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How long can a dependent child stay on health insurance?

A brief overview...
  • Under the Affordable Care Act, children are able to stay on their parents’ health insurance plans until they turn 26
  • This coverage will end when the child turns 26
  • At this point, they will be eligible for a special enrollment period to enroll in their own healthcare plan
  • If you do not get insurance after turning 26 and being dropped from a parents’ plan, you may be responsible for paying the individual mandate penalty fine

Under the new regulations set forth by the Affordable Care Act, a child is able to stay on their parent’s health insurance plan until they reach the age of 26 if the parent’s plan covers children. Children are able to remain on the plan even if they are married or support themselves financially. They can also stay on the plan even if they are eligible for employer-based health insurance through their job or if they do not live at home with their parents or if they are attending school.

Children are able to remain on the plan even if they are married or support themselves financially. They can also stay on the plan even if they are eligible for employer-based health insurance through their job or if they do not live at home with their parents or if they are attending school.

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What happens after the child turns 26?

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Soon after the child turns 26, they will be dropped from their parent’s health insurance plan. If they do not enroll in a healthcare plan shortly after, they may be responsible for paying the individual mandate penalty fine when they file their next tax return with the IRS.

If are about to turn 26 and work for a company that offers health insurance, you should be eligible to enroll in your employer’s plan. You should speak to your company’s human resource representative before your 26th birthday about your options. You should qualify to enroll outside of the open enrollment period. If you choose not to enroll in your employer-based plan and look for an insurance plan on the healthcare exchange marketplace, you will not be eligible for premium tax credits even if your income falls within the acceptable range.

In some cases, you might lose coverage immediately on your 26th birthday. If you are on your parent’s marketplace plan, your coverage will not end until December 31st of the year that you turn 26.

If you are not considered a tax dependent at this time, you will be eligible for income-based savings, such as tax credits and cost-sharing reductions, if your income falls within the acceptable range and your employer does not offer you health insurance.

If you are a tax dependent, you can enroll in your own health insurance plan during open enrollment period, but you will have to pay the full price. You will not be eligible for savings based on your income. However, you may be eligible for Medicaid.

If you are on your parent’s employer-based plan, you will probably lose your coverage the month that you turn 26 or soon after. If you wish to enroll in a marketplace plan at this time, you will be eligible for a special enrollment period. If you choose a plan before you lose your parent’s coverage, it can begin the first day of the month that you do lose coverage. If you choose a plan after you have already lost coverage, it can begin the first day of the following month after you enroll.

What is a special enrollment period?

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The open enrollment period to purchase an insurance plan on the Healthcare Exchange website occurs between November and January. However, when you turn 26 and are about to lose coverage through your parent’s plan, you will be eligible for a special enrollment period. Y

You can qualify if you lost your coverage in the past 60 days or expect to lose it in the next 60 days. You will not qualify for a special enrollment period if you decided to drop coverage voluntarily prior to this time or if you lose coverage due to not paying your premium.

There are many other circumstances in life that may qualify you for a special enrollment period, in addition to losing your insurance at 26. If you no longer have health insurance because your parents lose their insurance or their plan no longer covers dependents, you will still qualify for a special enrollment period. You will also qualify for a special enrollment period if you lose coverage because of the death of a parent or family member or because of a divorce.

How can you add a dependent child to your health insurance plan?

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If you are under the age of 26 and not covered by your parent’s health insurance, it is still possible to get on their plan. If your parent wants to include you on their employer-based health insurance plan, they should speak to the human resources representatives at their company. They should be able to add you during their job’s open enrollment period.

If your parent is applying for a new healthcare plan through the marketplace, they can just list you as a dependent on the application. However, they cannot just add you to their preexisting plan if it is not open enrollment time and you did not qualify for a special enrollment period.

What if your child is a student?

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If your child is a student, you can still add them to your health insurance plan. However, many colleges and universities offer student health plans that may be a cheaper or more accessible option for you and your family.

These student health plans usually count as minimum essential coverage under the Affordable Care Act so your student would not be responsible for paying the individual mandate penalty fine. It is not a requirement to purchase student health plans through their school, so you still have plenty of options for healthcare enrollment.

What happens if you do not get health insurance at 26?

If you do not have health insurance coverage, you may be responsible for paying the individual mandate penalty fine. The fee is calculated in one of two ways and you will have to pay whichever is greater. It can either be calculated as 2.5 percent of your income with a maximum that is roughly equivalent to the average price of a bronze plan sold on the marketplace or it can be calculated as a per person fee.

The 2016 fee is $695 per adult and $347.50 per child under the age of 18 with a maximum of $2,085. Only people in the household who do not have coverage are required to pay the fee and it is only charged for each month that you do not have coverage.

If you only went without health insurance coverage for less than three months, you might not have to pay the individual mandate penalty fine if you qualify for the short coverage gap exemption. You can only apply for this coverage gap exemption once in any given year.

How long can a dependent child stay on health insurance?

Under the Affordable Care Act guidelines, a dependent child can stay on their parent’s health insurance plan until they turn 26. Some plans might let the child stay on until the end of the year they turn 26, while others will drop them on their 26th birthday. It is important for the child to enroll in a new insurance plan at this time or they will be responsible for paying the individual mandate penalty fine.

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