Thanks to the ACA, parents all over no longer have to worry about high premiums simply because they put their children on their insurance. Now you can get one plan that covers all.
You will learn what children can be dependents for insurance purposes, what benefits they are eligible for as well as general questions surrounding things such as the age limit placed on children on adult policies, further insurance options after they age out and what they can do on the policy.
Children can stay on their parent’s health insurance until they are 26 years of age, even if they are married, have moved out, or any other factor. This means they can get all the benefits of that health insurance policy till they age out of it.
This article was created using information from reputable sources such as several state Department of Insurance, various health insurance providers, and the US Government’s Health Insurance Exchange site healthcare.gov.
What Benefits Can Children Get On Their Parent’s Health Insurance?
The age limit was 19, or when that dependent became a graduate. However, the Affordable Care Act has extended the coverage period till that dependent is 26 years of age. This means that you can have your child on your health insurance from the moment they are born until they turn 26.
When a child is placed on a parent’s insurance coverage, a few benefits have to be covered. These benefits are guaranteed under the Affordable Care Act. They include vaccines, obesity screening, and autism screening for little children.
Additionally, vision and dental coverage screenings have to be available for children till they are 19 years old. Pediatric dental coverage either comes with the main health insurance policy or with a stand alone dental plan.
Pediatric dental coverage is perhaps the sole pediatric benefit that insurance providers offer, as they aren’t typically required to provide adults dental coverage.
How Do Children Become Eligible For Parent’s Health Insurance?
Generally speaking, any child that fits the criteria below can be added to your health insurance policy:
Relationship: they have to be your biological child, a stepchild, foster child, or adopted. If your children have half-siblings or their own children, they can also be added to your health insurance plan.
- Income contribution: while your child can remain tax dependent while they work and contribute to their expenses, they cannot be dependent if they are their own major income source.
- Age: they have to be under 26
- Residency length: your child qualifies as a dependent only if they have lived with you for a minimum of 6 months.
Does A Child Have To Get Their Own Health Insurance If They Move Out?
Leaving home is perhaps something that every young adult thinks about and can't wait to achieve. It is one that kick starts a lengthy list of transformations in finances and lifestyle.
If the child is under 26 years of age, their health insurance coverage shouldn’t be on the list of things that need to change. The Affordable Care Act ensures dependents can remain on their parents’ health insurance policy, regardless of if they move out or live at home.
Does A Child Have To Get Their Own Insurance Policy If They Get Married?
There is nothing in the world that heralds a change in a person’s life, like marriage. Getting married traditionally means you leave your family to create a new one. Newlyweds can look forward to getting a joint policy that covers both or having one person put on their spouse’s policy.
Nevertheless, it doesn’t matter if the new spouse is under 26, as their parents’ health insurance policy still covers them until they are over 26. This legal status change from single to married does not make any difference in health insurance coverage according to the Affordable Care Act requirements.
You can generally remain on your parents’ health insurance plan till you turn 26, even if you do the following:
- Adopt or have a child
- Leave or start school
- Turn down a job-based health insurance cover
- Live with your parents or live alone
- Are not claimed as a tax dependent
How To Add A Child To Parent’s Health Insurance Coverage
There are 2 most popular ways which a child gets added to a parent’s health insurance coverage.
- Employment-based policies: a parent can add their children as a dependent to their health insurance policy gotten from their employer.
The inclusion is typically done during the policy’s yearly Open Enrollment Period. It can also be during the Special Enrollment Period. It is important that the parent checks with the employer’s HR or benefits department for details on the plan.
- Policies purchased via the Health Insurance Marketplace: if a parent gets a new plan via the Health Insurance Marketplace, they can add their child to the plan.
It is also possible to add their children to an already existing marketplace plan either during a Special Enrollment Period or the annual Open Enrollment Period.
Adding A NewBorn To Parent’s Health Insurance
You should know that there’s no cause for alarm about your child’s insurance immediately after the baby is born. Once you give birth, your current insurance plan automatically covers the baby’s health up to 30 days after birth. Accessing this 30-day coverage needs no registration or paperwork.
However, you should already be considering your baby even before birth, during pregnancy. Your insurance companies may already offer antenatal or expectant mother’s programs.
If they do, join one of these programs that will advise on the best insurance programs for families most inclusive of your newborn.
There are also additional benefits of these programs. For example, if you didn’t know, an expectant mother’s program may inform you that breast pumps are free, as your insurance must cover it.
You may also consider changing your current plan to a more comprehensive plan that caters to all your baby’s needs. If you were on a high deductible health plan (HDHP), an HMO or PPO may be better suited now that you have a baby.
Once you have given birth, take your birth certificate and social security details to your HR if your company covers your health insurance. If you use marketplace insurance, then talk to your insurance provider.
Having a baby is a life-changing event, so you don’t have to wait for an Open Enrollment Period. You qualify immediately for a Special Enrollment Period and you can add your baby to your plan right away.
What Health Insurance Options Does A Child Have After Turning 26
Typically when the parents’ health insurance plan covers an individual, the coverage cutoff date depends on how the health insurance policy was first acquired.
If the parents gained their health insurance policy via their employment, the coverage ends about a month after the dependent turns 26. But if the parents had gotten the health insurance policy in the Health Insurance Marketplace, its coverage continues till the last day of the year they turn 26.
When the dependent turns 26, they automatically get qualified for a Special Enrollment Period. The Special Enrollment Period, SEP, is open for 60 days, after which they lose health coverage status if they still haven’t gotten new health insurance.
The Special Enrollment Period ensures that nobody ever has to go months without health insurance while waiting for the next Open Enrollment Period.
If you are a dependent who just turned 26 and are worried about losing your insurance, you need not be as there are numerous options to get a health insurance policy of your own.
If you are in college, you can check with your college administrator. Most universities and colleges provide health insurance policies for their students. An employer might offer health insurance alongside a benefits package.
For individuals that are low income, the federal government offers Medicaid. However, you have to qualify. To be eligible for Medicaid, the income has to be up to 137% federal poverty level. As of 2020, Medicaid qualification for a family of three would require the total family income to be less than $30,000.
The Healthcare Marketplace can also be an avenue to find other viable options. There are different health insurance plans available. You may consider a plan depending on your health situation and income level.
For example, when you stop being a dependent at 26, you may qualify for the Catastrophic health insurance plan available to people younger than 30.
Whichever option you select, you must remember that you have to begin looking for health insurance options before you turn 26. Doing so gives you an idea of what coverage you want before you’re cut off.
Once your parents’ health insurance stops covering, you can use the information you’ve gotten and get an insurance policy within 60 days of your Special Enrollment Period.