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:
These rules apply to both job-based plans and individual plans bought inside or outside the Marketplace.
When someone turns 26
Under-26 coverage ends on a child’s 26th birthday.
They may qualify for premium tax credits and other savings based on their income.
Their Special Enrollment Period ends 60 days after 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.
If they don’t enroll in health coverage within 60 days of their birthday, they may not be able to get coverage until the next Open Enrollment period.
If they aren’t insured, they may have to pay the fee for being uninsured. If they’re uncovered for less than 3 months of the calendar year, they don’t have to pay the fee.
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.
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.
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.
If your employer's plan doesn't offer coverage to dependents, then it doesn't have to cover your child under 26.
During your plan’s next Open Enrollment period you can put them back on your plan until they turn 26.
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.
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.