What Should I Do When I Turn 26 and Need My Own Health Insurance?
When it comes to health insurance, turning 26 is a milestone. Why? Until your 26th birthday, you are eligible for coverage under an enrolled parent’s health insurance plan, even if you are married, not in school, or not living with them. But once you turn 26, you age out and aren’t eligible for their plan anymore.
What Are My Options?
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Enroll in Job-Based Coverage. If you are employed, and your employer offers health benefits, you may qualify to enroll in health insurance through your employer.
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Once you turn 26, you may be able to sign up for your job’s health insurance plan. Your birthday does not need to fall inside of the usual enrollment period.
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Employers usually pay a portion of your premium or the amount paid to an insurer for coverage.
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- Enroll in a Health Insurance Marketplace Plan. The federal government operates the Health Insurance Marketplace. Some states run their own Marketplaces. You can apply at HealthCare.gov or your state’s Marketplace website.
- During the application process, you will find out if you are eligible for Medicaid or the Children’s Health Insurance Program (CHIP). If you have limited income or are pregnant, you may qualify.
- These plans are independent of your employer, so you will have to pay the premium on your own. When you apply, you may qualify for subsidies.
- If someone claims you as a tax dependent, you can buy a plan through the federal or state Marketplace, but you won't qualify for savings based on your income.
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Student Health Plans. If you are under 30 and enrolled in school, you may be eligible for a student health plan. Contact your school’s health services department to explore this option.
How Long Do I Have to Enroll?
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If you are on your parent’s employer-based plan, coverage usually lasts through the month of your 26th birthday. For example, if your birthday is on May 1, you’ll have coverage through May 31.
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If you are on your parent’s Marketplace plan, coverage ends Dec. 31 during the year you turn 26 no matter when your birthdate is. If you want to enroll in your own Marketplace plan, you can do so during open enrollment (Nov. 1 – Jan. 15 every year).
What Should I Consider When Choosing a Plan?
- The NAIC’s Health Insurance Shopping Tool can help determine which plan is right for you. The Marketplace also has guidance on choosing a plan.
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Be careful! Some products aren’t health insurance and aren’t required to protect consumers in the same way as insurance. Health care sharing ministries (HCSMs), discount plans, or risk-sharing plans are not insurance products and are not governed by consumer protection laws.
About the National Association of Insurance Commissioners
As part of our state-based system of insurance regulation in the United States, the National Association of Insurance Commissioners (NAIC) provides expertise, data, and analysis for insurance commissioners to effectively regulate the industry and protect consumers. The U.S. standard-setting organization is governed by the chief insurance regulators from the 50 states, the District of Columbia and five U.S. territories. Through the NAIC, state insurance regulators establish standards and best practices, conduct peer reviews, and coordinate regulatory oversight. NAIC staff supports these efforts and represents the collective views of state regulators domestically and internationally.