Q. I’m 24 and a graduate student. I can get health coverage through my university, but my father has an excellent plan at work, and he says that I until I’m 26, I can get insurance through his plan. If I do this, will his premiums go up?
A. Your father is right; young adults under 26 can get coverage through a parent’s plan even if their school (or their own employer) offers health insurance. HHS reported in 2016 that 2.3 million young adults gained coverage under their parents’ health plans between 2010 and 2013, when the ACA’s exchanges opened for business, and young adults are significantly more likely to be covered under a family member’s plan now than they were prior to the ACA.
For small group plans, insurers can charge a premium for each additional child on the plan (up to a maximum of three under the age of 21, but children age 21 and older can be charged an additional premium regardless of how many children are on the family’s plan). But large group plans often charge a flat rate for a “family plan.” In that case, adding another dependent does not necessarily hike premiums as long as there are already other children on the plan. If your father has other children on his plan, the price he pays may be the same regardless of whether he has one dependent or several. According to the Commonwealth Fund, the under-26 rule led to an increase of just 0.9 percent in group plan premiums in 2011, the first year after young adults were allowed to remain on (or rejoin) their parents’ plans.
But some insurers that offer large group coverage have begun charging per member for family coverage rather than a flat rate. Some also are moving away from a single deductible for the whole family and opting for a separate deductible for each family member.
Before you sign up, your father should ask his employer whether his premiums will change if he adds you to his plan. If so, you and he can crunch the numbers to see whether it makes more sense for you to get your own plan (either through the university or in the individual market) or obtain coverage under your father’s plan.
Keep in mind that open enrollment periods and special enrollment periods apply, regardless of where you get your coverage. Your university will let you know when you can enroll in the coverage it offers. Individual market coverage has an open enrollment period each fall, from November 1 to December 15. Your father’s employer likely has an open enrollment period sometime in the fall, but it may be at another time of the year. When the ACA first made it possible for young adults to remain on their parents’ health plans until age 2016, insurers and employers had to offer a special enrollment period, during which young adults could rejoin their parents’ health plans. But that was in 2010/2011. Currently, the option to rejoin your father’s plan would only be available during his plan’s annual enrollment period, or during a special enrollment period triggered by a qualifying event.