Aging off a parent’s health plan at 26 is one of the most common triggers for young adults to shop for individual health insurance for the first time. Here’s what to expect and how to navigate the transition smoothly.
When Does Coverage End?
Under the ACA, you can stay on a parent’s health plan until the end of the month in which you turn 26. Some plans cover through the end of the plan year — check with the employer’s HR department to confirm the exact termination date.
You Have a Special Enrollment Period
Losing coverage from a parent’s plan is a qualifying life event. This gives you a Special Enrollment Period (SEP) of 60 days before or after your coverage ends to enroll in a new plan — you don’t have to wait for the November–January open enrollment window.
Don’t wait until your coverage actually ends. Start shopping at least 30 days before your 26th birthday so your new coverage starts immediately after the old coverage ends.
Your Options
- Employer-sponsored coverage: If your employer offers health insurance, your turn-26 event qualifies you to enroll even outside of regular open enrollment. This is often the best-value option.
- ACA marketplace: If your employer doesn’t offer coverage or the employer plan isn’t affordable, the marketplace is your next stop. Depending on your income, you may qualify for premium tax credits.
- Medicaid: If your income is at or below 138% of the Federal Poverty Level (in states that expanded Medicaid), you may qualify for free or very low-cost Medicaid coverage.
- COBRA: You can continue on your parent’s plan via COBRA for up to 36 months — but at full premium cost plus 2% administrative fee, which is usually very expensive.
Don’t Go Uninsured
A gap in coverage between your parent’s plan ending and your new coverage starting is a real financial risk. One ER visit without insurance can cost thousands of dollars. Plan the transition carefully so there’s no gap.
Contact Garden State Benefits to get help finding the right individual plan before your 26th birthday coverage ends.