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Turning 26 This Year? Here’s What You Need to Know

Updated: Jun 25

Approaching your 26th birthday marks a significant milestone in your health insurance coverage journey.

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Whether you’re a young adult about to turn 26 or a parent with a child in this situation, it’s vital to start exploring options well before the big day arrives. Planning ahead is essential to ensure the seamless continuation of your health coverage.

The Affordable Care Act and Turning 26

Under the Affordable Care Act, any job-based health insurance plan that extends coverage to dependents is required to allow the dependent to remain on the parent’s plan until their 26th* birthday. If a dependent is covered under their parent’s Marketplace plan, then they are eligible to remain on their parent’s plan until December 31st of the year they turn 26*.

*Some states have extended the coverage age past 26, but there are additional requirements and provisions.

If you are under the age of 26, you may join or remain on your parent’s plan even if you are attending school, are married, have children, are not living with your parents, are not claimed as a tax dependent, and even if you are offered health insurance through your own employer.

Getting Your Own Coverage

Since aging out of your parent’s insurance plan is considered a qualifying life event, you are eligible for a Special Enrollment Period. During this time, you have 60 days before you lose coverage and 60 days after to enroll in a new health plan.

You have the option to:

  1. Enroll in group coverage offered through your employer

  2. Enroll in your own Marketplace insurance plan

  3. Find out if you qualify for Medicaid

  4. Explore all of your options with a licensed insurance agent or broker

Enrolling in Job-Based Coverage

If your employer provides health insurance, you have the opportunity to enroll outside of your company’s annual enrollment period. However, if you decide to decline employer-offered coverage, you usually won’t have another chance to enroll until the next annual enrollment period. Additionally, you may not qualify for premium tax credits and other income-based savings through the Health Insurance Marketplace. It’s advisable to reach out to your company’s human resources department to explore the options available to you.

Finding Your Own Marketplace Insurance

You will find a variety of plans and prices available to you. When it comes to selecting a Marketplace plan, we suggest reaching out to an independent agent or broker who can help identify the most suitable plan that aligns with your requirements and financial considerations. Our team is here to provide you with support and expert guidance, so don’t hesitate to get in touch.

Eligibility for State Medicaid

If you have a limited income or are currently pregnant, you may qualify for free or low-cost health insurance coverage through your state’s Medicaid program. You can learn more about this option here.

Taking the Next Step

The transition to securing your own health insurance coverage is a significant step toward independence and personal responsibility. While it may seem daunting, understanding your options and planning ahead can make this journey smoother and more manageable.

LEB Insurance Group is a top health insurance agency in the United States with over 270 licensed agents nationwide. We offer health insurance, life insurance, supplemental coverage, and Medicare services. Learn more about your options and how we can help you by calling 920-215-5320 or completing this form.


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