Under 26? You’ve got health insurance options
If you're a young adult with questions about health insurance, you aren't alone.
As a member of the Highmark Blue Cross Blue Shield social media team, I’ll admit that I have more knowledge about health care than most people my age (23, if you’re wondering). But it wasn’t long ago that I knew next to nothing about health insurance. It was easy to stay in the dark because I was on my parents’ health insurance plan and didn’t have to worry about it.
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Then I graduated college. I moved to Pittsburgh, got a job, and my parents started asking about my company’s benefits plan. I took the hint; it was time to make my own health insurance choices.
For me, it was a pretty easy decision; I work for a health insurance company that offers affordable coverage. But it got me thinking a lot about my friends whose part-time jobs, full-time educational pursuits, and job hunts don’t make their health insurance choices so cut-and-dry, even though we’re all around the same age.
Having grown into a bit of a health care nerd, I started asking them what they were doing about their health insurance and if there was anything they didn’t quite “get.” And despite the general awkwardness of segueing a conversation about football into one about health insurance, it turned out a lot of my friends had questions.
So, if you’re like them, and you’re not quite sure what to do — or even what you can do — about your health insurance, here’s the good news: You’ve got options. Here they are, in no particular order.
Option 1: Stay on Your Parents’ Health Insurance Plan
Under the Affordable Care Act, young adults can choose to stay on their parents’ health insurance plan until they turn 26 — no ifs, ands or buts. That means you can stay on your parents’ plan whether or not you:
- Live with your parents
- Are claimed as a dependent on your parents’ taxes
- Have a full-time job
- Are eligible to enroll in your employer’s health plan
- Attend school
- Are married
For some, this is ideal, as plans that cover families may be less expensive per person than individual plans. Others, in their quest for independence, choose to purchase their own insurance before they turn 26 (I’m guilty of that).
If you do stay on your parents’ plan, you might want to help them out and take on the financial responsibility of paying for your own health insurance. You can work out a system with them to pay your portion of the monthly premium, and your share of co-pays and costs toward your family’s deductible.
Option 2: Enroll in a Student Health Insurance Plan
If you’re attending a college or university, you may be able to enroll in that school’s student health plan. These plans tend to be relatively inexpensive, and are a good option if your parents don’t have health insurance, or if you don’t want to stay enrolled under their plan.
Find out if your school offers health insurance options by poking around its website or calling the financial aid office.
Option 3: Enroll in Your Employer’s Health Plan
You don’t have to wait until you’re 26 to enroll in one of the health insurance plans offered by your employer. Depending on where you live and what you can afford, the coverage your employer offers may suit your situation better than your parents’ insurance plan.
If your employer does offer coverage, it’s a good idea to at least look at what they offer and compare it with your current plan. For what it’s worth, though you may have to pay a little more monthly than you have before, it feels really good to be paying for your own health care coverage. I know, it sounds crazy, but it’s true. Plus, you’ll be saving your parents some money — an angle you can easily cash in for brownie points.
Option 4: Choose a Plan from your Local BCBS company or on the Insurance Marketplace
If your employer or school doesn’t offer insurance, you can choose your own individual health insurance plan by contacting your local BCBS company, or online from the Healthcare Marketplace. Open enrollment runs from November 1, 2016 to January 31, 2017 this year.
You may also qualify for a special enrollment period as a result of certain life events, such as:
- turning 26
- getting married
- having a child
- moving or graduating from college
- losing your student health insurance coverage.
- In the case of these events, you have 60 days to visit www.healthcare.gov to see your options and sign up for a plan. Don’t forget to see if you’re eligible for financial help to pay for coverage.
When you’re choosing your own plan, be sure to consider all of your options. A low monthly premium may look appealing. But it may mean you’re agreeing to pay a higher share of any health care costs that arise during the year. Always think about your total health care costs rather than just the premium. If you anticipate needing a lot of medical care, or wouldn’t be able to cover a higher deductible if you had an unexpected medical issue, choosing an option with a higher level of coverage may be smarter, and less costly. If you have questions, a representative at your local BCBS company will be able to help.
Option 5: Investigate Your Eligibility for Medicaid Coverage
Depending on your annual income and other criteria, you could be eligible for Medicaid coverage through your state’s Medicaid program.
Medicaid is the state and federal program that helps to cover medical costs for Americans living with limited income or resources. You can find out if you’re eligible for Medicaid online.
Option 6: Look into a Catastrophic Health Insurance Plan
As someone under 30, you could be eligible to sign up for a “catastrophic health insurance plan.” Catastrophic plans are designed to protect you in worst-case-scenario medical situations. With a plan like this, you’ll be paying for all medical care you may need up to a maximum amount (your “deductible”).
Though catastrophic plans can have lower-cost monthly premiums than other plans, their deductibles are often significantly higher. Catastrophic plans do cover three visits to a primary care physician per year before you meet your deductible, as well as certain preventive services with no cost sharing, so you don’t have to worry about paying for those. But they also don’t apply to meeting your deductible.
Before selecting a catastrophic plan, consider the risk factors in your life that may require you to be more accident or illness prone or to need medical care. Do you smoke? Play contact sports? Ride a motorcycle? Are you managing a chronic condition? Any of these could increase your risk of needing medical care that a catastrophic plan wouldn’t cover until you’ve paid your deductible.
It’s worth noting, too, that catastrophic plans aren’t eligible for financial help through the Healthcare Marketplace, so an eligible silver-level plan could end up being a better option, with more robust coverage for an equal or lower cost.
I work in the industry, and there’s still a lot that I find confusing about health insurance and health care. But I have the advantage of being able to reach out to experts in the organization any time I need to understand something better. The good news is: so do you. There are 36 independent and locally-based Blue Cross and Blue Shield companies across the U.S. ready to help you understand your options for health insurance covered. You can find contact information for the BCBS company in your area here.
In any case, always keep in mind that what kind of coverage you get is your decision. Choice is a good thing. And with all of the options available, and a little expert help to understand them, you should be able to find a plan that meets your coverage needs and your price range.
Editor’s Note: This article appears on the Highmark Blog. Visit for more answers to your health insurance questions, healthy ideas, community stories and more.