For all types of health insurance, there are generally two opportunities to enroll and activate coverage. The first is during an open enrollment period. On the Health Insurance Marketplace, open enrollment occurs from Nov. 1 to Jan. 15. During the rest of the year, you can get health insurance, or make a change to your current plan, if you experience a qualifying life event, which gives you a special enrollment period. Turning 26 is a qualifying life event.

What is a Qualifying Life Event?

A qualifying life event is a change in your circumstances, such as losing a job or having a baby. Because these kinds of major life events can alter your health insurance needs, they are considered qualifying life events. They enable you to be eligible for a special enrollment period, during which you can choose a new insurance plan or make changes to your current coverage. You don’t have to wait for the yearly open enrollment.

Why is Turning 26 a Qualifying Life Event?

Turning 26 is a qualifying event because parents are only allowed to provide insurance coverage for their children through the age of 26. This is sometimes referred to as “aging out.”

When the coverage officially ends could vary, so you may need to check with the employer or the insurance plan. Some states and plans have different rules.

In addition, Marketplace plans may differ from most job-based plans. For example, if a child is covered under a parent’s Marketplace plan, the child can maintain coverage through the end of the year during which the child turns 26. So if a child turns 26 on Jan. 1, the child can stay on the parent’s Marketplace plan through Dec. 31 of the same year. However, if a child is covered under a parent’s job-based health insurance, that coverage usually ends on or close to the child’s 26th birthday.

How to Get Health Insurance When You Turn 26?

If you will be turning 26 soon, your first step is to determine when your health insurance coverage will officially end. If your coverage is through a parent’s job-based plan, ask your parent to check your end date with the employer benefits coordinator. If it’s a Marketplace plan, your coverage will continue through Dec. 31 of the year you turn 26.

Be sure to take action before your coverage ends. Otherwise, you will be without valuable health insurance, which means you will have to pay full price for medical care, including medical emergencies, which can be costly.

Here are two options for coverage.

1. Job-based health insurance.

If you are employed and your employer offers health insurance, you may want to check with your employer’s benefits coordinator prior to your birthday. It’s likely that you will have a limited time to enroll, so it’s best to learn about your employer’s options before your parental coverage ends.

2. Marketplace health insurance.

You can apply for your own plan on the Health Insurance Marketplace. How to do that varies depending on a few factors.

• If your parent or parents will not claim you as a dependent on the current year’s tax return, then you can create your own account and enroll in a plan that works for you.
• If your parent or parents will claim you as a dependent on the current year’s tax return and if they currently have Marketplace insurance, then you will stay on your parent’s Marketplace application. Then, during open enrollment, your parent can enroll you in your own Marketplace plan.

NOTE: If your employer offers health insurance that meets the requirements for being “affordable” and you decide not to enroll in it or miss your special enrollment opportunity, you can enroll in Marketplace insurance. However, you probably will not be eligible for Marketplace tax credits and other subsidies. This means you will pay the full price for any Marketplace plan.

Types of Insurance Plans for Young Adults

Choosing the right health plan can be confusing, even for those who are experienced with insurance. If coverage is available through your job, you may have more than one plan option, and it can be tough to decide which is the best for your needs.

Generally, if you are fairly healthy and don’t often need medical care, a plan with a higher deductible may be a good option. These types of plans should have lower monthly premiums and will help protect you in case of a medical emergency. However, you may have to pay more out of your pocket when you receive medical care.

If you don’t have access to coverage through your job, or you want to learn more about Marketplace options and compare costs, we’re here to help. Call us at 844-933-0380 (TTY: 711) from 8 a.m. to 9 p.m. ET to learn more about your health insurance options. Our licensed agents can help you find the right plan for your unique needs.

Frequently Asked Questions About Qualifying Life Events