LOSING HEALTH INSURANCE AT AGE 26
Good news…it’s your birthday.
Bad news, oh…you’re health insurance is cancelled.
Leave it to an insurance company to ruin a birthday.
Good news is that we have a present to take away that nasty surprise so lets take a look at how to celebrate the big day without worry!
Why Health Insurance Goes Away At 26
The Affordable Care Act changed many rules.
One of them had to do with how long a dependent child is able to stay on a parent’s health plan.
That age was increased from age 19 to 26.
This is a good things for many people (and many 25 years old!)
The plan could be individual/family or employer based. Same rule. At age 26, you come off.
This is good time to re-evaluate the options available and make sure you’re getting the best rates.
To jump right into the options, you can run your Covered California quote here:
Again, everything has changed!
So…when should we enroll?
Deadlines For People Losing Health Insurance At Age 26
First, your new coverage will be guaranteed issue (can’t be declined due to health) as long as you don’t procrastinate!
We want to enroll prior to losing the old coverage if possible.
Worst case, we’ll probably have a 60 day period from coverage that’s ending at age 26 but it affects our effective date.
Keep in mind, most policies will end on the 1st of the month following your 26th birthday.
For example, if your birthday is March 15th, the existing policy will usually continue till March 31st.
Always double-check with your carrier but that’s typical.
Here’s the effective date rule if you’re turning 26 and losing coverage.
We can get the 1st of the month following our enrollment date.
For example, we can enroll right up till March 31st to get a 4/1 effective date if we’re losing other coverage!
It’s best to enroll earlier obviously but that’s our worse case.
We can enroll you in 5 minutes over the phone and confirm enrollment in 24 hours at 800-320-6269.
So what are the options?
Health Insurance Options For Losing Coverage At Age 26
We might have some good news here.
Depending on income, there can be sizable tax credits that bring down the cost of coverage.
People age 26 generally qualify for these credits since they’re just starting out income wise.
The official range is up to $47K income estimate for this year.
The reality is a bit different.
Younger people (translated age 26) need their income to be quite a bit lower to get a good tax credit.
- Under $30K and we should start to see some real help.
- Between $17K and $25K, we’ll really get help with the premium.
- Below $17K, they will likely offer Medi-cal.
- Above $17K, we may also get the Enhanced Silver plans!
This is huge!
There are three versions…the Silver 94, 87, and 73.
The 94 and 87 are slam dunks!
Really rich coverage for the same price as the normal Silver.
It’s hard to turn these down.
If your turning 26 and wanted the lowest priced plan, you look at the Bronze.
This for people that want to keep their costs to a minimum and avoid the penalty!
Keep in mind that if you do not have coverage, you could be faced with a nasty penalty.
Penalty: $695 or 2.5% of income, whichever is higher!
At least get the baseline coverage to avoid the penalty.
There’s also a catastrophic plan which is priced a little lower than the Bronze plan.
The Catastrophic Plan Versus Bronze Plan For Young Adults
The two plans are very similar in benefits. We would like to see more savings with the downgrade than what is usually offered.
The Catastrophic plan then works best for people who the want the absolute lowest priced plans.
Here’s our quick advice to Californian’s turning 26.
- If you’re offered the Silver 87 or 94, that’s the way to go. The benefits far out-weight the premium savings to go downwards.
- If you have ongoing medication or medical needs, look at Silver plan.
- If you just want the lowest priced plan to avoid the market, look at Bronze or Catastrophic.
You Can Quote These Plans With Tax Credit Here:
You Can Quickly Enroll In These Plans Here:
Ideally, call us at 800-320-6269 to find the best value. As Certified Covered California agents, our service is 100% free to you.
How Will New Options Differ From Coverage You Are Losing At 26?
There are a few differences to keep in mind when transferring to the new ACA plans (including Covered Ca).
It depends on what you had before.
There are generally three main plans 26 years old are losing:
- Parents employer offered coverage
- Parents individual/family “grandfathered” plans
- Parents individual/family ACA plans (including Covered Ca)
We can help you figure this but here are the quick rules.
- Employer based plans generally have richer networks and RX lists.
- Grandfathered plans have richer networks and RX but might have limitations on benefits.
- ACA plans have smaller networks and RX lists.
Which are you losing?
#1 is pretty obvious. For individual/family, if your plan has a Metallic name (Bronze, Silver, Gold, or Platinum), then you have #3…an ACA health plan.
Again, we can help you figure this out at 800-320-6269.
Why does it matter?
If you health issues or want certain doctors, we need to find out who they contract with.
This can be tricky now as there are multiple networks available.
Best bet is to email us the doctor/hospital names and cities.
We’ll quickly find out who they participate with on the new networks.
This is really important now.
Recap For People Losing Coverage At Age 26
A quick look at the important points:
- Make sure to enroll prior to losing your coverage. Enrollment takes 5 minutes over the phone at 800-320-6269
- You may qualify for tax credits based on income. We can help with the calculation.
- There’s a penalty for not having health insurance now so don’t pay the IRS if you can help it!
- Doctor networks and RX lists can be different. We can check the network for you.
- Our services are 100% free to you as Certified Covered California agents.
And oh yes…most importantly…
Happy 26 Birthday!
Also, check out losing health insurance after divorce
Again, there is absolutely no cost to you for our services. Call 800-320-6269 Today!