Does Medicare Cover Dependents Under 26?

Medicare is a federal health insurance program in the United States. It provides health coverage for specific populations, primarily individuals aged 65 or older. The program also extends to younger people with certain disabilities and specific medical conditions.

Medicare Eligibility Rules

Medicare eligibility is based on an individual’s own qualifications, not on their status as a dependent. The most common pathway is reaching age 65, provided the individual is a U.S. citizen or legal resident who has lived in the U.S. for at least five years. Eligibility at age 65 requires having worked and paid Medicare taxes for a specified period, typically 10 years, which earns premium-free Medicare Part A.

Medicare coverage can also begin for younger individuals with disabilities. This applies to those who have received Social Security Disability Insurance (SSDI) benefits for at least 24 months. Individuals diagnosed with End-Stage Renal Disease (ESRD), which is permanent kidney failure requiring dialysis or a transplant, or Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease, can qualify for Medicare regardless of age and without the 24-month waiting period.

How Medicare Differs for Family Coverage

Many people are familiar with the Affordable Care Act (ACA) provision allowing young adults to remain on a parent’s private health insurance plan until age 26. This rule does not apply to Medicare.

Medicare functions differently from private health insurance plans that often cover entire families under a single policy. It is a social insurance program with distinct individual eligibility requirements. A person qualifies for Medicare based on their own age, disability status, or specific health condition, not through a parent’s Medicare enrollment. Even if both spouses are enrolled, they each have their own individual plan.

Health Coverage Options for Young Adults

For young adults under 26 who do not qualify for Medicare, several other health coverage options are available. A common choice is to remain on a parent’s private health insurance plan, whether employer-sponsored or purchased through the Health Insurance Marketplace, until their 26th birthday.

Young adults can also secure health insurance through their own employer if offered benefits. Alternatively, they can purchase a plan directly from the Health Insurance Marketplace, where they may be eligible for subsidies based on income to help reduce premium costs. Medicaid is another possibility for those who meet income and other eligibility requirements in their state, offering free or low-cost coverage. Students in higher education may also have access to health plans offered by their colleges or universities.