If you're turning 26 soon, it's time to think about your health insurance options. Under the Affordable Care Act (ACA), you can stay on your parents' health insurance plan until age 26, but it's up to you to find coverage afterward. And although there's a lot of information about health insurance, just knowing that you have a choice is the first step.
Here are seven common questions that many young adults may have concerning their health insurance.
The Affordable Care Act (ACA) allows young adults to be covered under their parents’ policy until age 26. But if you're on your parents' insurance plan, your insurance may not automatically end when you turn 26 because there are some exceptions to this rule:
Standard ACA plans have a set enrollment period each year, but adults age 26 have a special 120-day enrollment period. That means you can purchase a medical insurance plan either 60 days before you turn 26, or 60 days after.
The good news is you have several choices. Let's walk through each.
1.) Enroll in your employer's plan. If you have a job, an easy way to get insurance is to join a health insurance plan offered through your employer. If you're just landing a new job, though, it's important to note that there may be waiting periods before your health insurance kicks in.
2.) Join your spouse's plan. If you're aging off of your parents' insurance but are married, you may be able to join your spouse's health plan. Just ask your spouse’s employer to add you to the plan within 30 days of your loss of coverage under your parents' plan.
3.) Shop for a plan through the Health Insurance Marketplace. You can compare and purchase ACA plans, also known as Obamacare plans. One perk of the Health Insurance Marketplace is that you can’t be denied coverage for having a pre-existing health condition. Costs for marketplace plans vary greatly, depending on your location and the level of coverage you need. Tax credits to help offset the plan's cost and make it more affordable are also available for those who qualify.
4.) Get a short-term health insurance plan. Short-term health insurance provides temporary benefits quickly. Your policy can begin as soon as the next day, if you're approved. Plus, short-term plans are flexible: They can last as little anywhere from 30 to 364 days, which can be useful when you have a gap in coverage.
ACA plans can be a good option for health insurance once a young adult has aged out of their parents' insurance. If you have a chronic health issue, are planning on becoming pregnant, need more health service options, or want the assurance of a plan with the 10 essential benefits, ACA plans may suit you well.
By law, all ACA plans must offer 10 essential health benefits with no annual cap on the benefit amount:
Short-term health insurance, also known as temporary health insurance, is a medical plan that provides you with health insurance coverage for a set period - anywhere from one to 12 months, depending on individual state rules. Some states offer short term insurance plans while others don’t, so it's essential to compare what's offered in your specific area.
The big thing to know is that a short-term health insurance plan is entirely different than an ACA plan. Think of a short term health insurance plan as an option outside of the ACA, not an alternative to an ACA plan.
For example, short-term plans are not required to cover the 10 essential health benefits, but they may be a good transitional fit if you're aging out of your parents' insurance, maintaining good overall health, and aren’t sure where life is taking you next - whether it’s a getting new job, entering the gig economy, preparing for grad school, or backpacking across America.
Short-term plans several common medical services for many young adults, such as:
To better understand the costs and potential savings associated with short term health insurance plans, you should get familiar with these terms:
-Premium: the monthly amount you'll pay for your health insurance coverage. Short-term plans generally offer lower premiums than ACA-compliant plans, and you may have the option to choose a higher deductible plan with a lower premium.
-Deductible: the amount that you have to pay towards your medical bills before your insurance company will contribute any money.
-Copayment/Coinsurance: the percentage of your medical costs that you actually have to pay after hitting your deductible. Then, your insurance company will pay for the remaining percentage. So let's say your coinsurance amount is 20%: You'd pay 20% of the medical bill, while your insurance company will pay the remaining 80%.
-Out-of-pocket maximum: the total out-of-pocket amount that your insurance plan requires you to spend your medical expenses each year. Once you have met this amount, your insurer will pay 100% of all your covered medical expenses up to the plan's annual benefit limit.
An out-of-pocket expense is any medical service that you have to pay for with your money. Deductibles and copayments/coinsurance are considered out-of-pocket expenses, but your monthly premium is not. So if your plan does have an out-of-pocket maximum, you won't have to pay for any plan-covered medical services after you reach the set amount for your out-of-pocket expenses.
Here's an example:
If your plan has an out-of-pocket maximum of $8,000, you've reached your out-of-pocket maximum once you've contributed that exact amount: $8,000. From then on, your insurance company will pay 100% of any plan-covered medical services for the remainder of the plan year, up to your plan’s annual limit. So if you're going to your primary care doctor or hospitalized for a few days, you won't have to pay any additional money as long as the service is included in your coverage plan.
A few factors come into play such as plan costs, your health situation, and your specific healthcare needs.
The bottom line: The best thing to do is to simply shop around and compare plans as you age out of your parents' insurance plan. Just be sure to read the fine print so you understand what's covered and what's not, as well as your deductible amount and how much you’ll pay out of pocket.
At some point in life, you might wind up uninsured. You may know it’s coming and have time to plan for it, or you may not. Either way, you’ll be on the hook to pay for healthcare. That’s where short-term medical insurance comes in. Also known as short-term health insurance or temporary health insurance, this type of plan provides quick, temporary insurance coverage when you’re in between major medical policies. But is a short-term health insurance plan the right choice for you? Let’s look at answers to some common questions, including how temporary health insurance works, what it covers, when it makes sense, and why it differs from major medical insurance. Once you understand the basics, you’ll be better equipped to make an informed decision. What is short-term health insurance? Short-term medical is temporary health insurance. It’s designed to be cost-effective and flexible during times of transition, allowing you to: Get covered as soon as possible. Apply online and enroll within a few minutes. Coverage is available year-round and may begin as early as the next day, if you’re eligible. Choose your policy length. Policies last from 30 days and to 364 days, depending on where you live and how long you need coverage. Access benefits right away. Coverage is typically limited to unexpected medical expenses rather than long-term healthcare needs (i.e., preventive care, maternity). The Affordable Care Act doesn’t apply to short-term health insurance, which means it isn’t guaranteed issue and does not include all of the essential health benefits that major medical insurance (aka ACA plans) must include. While short-term health insurance does not provide major medical coverage, it does have some similarities: You pay a premium in exchange for coverage. You present your plan ID and pay a copay, if required, when visiting a healthcare provider. Your provider files a claim with your short-term health insurance carrier, which pays for covered medical expenses according to your policy. You receive a bill for your portion. Like ACA plans, short-term plans typically include a deductible, coinsurance and copayment. They may or may not include a provider network. What does short-term health insurance cover? Short-term health insurance generally covers high-dollar medical expenses related to injuries and unexpected illnesses. For example, plan benefits typically include things like hospital room and board, emergency care, and surgical services as opposed to preventive care, maternity, and treatment of pre-existing conditions. Of course, not all short-term coverage is the same. Some may include benefits for a few basic preventive care services (e.g., Pap smears) or limited coverage for pre-existing conditions. Bottom line: You’ll want to shop around to see what short-term plan best suits your needs. How much does short-term medical insurance cost? The amount you'll pay for short-term health insurance coverage depends on the plan you select. Short-term plans come with less benefits than a comprehensive major medical plan, so they could cost less. As with any type of health insurance, you can generally expect to pay a lower premium for a plan with a higher deductible and limited benefits and vice versa. Adding a spouse and dependents will also increase your cost. Short-term plans are not eligible for premium tax credits or cost-sharing reductions. If you qualify for these ACA subsidies, then you’ll probably want to enroll in an ACA plan through a state or federal exchange. You can use an online subsidy calculator to see if you might qualify. Short-term health insurance vs. Major medical insurance Short-term health insurance and major medical insurance are different products designed to serve different needs. It’s not a true apples to apples comparison. At a high level, here’s what to know about each product: Short-term medical insurance plans: Provide temporary coverage with a focus on unexpected healthcare. May be purchased year-round. There are no open or special enrollment periods. Does not include all of the essential health benefits. Is not eligible for ACA subsidies (i.e., premium tax credits and cost-sharing reductions) Is not guaranteed issue. You can be denied coverage based on your health history. Is not available in every state. Major medical insurance: Provides long-term coverage with a focus on healthcare across the spectrum (e.g., preventive, pre-existing conditions, unexpected). May be purchased during the annual open enrollment period or a special enrollment period, if you qualify. Includes all of the 10 essential health benefits. Is eligible for income-based ACA subsidies if you buy from a government exchange and qualify. Is guaranteed issue. You cannot be denied or charged more based on your health history. Is available in every state. The decision ultimately depends on how long you need coverage, your typical healthcare needs and your financial situation. Is short-term health insurance right for you? Short-term health insurance coverage isn’t available to everyone. Applicants can be denied based on health history, and plans aren’t sold in every state. These types of plans also may not be a fit if you qualify for an ACA subsidy, have pre-existing conditions, want all of the essential health benefits (e.g., preventive care, maternity), or expect to need long-term coverage. Generally speaking, temporary health insurance tends to be a fit for healthy people who are: Between jobs with employer-based benefits. Attending college outside a parent’s health insurance plan network. Early retirement before Medicare takes effect. Aging off a parent’s health plan and not yet being enrolled in other coverage. Looking for an alternative to COBRA, if it's too expensive. In an employer waiting period before group benefits take effect. Ineligible for an ACA subsidy or Medicaid but unable to afford major medical insurance at this time. How to buy a short-term health insurance plan Short-term health insurance isn’t sold through the state and federal ACA exchanges, but it’s easy to find online. [Hint, hint: You’ve come to the right place.] The application and enrollment process is fairly straightforward: Get plan quotes. Start here to find and compare plans. Enter some basic information, including your date of birth and ZIP code, to see what plans are available to you and how much they cost. Compare your options. As you narrow your options, you’ll want to consider the following: Cost— Look at premium, deductible, coinsurance, and copayment amounts. What is most affordable for you? Benefits — What medical expenses does the plan cover? Does this amount of coverage align with your healthcare needs? Availability — What is the maximum policy length in your state and you apply for another policy once your first policy expires? Will these limits keep you covered long enough? Decide and apply. Be ready to answer a few basic health-related questions. You’ll have an answer within minutes - and you can begin coverage as soon as the following day, if your application is approved. If you don’t qualify for a short-term plan, you may want to look into other options such as an ACA plan or Medicaid. Still not sure what’s right for you? Call one of our licensed agents to talk through your options: (855) 651-5094.
If you're a college student, you have several health insurance options. While many students stay on their parents' health insurance plans, others opt for choices like student health insurance plans or short-term health insurance plans. When shopping around, the first step is to understand your school's health insurance requirements. As examples, they can vary depending on if you're a part- or full-time student, and they can also require you to be covered by a specific type of plan if you're enrolled and living on campus. This is mind, let's walk through some of your options. #1. Stay on your parents' plan By law, you have the right to stay on your parent's health insurance plan until you turn 26 years old. If you're on your parents' insurance plan through their jobs, your coverage will end the month of your birthdate. But if your parents purchased insurance through the Health Insurance Marketplace, you will be covered until the end of the year. Marketplace plans are government-mandated insurance plans that comply with the Affordable Care Act (ACA) requirements for individual and family health plans. Keep in mind that there's a set "open enrollment period" when you can add or drop health insurance. The specific dates vary from year to year, but the open enrollment period usually begins in November and ends in December in most states. Note, some states offer extensions and allow individuals over age 26 to stay on their parent's insurance under certain conditions. Your state ACA marketplace can provide you with more information. #2. Enroll in an ACA plan The Affordable Care Act - also referred to as Obamacare - was signed into law by then-President Barack Obama in March 2010. It was enacted to ensure that every American has access to medical insurance, regardless of their medical history. As a college student, you have the option to compare plans and sign up for insurance coverage through the ACA Health Insurance Marketplace. Note, these plans are required to cover the 10 essential health benefits, so their level of coverage might be more extensive than some of the other options we're covering. As examples, an ACA plan might be a good choice if you have a specific medical condition like diabetes, or if you're pregnant or anticipate becoming pregnant. #3. Look for student health insurance options Another option for college students is a student health insurance plan offered through your college or university. These plans are generally inexpensive and offer a range of coverage options. You might even find this option appealing because it counts as a school associated fee, meaning it can be covered by student loans or other school funding. You can check out your school's website, or contact your school's financial aid department to find out if student health insurance is available. #4. Buy a short-term health insurance plan Short-term health insurance plans tend to attract college students because they typically have a lower premium than other health insurance options - a good fit for college students on a budget. But short-term plans can also have limited coverage. So if you're looking into a short-term plan, it's important to consider the full picture beyond the cost: Doctor office copays: Are doctors office visits important to you? Urgent care copays: Do you anticipate visiting an urgent care clinic during your coverage period? Prescription drug benefits: Are you currently on medication? Student-athlete accident benefits: If you're a college athlete, short term health insurance that does not cover intercollegiate sports? Physical therapy benefits: Do you anticipate needing therapy in the future? Not all short term health plans offer one or all of these benefits, though, so shop wisely. Depending on the plan, short-term health insurance provides coverage for preventive care, doctor visits, urgent care, and emergency care. And although many don't offer prescription drug coverage, they may offer prescription discount cards to help you with drug costs. Another important variable to weigh is whether or not you have a pre-existing health condition. If you do have one, you can be denied short-term health coverage. Though some short-term providers may allow you to buy a plan, but you'll have to pay out-of-pocket for any medical treatment you receive as a result of a pre-existing condition. And these additional out-of-pocket expenses coupled with the policy premium can quickly add up. In 2018, the Kaiser Family Foundation issued the following stats about short-term plans: 43% didn’t cover mental health services 62% didn’t cover substance abuse treatment 71% didn’t cover outpatient prescription drugs None of the plans covered maternity care So it's good to know the facts. But while short-term health insurance plans don't cover everything, they do have several benefits: There's no enrollment period. You can enroll at any time, and coverage can begin as soon as the next day. They have a flexible length of coverage. Your coverage period can range from one month to 364 days, with policy renewal of up to three years, depending on your state’s rules. They're a security blanket. Short-term plans will cover you in the event of an accident or illness, so you aren't faced with paying large medical bills out of pocket. They're widely accepted among health professionals. You should be able to find health professionals who accept short-term insurance plans. Some insurance carriers have a preferred network with special negotiated pricing and an extensive network of physicians. They offer choice. You can typically select providers and physician services you're already familiar with, depending on plan options. Some states even offer short-term health insurance for up to three years, so you may be able to lock in guaranteed renewability if the insurance company offers it. Short-term health insurance coverage can vary depending on age, state, and gender, so what works for one person may not be a good option for the next. Keep in mind that short-term health coverage is currently not offered in 10 states, but you can shop around to find other insurance plans are available in your area. Also, plan rules like coverage and renewal terms, coverage for pre-existing conditions, and coverage for specific medical services vary state-by-state, so getting a personalized quote is an important part of the process. The last important call out: Be sure that the coverage you’ve selected is the coverage required by your school. Some schools require full-time students to carry a major medical plan that complies with the ACA, rather than a short-term medical plan. Interested in getting a quote? Getting a quote is an easy, hassle-free task. For starters, you're not required to commit to a short-term health insurance plan when getting a quote, and there's no contract involved once you do apply. After answering a few basic questions, you'll learn about specific coverage options available in your area - a good tool especially if you're going to college out of state. Then, you should take time to look over the information, talk it over with your parents/family, and pick the plan that works for you. Choosing health insurance might be one of your first major financial decisions in life, so we're here to help you make an informed choice. Our plan comparison tool gives you the power to search for plan options and set filters based on the monthly costs, deductibles, and benefit maximums. Shop around to get the right coverage and price that works for you.
It's good to be a freelancer: You can commit to work you believe in. You have the flexibility to set your own schedule. And you can work as much (or as little) as you'd like. But with the freedom of being an independent contractor comes the responsibility of purchasing your own health insurance plan, so it's good to understand your options. What are the health insurance options? Whether you call yourself a freelancer, independent contractor, or self-employed, you typically have two primary options for health care coverage depending on your state: A plan through the Health Insurance Marketplace, which gives you the option to enroll in health plans in different states with a variety of monthly premiums during the open enrollment period. If you’re 65+, you can also qualify for (Medicare). But even though Medicare provides comprehensive benefits for retirees and independent contractors over 65, you may need supplemental insurance to cover the things that Medicare doesn't. Short-term health insurance, which has been on the rise for healthy workers in the "gig economy." ACA Health Insurance aka Obamacare Obamacare is the federal health insurance marketplace created by the passage of the Affordable Care Act that is open for annual enrollment for the year 2023 starting November 1st, 2022 through December 15th 2022 in most states. The ACA has 3 primary goals: Make affordable health insurance available to more people. The law provides consumers withs subsidies in the form of premium tax credits that lower costs for households with incomes between 100% and 4005 of the federal poverty level (FPL). A) if your income is above 400% FPL, you may still qualify for the premium tax credit in 2022. B) if your income is at or below 150% FPL, you may quality to enroll in or change Obamacare coverage through a special enrollment period. Expand the Medicaid program to cover all adults with income below 138% of the FPL. Support innovative medical care delivery methods designed to lower the costs of health care generally. Short term health insurance Short-term health insurance is temporary insurance that provides specific coverage in certain medical situations like an unexpected accident or illness. However, it doesn't include the same basic coverage requirements as qualifying plans outlined by the Affordable Care Act (ACA). For example, short-term health insurance doesn't cover maternity care, ongoing mental health conditions, or pre-existing conditions. But short-term plans do offer coverage for doctor office visits, emergency room care, hospitalization, and select lab tests. And like other health insurance plans, short-term health insurance also has set copays, deductibles, coinsurance, and out-of-pocket maximums for different provider services. Some short-term medical insurance plans can have a preferred provider organization (PPO) network, meaning you must use certain doctors to receive the in-network price. Others may allow you to visit any doctor. And some plans have an all-access policy, allowing you to visit your preferred doctor. If you're pregnant or have a pre-existing condition, short-term coverage may not be the right choice, as most pre-existing conditions — including pregnancy — aren't covered. However, if you need health insurance for a short period of time to cover emergency-related medical expenses at a budget-conscious price, a short-term health plan may work for you. What are the benefits of short-term health insurance? Whether you're starting your own business, transitioning to become a full-time independent contractor, or just filling a gap in your coverage, short-term health insurance may help you cover unplanned medical expenses. No matter your situation, evaluating the benefits of each short-term medical plan is essential. No long term commitment. When signing up for short-term insurance, you can choose how long you want the coverage to continue. The coverage automatically ends after that date, but you may have the option to reapply depending on your state of residence. In 2019, the U.S. Department of Health & Human Services (HHS) finalized regulations allowing individuals and families to purchase short-term health plans for up to 364 days and in some states, extend the length of the policy for up to three consecutive years. Shorter-term policies for as few as 30 days are also available, and you can cancel at any time. Enroll anytime. When it comes to short-term insurance, you can apply and enroll at any time of year. Meanwhile, the ACA open enrollment period is between November 1 and December 15 each year (in most states), so if you want to enroll in a federal marketplace plan, you have to wait until the open enrollment period. But if you need insurance outside of the open enrollment period, you may not qualify for an ACA plan unless you're facing an unexpected life event such as a death, birth, or divorce. No waiting period. With short-term insurance, there's almost no waiting period for coverage to start like there is with many long-term insurance plans. In many instances, you can get coverage as soon as the day after you apply. Good for many life stages. Short-term health insurance helps to fill the gap for many stages in your life. For instance, college students are increasingly working in independent contractor roles like Uber or Lyft drivers. Under the ACA, college students can stay on their parents' health plans until they’re 26, but not every parent can afford to keep their adult child on their plan. As a freelancer, you may receive medical insurance benefits under your spouse's plan. If not, short-term health insurance can come to the rescue in these types of scenarios. What to look for when comparing health insurance options You should compare health insurance plans in your local area to make the best choice based on your needs. While each person is different, selecting a short-term health plan typically comes down to benefits and costs. Keep these factors in mind when choosing insurance: Doctor visits Look at how many doctor visits come with the premium and what each copay includes. You should also consider how many times you typically visit a doctor, and whether the visits are only for emergencies or accidents. Hospital stay benefits Temporary health insurance comes with hospital coverage. When choosing an insurance plan, look closely at hospital stay benefits to help you choose the right policy. Limitations and exclusions Short-term health plans in your local area may have limitations and exclusions, otherwise known as services that are limited or not included in your policy. Some examples of items not covered may be alcoholism and drug abuse, pregnancy care, and treatment for pre-existing conditions. If you understand what is and isn't included, choosing the right plan becomes easier. Plan network For the most part, short-term insurance lets you stay with your current doctor or choose the right one for your needs. However, not all plans allow this, so it's wise to check each plan to make sure you have this option. Some short-term insurance plans have a PPO, where you can choose any doctor who accepts this kind of insurance based on the network. When you stay within the listed provider network, the out-of-pocket costs can be lower overall. Prescription drug coverage While most short-term insurance plans don't offer prescription drug coverage, some plans do: Many brokers have options that allow you to add prescription coverage for an additional fee. It's no secret that prescriptions can be costly, so weigh your costs and options when choosing a policy. Telemedicine Some short-term medical plans offer a telemedicine benefit. Telemedicine gives you access to healthcare providers online or by phone 24/7. Whether you live in a small town or a big city, telemedicine is a convenient, interactive way to get non-emergency health care, and usually at a lower cost than seeing a doctor in person. Get a quote Getting a quote through our secure online application only takes a few minutes with fast approval, if you’re eligible for a short-term health plan. Just be prepared to answer a few questions and provide personal information (name, date of birth, gender and zip code). You won't have to answer any immediate medical questions to get your quote. If you're approved for a plan, coverage may begin as soon as the next day, and you can cancel at any time. After all, you're working for yourself, so you should find a health care plan that works for you