Clarify health insurance options for under 26?

<p>My DS has graduated and actually has 2 job offers. He has another interview next week for an even better job, so fingers crossed. He graduated in Liberal Arts and these are entry level positions but are decent.</p>

<p>I thought he could stay on his dad’s employer insurance. We pay for the family plan so it covers us and our 2 kids. I thought he could stay on it until age 26. It has good coverage and the premium is the same for 1 child or more, so there is no savings by taking him off. He is also covered for dental.</p>

<p>I just read that if he has an employer sponsored plan then he can’t stay on ours.</p>

<ol>
<li><p>Is it still “employer sponsored” if he has to pay about $60 biweekly? </p></li>
<li><p>Can he finish out this year on our plan and then switch to his employer in 2014? He has 30 days to enroll once he begins work, otherwise he has to wait until 2014.</p></li>
</ol>

<p>Our plan is better than the one he will get.</p>

<p>I sure hope he gets the second job he is interviewing for, that one may not start so soon, giving him time to visit any drs. Under our coverage.</p>

<p>Any tips or experience with this? Thanks</p>

<p>This is from the official ACA website. The way I’m reading it, he can stay on your plan:</p>

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<p>But it sounds like he falls under the temporary exception:</p>

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<p>[Young</a> Adult Coverage | HealthCare.gov](<a href=“http://www.healthcare.gov/law/features/choices/young-adult-coverage/]Young”>http://www.healthcare.gov/law/features/choices/young-adult-coverage/)</p>

<p>So I guess the first thing to do would be to ask your insurer. Worst case, he goes on his employer’s coverage for the rest of this year, and then right back onto yours in 2014.</p>

<p>I was able to stay on my parents’ plan even with a work plan offered. (My parents’ plan was much better). I was off the first day of the month following my 26th birthday.</p>

<p>There’s a grandfather clause until Jan 1, 2014 that allows employers to kick off dependents who have an employer-sponsored plan of their own. Not all are grandfathered in though.</p>

<p><a href=“About the ACA | HHS.gov”>About the ACA | HHS.gov;

<p>Says exception is if you can get your own plan. I guess hubby will have to ask HR, but I get the impression that sometimes they don’t even have accurate answers…</p>

<p>I guess its not worth the risk in case he has an emergency and the insurance decides to deny him.</p>

<p>I have to look more into this. Have to look up what plans are grandfathered.</p>

<p>[Dependent</a> Health Coverage (State Implementation)](<a href=“http://www.ncsl.org/issues-research/health/dependent-health-coverage-state-implementation.aspx]Dependent”>http://www.ncsl.org/issues-research/health/dependent-health-coverage-state-implementation.aspx)</p>

<p>Explains the grandfathered concept. Refers to plans enacted after oct 2010. Our company has had a plan since forever, but the plan did change this year to a new carrier. So,is it grandfathered?</p>

<p>OP, I clicked the link in #5, and you’re right, it does give that exception. However, I clicked the first link in that pdf, and it took me right back to the page I linked above which says kids CAN stay on parents’ plans even if offered their own coverage.</p>

<p>The page I linked was last updated in July of last year. Maybe the page you found was older, before they clarified this aspect of the law?</p>

<p>I wouldn’t ask your HR. No HR department really knows what’s going on at this point.</p>

<p>ETA – There’s also this from the US Department of Labor:</p>

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<p><a href=“http://www.dol.gov/ebsa/faqs/faq-dependentcoverage.html[/url]”>http://www.dol.gov/ebsa/faqs/faq-dependentcoverage.html&lt;/a&gt;&lt;/p&gt;

<p>So, again, it looks like at worst, he can come BACK to your coverage next year. And your HR dept probably WOULD be able to tell you if the plan is grandfathered.</p>

<p>OP…dealt with this when my D graduated last year and got a job. There was a thread about this then and I THINK it was KELSMOM who had the quote below. A little checking with H’s employer confirmed she could stay on our plan (we still have S, so family plan) and with D’s employer that she could get coverage at later date, without a waiting period. Our deal with her is that she deposits in savings monthly what she would have been paying had she taken her own insurance–just so she appreciates the cost and so she’ll have a little stash for deductibles, etc., when she gets her own insurance, in two years. I believe she saves ~$120 per paycheck, which is a healthy sum annually.</p>

<p>"Unless the state has its own rules (like MA), the federal rules are different for grandfathered and non-grandfathered health plans. You need to find out if your health plan is GF or NGF. GF plans don’t have to cover those under 26 who have access to health care through their own employers. NGF plans have to cover dependents to 26 regardless of whether or not they have access to their own health care through their employers. In 2014, all plans will be NGF, and all will be required to cover all dependents up to 26 (some will cover just until the 26th birthday, while others will cover through the end of the year in which they turn 26 - that part is employer choice in conjunction with the insurance carrier).</p>

<p>Check with your employer, because even if the plan was GF last year, it might be NGF this year … so you might not have been able to cover your kid last year but can this year."</p>

<p>I am not going to bore you by explaining what GF and NGF actually mean. Just find out which it is for your plan & you will know the dependency rule. If the plan is GF, that should be on all your plan information, by the way."</p>

<p>Our S has a great job that he started in June 2011. It comes with excellent health insurance that he’d have to pay a partial premium for. We got H’s insurer to confirm in writing that S remained covered until he turns 26 even tho he lives independently 5000 miles away, is totally self-supporting, and has employer sponsored plan available. I’d recommending calling your existing insurer and get written clarification.</p>

<p>My employer pays for 100% of our health insurance, even tho D1’s employer also offers very good plan, we have her on my insurance because it is free. We are in NY state.</p>

<p>My D could not stay on my plan because she was given coverage at her teaching job. In 2014 she could be on my plan even though she has coverage at her job.</p>

<p>My D will be leaving her teaching job at the end of her contract because while she loved teaching (she had 100% pass rate for her HSPA tests- even with her non-academic non-english speaking students) she was not a fan of her supervisor. I will add her back on my insurance while she looks for a new position.</p>

<p>Be careful if you ever need to get an under-26 back on your plan. It may not be possible to do it overnight.</p>

<p>My son got a job offer just before finishing his master’s degree. He was on his university’s student health insurance at the time, and he was 25. The health insurance for his new job started 3 weeks after graduation. We were unable to get him back on our plan to cover the 3-week gap. There just wasn’t enough time to arrange it. He had to go without health insurance for 3 weeks.</p>

<p>Did it in one day- we already have the cards effective 06/29/2013</p>

<p>I was curious about if it was possible to be added back onto the parents plan as an under-26 once you’d been taken off. I haven’t worked out the logistics yet but depending on the circumstances I may have a 3-4 week gap in coverage to cover at some point.</p>

<p>Great replies, I think he is going to,be on ours until 26 because I think our plan is NGF. We switched to Aetna starting in 2012, which I believe makes it an NGF. </p>

<p>The question will be in 2015-6 will his coverage expire on his birthday? I have read its up to the plan. I guess it’s also up to the child’s employer if they will make them wait for open enrollment, or if it qualifies as a life status event like marriage etc.</p>

<p>In my case I think we have to ask our HR dept because our plan in technically self insured but administrated by Aetna, so I think the employer sets the rules etc.</p>

<p>I knew this would be a great forum to find real life experience answers!</p>

<p>D has declined her employer-sponsored plan in favor of H’s (much richer) plan. We made sure to call our insurer first to confirm that she was eligible. Since we have chosen one of the less expensive plans offerred to H, it requires in-network providers, referrals to a specialist, etc. (it is a “gatekeeper plan”) so we also made sure that D would be able to find in-network providers even though she doesn’t live in our geographic area. Luckily, our insurer (United/Oxford) has a pretty robust national network from which she can choose physicians. It’s worked out pretty well, especially since we still have a family plan anyway (we still have S on the plan).</p>

<p>My point is, make sure to find out if your provider network will cover your child out of area…</p>

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<p>For me, it expired at the end of my birthday month. So my birthday is in January and my coverage switched at midnight on 2/1. And losing other insurance is considered a qualifying event, so I did not have to wait for open enrollment.</p>

<p>I should also mention that I had college “away from home” coverage and I was allowed to keep that after I graduated. So I had a card for both Anthem CT, which I could use out of network, and Blue Cross MA, which I could use for local in-network providers.</p>

<p>We had no problem adding older d back on our plan. Initially she had aged out at 22, pre-Obama plan but was covered while in grad school under student health/teaching assistant coverage ,then was able in PA to continue coverage as an individual plan but not at a huge cost. She moved back to NY and we easily picked her up again, no questions asked under DH’s family plan. He is retired federal employee and we have family coverage as I decline my company’s crummy plan in favor of his. Younger d is covered as well under family plan. When older d turned 26, she had 30 day grace period under his coverage. Then as she did not have a full-time job that offered coverage and had very little income, she was able to get bare-bones coverage through Healthy NY which cost us 2x what we paid in PA for individual plan. She now has a good full-time job with good benefits and is managing quite well… but younger d, the actress/singer/nanny will age out in August 2014 and we will be faced with that issue again. No one has ever questioned me or required that I elect health coverage from my employer ever.</p>

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<p>Employers have some leeway in this, as I understand it (and that’s the big caveat on a lot of this stuff). Technically, they can boot him at the end of the month in which he turns 26. But apparently some employers are waiting until the end of the year in which the child turns 26. Another option, if the company likes to make its changes all at once, would be to wait until their next open enrollment, which could be into the next calendar year following his turning 26.</p>

<p>Our S aged off our plan the year he turned 22, since that was how the plan was originally written. We bought coverage from his U and then a policy with our insurer to carry him over until he was allowed back on our plan as an under 26. There were no gaps in coverage and he was allowed retroactive coverage.</p>

<p>S will turn 26 in 11/2013. That qualifies as a life status event and he will purchase his own policy within 30 days of that. It will also near his annual open enrollment period with his employer.</p>