Should you stay on your parents' health insurance plan?

You’ve got an option to remain on your parents’ health plan until you turn 26, but it’s important to note that the plan’s network might not include hospitals and doctors in the area where you’re going to school, and might not provide maternity coverage for dependents. It’s also important to understand that the health plan will likely send the explanation of benefits (EOB) to your parents if you receive medical care as a dependent on their plan. If this is a concern for you, a policy obtained in your own name might make you more comfortable. Read: Should I buy the health plan my college offers? or buy through an ACA exchange?

Will your insurance cover your healthcare providers?

If you move – and don’t live in the same area as your parents – it might make more sense to shop for your own policy rather than staying on their plan, since the provider network for your parents’ plan may be limited in your area.

Will buying your own coverage make your parents' health plan more affordable?

Depending on how your parents’ health plan is structured, taking you off the plan may or may not affect the amount that they pay in premiums. This may depend on whether they buy their own plan or have employer-sponsored coverage (and if so, how the employer’s contributions to the premium are structured) and on whether they have other children who will remain on the plan.

Is the health insurance offered by my school good coverage?

Nearly all student health plans offered by colleges and universities are fully compliant with the ACA , with just a few exceptions. ACA-compliant plans cover pre-existing conditions, provide preventive care with no cost-sharing, include coverage for the essential health benefits, and don’t have annual or lifetime benefit caps. (If a student health plan is self-insured, it doesn’t have to be compliant with the ACA . Some schools with self-insured student health plans have opted not to bring their plans into compliance with the ACA.)

If my college offers coverage, can I buy ACA-compliant health insurance?

College and graduate students can qualify for subsidized insurance on an exchange even if they’re eligible for student health insurance offered by their college or university – as long as they don’t enroll in the university’s plan. (This differs from the rules that apply to employer-sponsored health coverage offered to employees, which generally makes people ineligible for subsidies in the exchange .)

Stay on your parents' insurance

The ACA requires almost all health plans (with the exception of retiree-only plans) that offer dependent coverage to allow young adults to remain on a parent’s plan until they turn 26. Points to consider when deciding whether to remain on a parent’s plan .

Buy an individual plan through the ACA marketplace

For grads who want a more robust, ACA-compliant plan that covers the essential health benefits and pre-existing conditions, a plan purchased through the state health insurance exchange is likely to be an ideal solution. ACA-compliant plans for individuals are available in every state and premium subsidies and cost-sharing reductions are available through the marketplace to make coverage and care more affordable. Check your eligibility for ACA premium subsidies.

Purchase a short-term health plan

College grads who need temporary coverage until another policy kicks in may consider short-term health insurance. Even grads who have a job lined up may face a waiting period before employer-sponsored health insurance coverage is available. Note that each state has its own rules and regulations regarding short-term health insurance. Check availability of short-term plans in your state.

In 38 states, Medicaid has been expanded to cover all adults with income up to 138% of the federal poverty level. For a new graduate living in a state where Medicaid has been expanded, Medicaid could be a perfect solution while job hunting. Medicaid enrollment is available year-round, and Medicaid covers pre-existing conditions. In most cases, there are no premiums. See whether your state has implemented Medicaid expansion.

Get coverage through a new employer

Getting health insurance through an employer-sponsored plan is a coverage option many college grads envision, and it’s an excellent option if available. Employer-sponsored health insurance generally offers substantial benefits, and employers typically pay a large portion of the premiums . But while obtaining employer-sponsored health insurance may be the goal, it might not necessarily materialize soon after graduation, or even in the near future. Thanks to the ACA, it’s easier than ever for young adults to have health insurance coverage, even if the benefits they assumed they’d receive from employers take longer than expected to materialize.

Guide to special enrollment periods

special-enrollment-guide

Key Takeaways

What is a special enrollment period?
How long are special enrollment periods?
Qualifying life events that trigger a special enrollment period
Frequently asked questions about special enrollment periods and qualifying life events

Not everyone who’s eligible to enroll in ACA-compliant health insurance bought coverage during the most recent open enrollment period.¹ Some people may have missed the annual enrollment deadline. Others may have decided that coverage was too expensive – perhaps unaware that they were eligible for premium subsidies if they enrolled on the Marketplace. Others may have felt they didn’t have enough information to make a decision.

But depending on the circumstances, many people can still enroll in ACA-compliant health coverage – even after the annual open enrollment period has ended – during a special enrollment period. There’s a lengthy list of qualifying life events that make consumers eligible for special enrollment, and this guide will walk you through all the qualifying life events and the specific rules for how they trigger special enrollment periods.

What is a special enrollment period?

Normally, ACA-compliant coverage is only available for purchase during the annual open enrollment period, but a special enrollment period allows people to sign up for coverage outside of that annual window. In most cases, this requires a qualifying life event.

In many cases, a special enrollment period is only available if an applicant already had minimum essential coverage prior to the qualifying life event. Other restrictions prevent people from using special enrollment periods (SEPs) to upgrade to better coverage during the year, though some of those restrictions have been relaxed in recent years.

During most SEPs, an individual (and dependents) can enroll in any health plan available in their Marketplace / exchange, although some SEPs limit current enrollees to a replacement plan at the same metal level as their current coverage. Most of the SEPs also apply to health plans available outside the exchange, giving people an option to pick off-exchange coverage if that’s their preference.

Have a qualifying life event?

See what kind of ACA compliant coverage is available outside of open enrollment. Compare health plans and check available subsidy savings with the help of a licensed agent.

How long are special enrollment periods?

Most of the qualifying life events trigger a special enrollment period that begins on the date of the qualifying life event and continues for 60 days. In most cases, the earliest that coverage can take effect is the first of the month after the special enrollment is completed.

However, in the case of involuntary loss of coverage, the special enrollment period begins in advance of the loss of coverage so that enrollees can purchase a new plan with no gap in coverage.