If a plan covers children, they generally 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 claimed as a dependent on their parent’s tax return
- Eligible to enroll in their employer’s plan
These rules apply to both job-based plans and individual plans bought inside or outside the Marketplace.
Note: Some states and plans use different maximum coverage ages. Check with your plan to find out how long an adult child can stay on your plan.
When a child turns 26
If they're covered by their parent's Marketplace plan
- They can stay on their parent’s policy until the plan year ends on December 31.
- If they’re no longer their parent’s tax dependent when coverage ends December 31, they can enroll in a Marketplace plan themselves for the next year during Open Enrollment.
- They may qualify for premium tax credits and other savings based on their own income.
If they’re covered by a parent’s job-based plan
- Their coverage usually ends during their 26th birthday month. Check with the plan or the employer’s company to find out exactly when the coverage ends.
- If they lose coverage this way, they qualify for a Special Enrollment Period. This means they can enroll outside the yearly Open Enrollment Period. Their Special Enrollment Period starts 60 days before their birthday.
- If they enroll before their 26th birthday, coverage can start as soon the first day of the month they lose coverage.
- If they enroll during the 60 days after their birthday, coverage can start the first day of the month after they pick a plan. They may qualify for premium tax credits and other savings based on their own income.
Remember if they aren’t covered for any part of the year, they may have to pay a fee.
- How do I get coverage for a child under 26?
Adult children may be enrolled in a parent’s plan during the plan’s Open Enrollment period or during other enrollment opportunities. When a parent applies for a new plan in the Marketplace, they can usually sign up an under-26-year-old on the same application. They should include them on the list of people to be covered.
- For job-based coverage, the employer or insurance company can provide details.
- What if the child under 26 isn’t a dependent?
If a child under 26 isn't a dependent for the parent’s tax purposes, the child should fill out their own application to apply for a tax credit. They can select the same plan, if they choose, but will be on a different policy.
- Note: This is true only if anyone on the same application wants to qualify for premium tax credits and other savings based on household size and income. The same rules apply for all tax dependents. For example, children who claim their parents as tax dependents on their tax return need to follow these instructions.
- In this case, contact the Marketplace call center at 1-800-318-2596 (TTY: 1-855-889-4325). The representative will explain how to fill out the 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 it doesn't have to cover your child under 26.
- What if my child dropped off my plan already?
During your plan’s next Open Enrollment period you can put them back on your plan until they turn 26.
- Do I have to cover my under 26 year old?
No. If you don’t cover your under-26-year-old on your plan, they have the same options as anyone else who doesn’t have coverage, including getting a private health insurance plan through the Marketplace. Depending on their income, they may qualify for lower costs on monthly premiums and out-of-pocket costs, or for Medicaid coverage. If they don’t have health coverage, they may have to pay the fee for not being insured.
- If a child under 26 can be covered under a parent’s policy, can they get lower costs on Marketplace insurance based on income if they apply themselves?
It depends on whether the child is included as a dependent in the parent’s tax household.
- If the under-26 child is a dependent in the parent’s tax household — and if they have access to a parent’s job-based coverage that’s affordable and pays for a certain percentage of benefits — they aren’t eligible for lower costs on a Marketplace plan. This is because they have access to job-based coverage.
- If the child isn’t a dependent in the parent’s tax household, they may be eligible for premium tax credits and other savings on a Marketplace plan based on their income. This is true even if they have access to a parent’s job-based coverage. But if they are enrolled in a parent’s job-based coverage, they’re not eligible for lower costs on a Marketplace plan.