NWPC Blog

How to get Health Insurance After Your 26th Birthday

In 2010, the Affordable Care Act (ACA) expanded access to health care to millions of young adults by allowing parents to cover their children until they turn 26. What happens to your insurance after 26? Depending on your plan, you could lose coverage the day after your birthday or continue the special enrollment period that may give more time to find new benefits.

Whether you’re looking to buy insurance from HealthCare.gov or getting a new plan from an employer, here’s how to get health insurance after your 26th birthday.

What happens to your health insurance when you turn 26?

In general, you’re no longer covered under your parents’ insurance, but there are some exceptions. We recommend checking with the National Conference of State Legislatures to learn about your state’s insurance laws and consulting with your current provider to know exactly when your coverage will end. Depending on your insurance, you may have health care until the end of your birthday month or even tax year. This is contingent on whether or not the plan you’re covered on is from a parent’s job or through the Health Insurance Marketplace.

Here are the general rules for staying on your plan as a young adult:

If you are covered by a plan from a parent’s job: Your benefits typically end either on your birthday or shortly after turning 26, depending on the job-based plan.

If you’re covered by a parent’s Health Insurance Marketplace plan: You can stay on your parent’s plan until December 31 – even if you have a mid-year birthday.

Each insurance policy differs with how they handle dependents aging off their parents’ plans. So, it’s important to research your benefits a few months ahead of your 26th birthday to make sure you don’t experience a lapse in coverage.

How long do you have to get health insurance after turning 26?

You can only enroll in a plan from the federal health insurance marketplace during their open enrollment period, which is usually from November to January. However, you get an exception when you turn 26 by qualifying for a life event that could trigger a special enrollment period.

If you’re covered by your parents’ employers, you have about four months to find a plan through the Health Insurance Marketplace—60 days before you lose coverage and 60 days afterward. Your new insurance will start at the first of the month after picking a plan.

If you’re struggling to afford insurance, you may also qualify for Medicaid, Medicare (if you have certain medical conditions) or CHIP (if you’re a pregnant mother). You can apply for these government-assisted health insurance programs at any time depending on your state.

If your own employer offers insurance, turning 26 could also trigger a special enrollment period in the company’s program. Consult with your human resources department before your birthday to learn if this an option. Married individuals may also be able to opt into their spouses’ plans within 30-days of losing their coverage as well.

Can I stay on my parents’ insurance after 26?

Unless you live in one of the few states that let you remain on your parents’ insurance plan until you’re 30, you may need to find another option. If you love the coverage you’re getting under your parents’ employer, you can elect for a special insurance plan called COBRA for up to 36 months. COBRA lets you stay under your same insurance plan temporarily, but costs are no longer subsidized by your parents’ employer, so it tends to be a more expensive option.

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What are my coverage options?

Besides COBRA, you have a number of other options to consider when shopping for coverage after 26:

  • Catastrophic Plans: If you’re under 30 or qualify for an affordability exception, a catastrophic plan ensures you have insurance if the worst happens. It also boasts affordable monthly premiums, but you may have higher deductibles outside of free preventative care and primary care visits.
  • Employer Coverage: Most Americans access health care through their jobs. Talk with your current employer about their benefits program to learn more about job-based plans.
  • Marketplace Plans: You receive more customized coverage that suits your health care needs and budget. You may also qualify for subsidies if you’re not a tax dependent or meet specific income requirements.
  • Medicaid & CHIP: You get access to affordable or free health care. However, you need to prove that you meet certain criteria, including income, disability and employment standards in most states. Your coverage may fluctuate depending on who’s in office, especially if you’re seeking women’s health care or another politicized service.
  • Student Plans: If you’re enrolled in college, your university could be offering affordable insurance to students. These benefits typically offer cost-effective and comprehensive coverage designed to meet the unique needs of students.

Can I just go without insurance?

If you’re young and healthy, it can be tempting to save money by not finding a new insurance plan after 26. However, accidents can strike at any time and paying in full for medical bills out-of-pocket can add up quickly. We encourage you to find immediate coverage to avoid lapses in care in case of an emergency.

Have more questions about what happens to your health insurance after you turn 26? NWPC is here to help. Contact us or visit one of our Portland offices for more information.