How long can you stay on your parents’ insurance? What young adults should know before turning 26

How long can you stay on your parents’ health insurance?

Young adults can stay on a parent’s health insurance until age 26 under the Affordable Care Act (ACA) – also known as Obamacare. You can remain on a parent’s plan until age 26 even if you:

• Live in a different state
• Are not financially dependent on your parents
• Are not a student
• Have access to other coverage
• Are married

Below, we explain more about how the ACA’s ‘age 26 rule’ works, when coverage typically ends, possible exceptions, and the health insurance options available once you need your own coverage.

When will I get kicked off my parents’ insurance?

This varies by plan, so you’ll need to contact the plan for specifics.¹

Coverage could end:

• On your 26th birthday
• On the last day of the month that you turned 26
• On the last day of the plan year that you turned 26 (Employer-sponsored plans don’t have to follow the calendar year, so this could be any month.)
• On December 31 of the year when you turned 26. This will be the case if the policy was obtained via HealthCare.gov.²
  

Must all health plans follow the ‘age 26 rule’?

The ACA doesn’t require small-group health plans to offer dependent coverage, although most of them do. Large-group plans must offer coverage to full-time employees and their dependents to comply with the ACA’s employer mandate.³ Plans that do offer dependent coverage must allow adult children to remain on a parent’s plan until age 26, regardless of whether the young adult lives with the parent, is financially dependent on the parent, has other coverage options, is a student, or is married.⁴

The requirement to allow young adults to remain on a parent’s plan until age 26 applies to all individual-market plans and all employer-sponsored plans,⁵ including grandfathered plans.⁶

Are there exceptions to the ‘age 26 rule’?

Plans that are not regulated by the ACA – including short-term health insurance and “excepted benefits” – do not have to allow dependent coverage to continue until age 26.

On the other hand, some states require fully insured group health plans to allow young adults to remain on a parent’s health plan past the age of 26. There are varying rules for this, so it depends on whether the young adult is disabled, living with the parent, going to school, married, etc.⁷

Even in states that have rules allowing young adults to stay on a parent’s plan past age 26, state rules don’t apply to self-insured plans, which cover the majority of people with employer-sponsored health insurance.⁸ So it’s always a good idea to contact your plan to inquire about the specifics, rather than assuming you can remain covered.

Do you have to wait for an open enrollment period to get your own coverage?

No. Losing coverage under a parent’s health plan when you turn 26 makes you eligible for a special enrollment period. This allows you to enroll in a new health plan outside the regular open enrollment window each fall.

You generally have 60 days before your coverage ends or 60 days after it ends to enroll in an individual health insurance plan through the Marketplace or directly from an insurer.

If your employer offers health insurance, losing coverage on your parent’s plan also allows you to enroll in your employer’s group plan. In most cases, you’ll have about 30 days to sign up through your employer.

To avoid a gap in coverage, it’s best to enroll before your coverage on your parent’s plan ends. If you sign up in advance, your new plan can start the first day after your existing coverage ends. If you wait until after your coverage ends, your new plan will typically begin the first day of the following month.

Approaching age 26 and considering Marketplace coverage? Explore plans and coverage here.

If I stay on my parent’s plan, will it cover my spouse and children?

If you are married or have a child, your parent’s plan is not required to cover your spouse or child. They will typically need their own separate coverage if you’ve chosen to remain on a parent’s policy.¹² If a young adult has a child while still covered under their own parents’ health plan, they will likely need to secure separate coverage for the baby.

And if they get married, they will likely not be able to add their spouse to their existing coverage. CHIP or Medicaid may be available for the baby, depending on income. And either of those events – marriage or the birth of a baby – would count as a qualifying life event that would allow the young adult to disenroll from their parents’ health plan and enroll in a new health plan together with their spouse and/or new baby. The new health plan could be an employer-sponsored plan or a plan obtained in the Marketplace/exchange.

What did coverage look like for young adults before the ACA?

Before the ACA took effect, young adults often lost access to their parents’ health insurance much earlier – typically when they graduated from college or turned 19, depending on the plan’s rules.

The ACA changed that in 2010. The change had a measurable impact on coverage among young adults. Federal data show that the number of insured people ages 19 to 25 increased by about 5.5 million between 2010 and 2015.¹³ Much of that early gain occurred before the ACA’s Marketplace and subsidy programs began, suggesting that many young adults gained coverage by remaining on their parents’ health plans.

There is still a substantial spike in the uninsured rate around age 19 and age 26.¹⁴ The spike at age 19 is because Medicaid/CHIP eligibility guidelines are much more generous for people age 18 and younger, so many people no longer qualify for that coverage once they turn 19.¹⁵ The spike at age 26 is because young adults are no longer eligible for coverage under a parent’s health plan.¹⁶

Before age 26, is it better to stay on my parents’ plan or get my own?

Allowing young adults to stay on their parents’ insurance adds an extra coverage option for people at the start of their careers. But that does not mean that remaining on a parent’s health plan is always the best choice.

If a family has minor children as well as young adult children under age 26 – and if their premium is one family rate regardless of how many children are on the plan – it might make sense to keep the young adult members on the policy until age 26, unless the young adult lives in a different area where the family’s plan doesn’t have any in-network providers.

But if the only dependents on the plan are young adults, or if the premium is based on the number of dependents, there are other considerations to take into account. Some employers contribute only to employees’ coverage, with dependents’ premiums entirely payroll-deducted. In that case, the total premium cost to insure the whole family (including the employer-sponsored plan plus individual plans for some family members) might be lower if young adults get their own coverage in the individual market.

This is especially true for young adults with relatively low incomes who qualify for a subsidy in the exchange, or for premium-free coverage via Medicaid. If your parents do not claim you as a dependent on their tax return, you can apply for a policy in the exchange, with subsidy eligibility based on your income alone. If your parents do claim you as a dependent, your subsidy eligibility is based on the entire household’s income. (Here’s an FAQ that explains how premium subsidies are calculated in situations like this).

If your parents have Marketplace coverage, it’s important to understand how premium subsidies are calculated, and how household size (number of people on the tax return) and total household income will affect Marketplace subsidy eligibility.

Learn more about subsidy calculations when only some members of a household enroll in Marketplace coverage.

If you have an offer of coverage from your own employer, you might find that it’s an affordable way of obtaining your health coverage with an adequate provider network in the area where you live and work.

Special considerations: Provider networks and maternity coverage

If you don’t live in the same area as your parents, it might make more sense to shop for your own policy, since the provider network for your parents’ plan may be limited in your area. And although maternity coverage is now included on virtually all plans, it’s not required for dependents on large-group plans. Getting your own policy guarantees that you’ll have maternity coverage if that’s something you’re concerned about.

If you’re not yet 26 and you still have coverage on a parent’s plan, you can shop for your own individual-market plan during the annual open enrollment period (in most states, that’s November 1 to December 15, although state-run Marketplaces have the option to extend the deadline to as late as December 31), or if you experience a qualifying life event, such as moving to a new area where different health plans are available.¹⁷ You can also enroll in your own employer’s plan if that option becomes available to you.