Health Insurance After 26

I haven’t ever really had to think about health care before this year. My mom has always had health insurance which helped cover all of my broken bones, stitches, and surgeries as a kid (and adult.) But I just turned 25 a few weeks ago, which means my doomsday countdown has already started. And given my medical history, I’m starting to freak out a bit. 

Health Insurance After 26

When you turn 26, you have to become a real full-fledged adult. You can’t hide behind your parents like I’m currently doing. I am still under my mom’s health insurance, and I thank her for it all the time. Of course, being under your parent’s health insurance up until the cut-off point doesn’t make you any less of an adult. But it’s a nice privilege when you don’t need to worry about something as expensive and stress-inducing as health insurance. 

Aging Out

Maybe it’s the anxiety induced by the unknown, but there seems to be ever-looming stress hanging over me about this stupid health insurance problem. Do I get kicked off my mom’s health insurance the day I turn 26? Or is it the month? The year? What’s the timeline? 

Lucky for you, I did the research, and the answer is simple enough. If your parent’s insurance is from the Obamacare marketplace, you have until the end of the year you turn 26. If your parent’s insurance is private or employer-sponsored, you have until the end of the month when you turn 26. But, of course, some of us are a little luckier than others regarding our doomsday clocks. 

There are exceptions to the 26 aging out rule in 7 states, but Oregon isn’t one of them. Sorry. 

What to Do

Aging out of your parent’s health insurance grants you a special enrollment period. You have 120 days to sign up for health insurance. It starts 60 days before your drop date and 60 days after it. It’s better to be safe than sorry, so you should sign up for health insurance during the first half of your birthday month. Make sure it’s before the 15th of your month to have no gap in coverage. For example, if you sign up for insurance on the 16th, your insurance won’t start until the month after next. (Why must there always be a deadline. This world was not made for those of us with ADHD who like to procrastinate.) 

What Are Your Options

It’s no secret that health insurance isn’t cheap. Honestly, the health care system in the US is scuffed. It’s one giant scam that needs to be completely reworked from top to bottom. And if you don’t agree, you either have an insane amount of money, work in the industry, or are completely ignorant of the world around you. Either way, you can keep your opinion to yourself. But there are so many options out there for picking health insurance. And all of those options are abbreviated into three-letter acronyms. (Because it wasn’t already confusing enough.)  

This is a breakdown of the insurance plans out there. Fun, I know. If you want to learn more about buying health insurance for the first time, check out our article.

Plan typeStay In-NetworkReferralBasic Breakdown
PPO: Preferred Provider OrganizationNo, but staying  in-network costs less.NoYou get more options in who is providing your care but your out-of pocket costs are higher
EPO: Exclusive Provider OrganizationYes, except for emergencies.NoYou don’t have much say in who is providing your care but your out-of-pocket costs are lower with the added benefit of no referrals needed.
POS: Point of Service PlanNo, but staying  in-network costs less.YesYou have more options in who is providing your care but you will have a primary doctor who is in charge of your care.
HMO: Health Maintenance OrganizationYes, except for emergencies.YesYou pay less for services out-of-pocket, but you have a primary doctor who is in charge of your care.

Adulting Sucks (I use this phrase way too much) 

I feel old. I want to go back to when my knees didn’t creak every step, my back wasn’t sore after sleeping, and I could eat whatever I wanted with zero consequences. If I could, I would go back to when it was acceptable to eat crayons, so like five years old. But alas, my doomsday clock has started, and at the time of my writing this article, I have 351 days and 11 minutes before I age out of my mom’s health insurance. Hopefully, the anxiety-fueled research from my quarter-life crisis helps ease any of your anxiety.    

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