Can children stay on a parent’s plan until age 26?
If a plan covers children, they can be added to or kept on a parent's health insurance policy until they turn 26 years old.
Children can join or remain on a parent's plan even if they are:
- not living with their parents
- attending school
- not financially dependent on their parents
- eligible to enroll in their employer’s plan
These rules apply to both job-based plans and individual plans you buy yourself, inside or outside the Marketplace.
How to get coverage for adult children
Adult children may be enrolled during a plan’s Open Enrollment period or during other special enrollment opportunities. The employer or insurance company can provide details.
When you apply for a new plan in the Marketplace, you can usually sign up your under-26-year-olds on the same application. Be sure to include them on the list of people to be covered.
Important: If your child under 26 is not your dependent for tax purposes, you’ll need help to fill out your application correctly. This is true only if you or anyone who'll be part of the same application wants to qualify for premium tax credits and lower out-of-pocket costs based on household size and income.
If this applies to your situation, contact the Marketplace call center at 1-800-318-2596 (TTY: 1-855-889-4325). Explain your situation and the representative will tell you how to fill out your application.
Does it cost more to insure an under-26-year-old?
It depends. For coverage that covers any number of dependents for a set price, there may be no additional cost. If the insurance offers dependent coverage as an option for additional cost, the premium may rise when the child is signed up. The insurance company can provide details.
What if my plan doesn't cover dependents?
If your employer's plan doesn't offer coverage to dependents, then the plan doesn't have to cover your child under 26.
What if my child under 26 isn't covered at all?
What if a young adult turns 26 mid-year?
Her coverage ends on her 26th birthday. She may switch to employer coverage or get a Marketplace health insurance plan. When her coverage ends she'll qualify for a special enrollment period so she can enroll outside of open season. If she doesn't get insurance in 2014, she may have to pay a fee. Because she is under 30, she may qualify to buy a “catastrophic” plan with a lower premium but a very high deductible.
What if my child dropped off my plan already?
During your next open enrollment period you can put her back on your plan until she turns 26.
What happens when a child turns 26?
The health care law requires insurers to allow young adults to remain on a parent's plans only until their 26th birthday.
Do I have to cover my under-26-year-old?
No. If you don’t cover your under-26-year-old on your plan, she has the same options as anyone else who doesn’t have insurance, including getting a private health insurance plan through the Marketplace. Depending on her income, she may qualify for lower costs on monthly premiums and out-of-pocket costs, or for Medicaid coverage. If she doesn’t have health coverage, she may have to pay the individual shared responsibility penalty for not being insured.
If a child under 26 can be covered under a parent’s policy, can she get lower costs on Marketplace insurance based on income?
It depends on whether the child is included as a dependent in the parent’s tax household.
If the under-26 child is included in the parent’s tax household, - and she has access to a parent’s job-based coverage - she isn’t eligible for lower costs on a Marketplace plan based on her income. This is because she has access to job-based coverage.
If the child files taxes herself, then she may be eligible for lower costs on a Marketplace plan based on her income. This is true even if she has access to a parent’s job-based coverage. But if the child is enrolled in a parent’s job-based coverage, she isn’t eligible for lower costs on a Marketplace plan.