Q. We are going to be covered in July through my husband's employer. Our adult daughter will turn 26 in September. We were told we can make no changes to our policy until open enrollment the following year. How will this affect her? Will she need to seek other coverage?
A. Eventually she’ll have to get her own plan, but first check with your husband’s employer to find out exactly when your daughter will lose her coverage.
Some plans terminate coverage on the 26th birthday, and others will retain coverage through the end of the plan year,” says Cheryl Fish-Parcham, private insurance program director at Families USA, an advocacy group.
If your daughter wants to keep her coverage through your plan after she “ages off,” she may be able to extend it for up to 18 months under the federal law known as COBRA. But she would be responsible for paying the entire cost.
If she doesn’t have access to good coverage through her own job, she can also check out individual plans on your state health insurance marketplace. Because she’s losing her coverage under your plan, she’ll be eligible for a special enrollment period. If her income is between 100 and 400 percent of the federal poverty level (currently $11,490 and $45,960 for an individual), she could be eligible for premium tax credits to make coverage more affordable.
If her income is less than 138 percent of the federal poverty level ($15,856 for an individual) and you live in one of the roughly half of states that have expanded Medicaid to cover childless adults, she may be eligible for that coverage. Check out your state’s health insurance marketplace for more information.
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.