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Just Turned 26? What You Need to Know About Health Insurance Plans

by | Jun 11, 2023 | Articles, Health Insurance | 0 comments

First of all, happy 26th birthday! 

Having to pay for your health insurance now may not be the best birthday gift, but here is what you need to know…

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    When You Turn 26, When Does Health Insurance End? 

    In the United States, hitting the big 26 is a bit like crossing a health insurance threshold. Up until that age, thanks to the Affordable Care Act (ACA), you’re usually allowed to ride on your parents’ health insurance plan. It’s like a safety net that ensures you have access to healthcare when you’re stepping into the world as a young adult.

    But, here’s the thing – once you blow out the candles on your 26th birthday cake, your eligibility for coverage under your parents’ plan usually comes to an end. It’s like a gentle nudge into the realm of adulting, especially when it comes to healthcare.

    Now, I know this might sound a bit daunting, but don’t worry! There are plenty of options to keep you covered. Many jobs come with health insurance benefits, which can become your new best friend in terms of coverage. However, if your job doesn’t offer health benefits, there is the public and private healthcare marketplace where you can purchase a health plan for yourself. It’s like shopping for your health – and who doesn’t love that?

    And hey, if your income is on the lower side, you might even qualify for Medicaid, a kind of health insurance hug from the government.

    Here are some other things you need to know about health insurance plans when you turn 26 years old:

    If you’ve just turned 26, there are some important things to know about health insurance plans:

    1. You can no longer stay on your parent’s health insurance plan: Under the Affordable Care Act (ACA), young adults can stay on their parent’s health insurance plan until they turn 26. However, once you turn 26, you are no longer eligible to be covered by your parent’s plan. Some states and some programs may have exceptions and variations to this rule.

    2. You may qualify for a Special Enrollment Period: When you turn 26, you have a 60-day window to enroll in a new health insurance plan through the Health Insurance Marketplace. This is called a Special Enrollment Period (SEP). There are other private plans available if you happen to miss this window, or don’t like any of the public market plans available to your in your state.

    3. You may be eligible for financial assistance: Depending on your income, you may be eligible for financial assistance, from the government, to help pay for your health insurance premiums. You can apply for financial assistance through the Health Insurance Marketplace at healthcare.gov or healthsherpa.com.

    4. You have a variety of plan options: When you enroll in a new health insurance plan, you can choose from a variety of plan options, including different levels of coverage (such as bronze, silver, gold, or platinum) and different types of plan networks (such as HMOs, PPOs, or EPOs). Within these network access types, there are different coverage levels.

    5. You can seek help from a health insurance advisor (like me!). These professionals can help you understand your options and enroll in a plan that meets your coverage needs and budget.

    When you turn 26 and get kicked off your parent’s health insurance plan, there are several steps you can take to obtain health insurance coverage:

    1. Check if you can get coverage through your employer: If you have a job that offers health insurance benefits, check with your employer to see if you’re eligible for coverage. Many employers offer health insurance to full-time employees. If they don’t, ask for a health insurance stipend towards your individual plan.

    2. Consider purchasing an individual health insurance plan: You can purchase an individual health insurance plan through the Health Insurance Marketplace or directly from a private health insurance company. You can enroll in a plan during the Open Enrollment Period or during a Special Enrollment Period if you experience a qualifying life event. Some companies don’t have an open enrollment period.

    3. Check if you’re eligible for Medicaid: If your income is low, you may be eligible for Medicaid, which provides free or low-cost health insurance. You can check your eligibility on your state’s Medicaid website or healthcare.gov.  

    4. Look into short-term health insurance plans: If you need temporary coverage while you search for a long-term plan, you can consider a short-term health insurance plan. These plans typically have lower premiums but may not cover all of the same benefits as a comprehensive plan.

    5. Seek assistance from a health insurance advisor (hi!) if you need help figuring out which plan to sign up for. These professionals can help you understand your options and enroll in a plan that meets your needs and budget.

    Is Turning 26 a Qualifying Life Event? 

    Turning 26 is a key moment that shakes up the health insurance game in the United States. It’s like a door swinging open to a Special Enrollment Party (SEP). This party is all about giving you another shot at enrolling in a health insurance plan, even if it’s not the usual enrollment season.

    So, picture this: you’ve blown out the candles, had your cake, and suddenly you’re not covered by your parents’ insurance anymore. Guess what? You’re now the VIP guest at the Special Enrollment Period extravaganza.

    This means you’ve got a limited window – around 60 days – to explore your options and hop onto a new health insurance plan. Whether you’re rocking a job with health benefits or want to check out what the ACA marketplace has to offer, it’s your chance to score coverage that suits your needs.

    Here’s the deal: missing out on this Special Enrollment shindig could leave you without coverage and facing potential healthcare expenses. That’s definitely not the kind of party you want to attend.

    So, mark your calendar when you’re turning 26, and remember that this event isn’t just about celebrating another year older – it’s about celebrating your ability to take charge of your health insurance destiny. 

    And even if you miss it, there are plans and options for you in the private health insurance market, not to worry!

    Is There a Grace Period To Getting Health Insurance When I Turn 26? 

    When you turn 26 and your parents’ insurance coverage isn’t giving you a lift anymore, you do get a little window of time known as a “Grace Period.”

    This Grace Period gives you some breathing room, usually about 60 days, to sort out your new health insurance situation. It’s like a safety net, a little extra time to explore your options and make a choice that fits your needs.

    During this Grace Period, you can check out job-based health plans if your workplace offers them. If that’s not your jam, you can also take a look at the health insurance marketplace established under the ACA or the private market. It’s like having a menu of options to choose from.

    But (and here’s the important part), don’t dawdle too much during the Grace Period. If you miss this window of opportunity, you might have to wait for the next regular enrollment period, which could leave you without coverage and potentially facing some unplanned healthcare costs.

    So, while you’re basking in the glow of being 26, remember that the Grace Period is your friend. It’s there to help you transition smoothly into your own health insurance setup. Take advantage of it, explore your choices, and keep that coverage train rolling. 

    It’s important to note that going without health insurance can be risky and expensive. Unexpected medical expenses can be financially devastating without insurance coverage. In fact, 58% of bankruptcy is due to medical debt from unexpected costs.

    So, when the balloons drop and the confetti settles on your 26th birthday, remember that it’s not just a year older you’re getting, but a step closer to managing your own health insurance. It might seem like a lot, but it’s all part of the journey into the world of responsible grown-upping. You got this! 

    Still confused? Work with an experienced, licensed health insurance advisor with a medical background, who specifically helps young adults aging out of a parent’s health insurance plan. 

    Book a quick 15-minute health insurance consultation with me.

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