The Young Adult’s Guide to Turning 26

At Pilichowski Insurance, we are your partner when you turn 26, and beyond.

What You Need to Know About Turning 26

Turning 26 can be a time of change for many young adults aging out of parent-based coverage. Continue reading to learn what you need to know about transitioning off your parents’ plan, exploring new options, and staying insured.

Insurance Changes for Young Adults Aged 26

Under the Affordable Care Act (ACA), young adults can remain on their parent’s health insurance plan until age 26. Once you reach this age, your coverage typically ends. This coverage can end on one of three dates:

• Your birthday
• The last day of your birth month
• The last day of your plan year

It’s essential to understand when your coverage will end so you can prepare to enroll in a new plan before you lose your current one.

Health Insurance Options After Turning 26

Employer-Sponsored Health Insurance

If you’re employed, check if your job offers health insurance benefits. Employer-sponsored plans are often more affordable than individual plans because employers typically share the cost of premiums.

ACA Marketplace Plans

The ACA Marketplace offers a variety of health insurance plans tailored to different needs and budgets. Losing coverage under your parents’ plan qualifies you for a Special Enrollment Period (SEP), allowing you to enroll in a plan outside the regular Open Enrollment Period.

Medicaid

If your income falls below a certain threshold, you may qualify for Medicaid, a free or low-cost health insurance program.

Catastrophic Health Plans

If you’re under 30 or qualify for a hardship exemption, you may be eligible for a catastrophic health plan.

COBRA Continuation Coverage

COBRA allows you to temporarily continue coverage under your parents’ employer-sponsored plan for up to 36 months.

Important Deadlines & Enrollment Periods

There are multiple opportunities when you turn 26 to enroll in new coverage:

• Special Enrollment Period (SEP): Starts when your coverage under your parents’ plan ends and lasts for 60 days
• Open Enrollment Period: Typically runs from November 1st to December 15th, depending on your state
• Employer Enrollment Periods: Check with your employer for specific dates if you’re eligible for workplace coverage

Tips for Choosing the Right Health Insurance Plan

One of the most important steps before finding the right plan is to assess your health insurance needs. Review the following:

• Health Status: Do you visit the doctor frequently or take prescription medications?
• Budget: How much can you afford in monthly premiums, deductibles, and copays?
• Provider Preferences: Who are your preferred doctors and providers?

Then, compare and contrast:

• Premiums vs. Deductibles: Lower premiums often mean higher deductibles and vice versa. Choose a balance that works for your financial situation.
• Benefits: Look for additional perks like telehealth services, wellness programs, or mental health coverage.
• Networks: Ensure the plan’s provider network includes your preferred healthcare providers.

There are also many subsidies available to lessen the burden of healthcare costs for you and your family. Consider those in your comparison planning. If you’re unsure which subsidies you qualify for, contact our team!