this option and it’s often the most cost effective way to get basic insurance coverage. Being enrolled on a student health plan qualifies your child to be covered under the health care law.
Apply For Medicaid
If your child is earning a low income, starting up their own business, or facing certain life situations, they may apply for Medicaid. Depending on your child’s income level, they may qualify for low-cost insurance, free coverage, or low-cost coverage.
Apply For COBRA
If your employer’s health plan covers you for The Consolidated Omnibus Budget Reconciliation Act (COBRA), then your child can apply for continued coverage under your plan. However, this option only allows for 36 months coverage and is one of the most expensive ways to get short-term insurance cover.
How Can I Stay On My Parents’ Insurance After I Turn 26?
Once you turn 26, your parents can apply for an extension depending on your circumstances and the state laws.
Certain requirements will need to be met and these are also dependent on your state laws. These can include you being unmarried, having no dependents, being unemployed, residing in the state of application, and/or being enrolled as a full-time student in that state.
You can also apply for COBRA under your parents’ group coverage if applicable. Bear in mind, though, that this is only a short-term solution (36 months) and is often your most expensive option.
How Long Can I Stay On My Parents’ Insurance After I Turn 26?
If you apply for an extension on your parents’ health insurance plan and depending on your state’s laws, you may qualify to stay on your parents’ plan. Refer to your state laws to find out the age limits as each state has different age limits. The maximum age limit will be until you turn 30 years old.
How Much Is Insurance For A 26-Year Old?
The cost of you insurance plan is based on a number of variables including:
- The plan you select and tier
- Your medical history
- If you’re joining your employer’s health insurance plan
- Whether you’re applying for an individual or family coverage
- Your age
- The state you reside in
The average premium for a 26-year old person can be estimated at around $205 to $300 per month. However, this estimate varies depending on the factors mentioned above.
By law, implemented by ACA, your child can stay on your health insurance plan until they turn 26 years old. Thereafter, your child needs to assess the options available to them. As their parents, you can help them through this decision-making process and guide them in the right direction.
There are no restrictions preventing your child staying on your insurance plan before they turn 26. However, once they turn 26, a few options are available to them going forward. Knowing the different state laws will help you and your child if you wish to apply for an extension.
The information shared in this article will help both you as the parent and your child in deciding what can be done to get the best health insurance plan and how to be best prepared when your child reaches their 26th birthday.
Do you have children you need to take off your health insurance? What are your thoughts on today’s article? Let us know in the comment section below.