When Do You Get Kicked Off of Parents Insurance?

It appears you’re looking for information about when young adults are removed from their parents’ health insurance, and what options they have for new coverage. This is a common and important transition point for many.

The 26-Year-Old Rule

The Affordable Care Act (ACA) allows young adults to remain on a parent’s health insurance plan until their 26th birthday. This federal provision applies to most private health insurance plans, including those obtained through employers or the Health Insurance Marketplace.

This rule applies universally, regardless of the young adult’s other circumstances. Whether the young adult is married, living with their parents, financially dependent, or enrolled as a student does not affect their eligibility. Even if eligible for employer-sponsored health insurance, they can still choose to remain on their parent’s plan.

Specific Circumstances Affecting Coverage

Some variations and exceptions to the 26-year-old rule exist. Certain states have laws allowing dependents to remain on a parent’s plan beyond age 26. These conditions can vary significantly by state and may include being unmarried, a full-time student, or financially dependent.

Individuals with certain disabilities may continue coverage on a parent’s plan indefinitely if they meet specific criteria. This requires the disability to prevent self-support and to have begun before age 26. Documentation, such as physician statements and proof of financial dependency, is required, and ongoing recertification may be necessary.

When Coverage Actually Ends

The timing of coverage termination depends on the health insurance plan type. For most employer-sponsored plans, coverage ends at the end of the month in which the dependent turns 26. For example, if a young adult’s birthday is in mid-May, their coverage continues until May 31.

If the parent’s plan is through the Health Insurance Marketplace, coverage extends until December 31 of the year the dependent turns 26, regardless of their specific birthday. Families should understand their plan’s termination date to avoid a gap in coverage. The insurance company or employer provides notification about impending termination and available options.

Your Options for New Coverage

Losing health insurance coverage due to aging off a parent’s plan is a “qualifying life event.” This triggers a Special Enrollment Period (SEP), allowing enrollment in a new health insurance plan outside the annual Open Enrollment Period. This SEP begins 60 days before the loss of coverage and extends for 60 days after coverage ends.

One option is to enroll in an employer-sponsored health plan if available through one’s job. Employers offer a range of plans and often contribute to premium costs, making these plans cost-effective. Enrollment can be done outside the usual open enrollment period due to the qualifying life event.

Individuals can also explore plans on the Health Insurance Marketplace, accessed through Healthcare.gov or state-specific websites. Depending on income and household size, individuals may be eligible for financial assistance, such as Premium Tax Credits and Cost-Sharing Reductions, which can significantly lower monthly premiums and out-of-pocket expenses. While there is no income limit to purchase a Marketplace plan, subsidies are tied to income levels relative to the federal poverty level.

Another option is COBRA continuation coverage, allowing individuals to temporarily maintain their existing health plan from their parent’s employer for a limited time, up to 18 or 36 months. While COBRA provides continuity of care, it can be expensive as the individual is responsible for the full premium, plus an administrative fee. For those with very low incomes, Medicaid may be an option, depending on state eligibility rules.