Health Insurance Options When You’re Turning 26

You lose your parents’ health insurance in California when you turn 26. If you’ve aged off your parents’ health plan, you may wonder what options you have.

Can I Stay on My Parents’ Health Insurance After 26?

With the Affordable Care Act, you can stay on your parents’ health insurance until age 26. If you’re about to reach that milestone birthday, you must prepare for what comes next.

Depending on your parents’ health insurance, you may be able to hold onto your coverage a little longer. If they have a policy through the ACA marketplace, you’ll stay on their plan through Dec. 31. That’s almost a whole extra year of coverage if you’re a January baby!

However, if your parents have an insurance policy through their work, your coverage will probably end on your birthday or at the end of that month.

Special Circumstances for Extended Coverage

How long can you stay on your parents’ health insurance, really? While the vast majority of young adults can only stay on family health insurance until age 26, there are a few circumstances in which you may be able to stay under their coverage past then, such as:

• You have a disability: Adults with certain disabilities will likely be able to stay on their parents’ insurance past age 26 or even indefinitely.
• State-based exceptions outside of California: Some states also allow people to stay on their parents’ insurance up to age 30 if they meet certain requirements, like being unmarried and not having any dependents. Unfortunately, this is not the case in California, but if you live or move to another state, it may be worth exploring your state’s laws and whether your parents’ insurance policy abides by them.

OK, I’m Not on Their Insurance Anymore. So What Are My Options?

California law requires qualifying health insurance for all state residents. After turning 26, you’ll need to secure your policy. Let’s look at your options.

First, your employer might provide health insurance through your job. If that’s the case, congratulations — you’re already set! Otherwise, you’ll want to check out the ACA marketplace.

You can get on a Covered California plan or apply directly with a health insurance carrier. If you end up on one of these plans, you’ll have plenty of options, including most of the major health insurance companies in California:

• If you want a PPO with many doctor options, choose Blue Shield or Anthem Blue Cross.
• If you want a high-quality HMO, Kaiser Permanente is currently popular.
• If you’re looking for affordability, you might choose Molina or another one of the low-cost HMOs offered in your area.

Exploring Insurance Options After Age 26

At age 26 and through your early 30s, most people are in the prime of their lives. Going through all these options and exploring what they have to offer may feel overwhelming and possibly even unnecessary — if you only go to the doctor once a year for a physical, what’s the point of shelling out money for more than you need?

Many freshly aged-out adults feel this way, which is why there’s another option for people in this transitional period of their lives. From ages 26-30, you can qualify for a minimum coverage health plan, commonly known as a catastrophic plan. This subset of insurance plans is one of the most affordable options on the market and generally covers preventive health visits and significant emergency medical bills. As their name suggests, they offer the minimal amount of coverage of almost any plan, so they are only a good option if you are healthy and can afford deductibles in case of emergency.

Can I Afford It?

If you file taxes, you could qualify for discounts when you enroll through Covered California. You may get upfront tax credits or even qualify for Medi-Cal — that’s Medicaid for those outside California. Many Californians get discounts that lower the price of coverage by 50%, 70%, 90% or more.

Financial Planning for Health Insurance Transitions

Insurance is an investment in your future, and as such, it will require some planning and budgeting for you to afford. As draw near to the family insurance age limit and you explore your options and look at the costs, there are a few things to keep in mind:

• Understand the hidden costs: It’s easy to simply look at the premiums, or monthly payments, your insurance will have and go with the cheapest option. However, looking at the other costs involved before you choose can save you thousands. Be sure to understand how deductibles, copayments and coinsurance costs will change the real cost of your insurance.
• In-network vs. out-of-network: If you have a preferred primary care provider or other doctor, it’s especially important to know whether they’re considered in-network with your insurance of choice. If they aren’t, you may be on the hook for the full cost of your appointments or have to schedule with a different provider that is in-network.

Can My Parents Pay for My Health Insurance?

Sure. Likely, they’ve already been paying for your medical insurance if you were on their plan. If they still want to pay for you, that’s fine — your insurance provider won’t care as long as they get the money. Make sure the bill goes to your parents if they’re paying it!

I Heard Open Enrollment Is Over. Can I Still Apply?

Yes, you can still apply because you have a qualifying life event. You must apply for coverage within 60 days of aging out of your parents’ plan.

Loss of coverage is the most typical life event, and that’s what’s happening to you — you turned 26 and aged off your plan. You can get coverage outside open enrollment during the special enrollment period.

OK. So What Do I Do?

You can get started on our website or call 877-752-4737. Press 2 to go straight to a person who can help you.

But wait — you’re young, so you probably want to do this online. Good news! You can get an instant quote by filling out our simple online form. You’ll need to enter your income information and household size, so be sure you have this year’s estimated household income handy.

For household size, put “1” if you’re single. Otherwise, count all the people you include when you file your taxes. If you’re married, you must file taxes as married filing jointly to qualify for a discount.

And that’s it! It’s quick and easy — fill out the form or make the phone call. You’ll get quotes for several insurance plans with no obligation.

We don’t require any contact information, which brings us to a little word of advice. If a website wants your email address or phone number before giving you a quote, run. They will sell your info to everyone under the sun, and your phone will start ringing off the hook.

How to Get a Discount

Be sure to click “Yes” on the online form to see if you qualify for a discount, usually referred to as a “government subsidy” or an “upfront tax credit.” “Upfront” is the key word. If you qualify for a subsidy, you’ll never have to pay the full price. You’ll just pay the discounted price each month as your health insurance premium.

Covered California bases some discounts on how your income compares to the federal poverty level.

• Medi-Cal: You should qualify for Medi-Cal if your yearly income is up to 138% FPL. If you have $0 income, you’re a ringer for this program!
• Silver 94: An annual income of 100% to 150% FPL qualifies you for the Silver 94 plan.
• Silver 87: You can qualify for the Silver 87 plan with an annual income between 150% and 200% FPL.
• Silver 73: If your yearly income is between 200% and 250% FPL, you can qualify for the Silver 73 plan.

But wait! Thanks to the American Recovery Act, you still qualify for subsidies with a high income! You can get a benchmark plan — the second-lowest-cost silver plan available to you — for no more than 8.5% of your income.

How Do I Pay?

First, you’ve got to get a quote and apply. Then, you can pay immediately or wait to get your bill in the mail. Pay by check or credit card, or set up auto-pay with the health insurance carrier.

Celebrate Turning 26 With a Health Insurance Quote From Health for California

Finding an affordable, comprehensive insurance policy can be painless when you have the right help. At Health for California, we make it easy to compare plans and find the best one for you. Our licensed agents have certification from the California Department of Insurance and Covered California, so you can trust they know their stuff. We’ll help you calculate your discount, choose a plan and tackle the application process.

Get your free quote with our fast and simple online application, or call 877-752-4737 to get a quote by phone.