Surely someone here will know: S2 turns 26 in the same month as his company’s open enrollment. He can sign up for his company’s coverage the 1st of the birthday month (when he will come off his father’s coverage because he’s aging out).
But, that coverage won’t be effective until the 1st of the following month. So for the 18 days after his 26th birthday, is he uninsured? I am concerned about the ramification of a coverage gap, however small, for someone who has very large medical expenses. But maybe that’s not a problem until the current Congress revokes pre-existing condition protections?
Thanks in advance. And here I thought we had carefully covered all the angles, but his company changed companies this fall and S2 thought open enrollment would be the same time as before (which would have been before his 26th, so no gap)
Not exactly answering your question, but if your S has a qualifying event, he should be eligible for his employer’s insurance plan before open enrollment begins. Losing health coverage is a qualifying event.
Wouldn’t aging out of his current insurance count as a life event and so he can sign up for insurance at his current job when that happens? He should see if he can sign up a month early. Also see if his current insurance will cover him for the entire month and end at month end instead of his birthday, essentially going by his age on the first of the month and not a day by day thing.
I’m pretty sure my older daughter was covered under my plan until the last day of the month she turned 26. However, this might have been because of the specific insurance plan. It does appear that turning 26 and losing coverage starts a special enrollment period for other insurance, including the young person’s employer’s plan.
Kid doesn’t have to wait for open enrollment. He should apply for company insurance before he ages off the parent policy. Start the process as soon as possible so you know any waiting period for it to become effective.
My DD was also done with my insurance in the middle of the month. That was considered a life event, and she was able to enroll in other coverage as of the middle of the month as well. She was able to enroll outside of the open enrollment period and didn’t have to wait.
Are you saying that you son’s employer won’t allow him to enroll until the first of the following month? Why is that? He needs to ask HR about this.
If t company really won’t let him enroll…you should be able to purchase an individual plan beginning the month of his birthday…or on his birthday…through the ACA…and then just cancel it when he can enroll in his company plan two weeks later.
Plans are different. Some cover the child though the year they turn 26 (until the next plan year) but some only through the month of their 26th birthday. However, if he is indeed dropped on his 26th birthday, he should receive the option of COBRA for that policy. Usually you can sign up for COBRA for 60 days after the policy ends with coverage retroactive (and the premium charge too), so if anything happened during those first 30 days without coverage he could sign up for COBRA. If nothing happened, the new group coverage (which is fine to have a gap in coverage) will kick in.
If your son is already at the employer, just sign up for the coverage because of a ‘life event’ the month before the new year policy starts. His HR reps should be able to help.
My daughter started her new job in July and I thought her insurance would start the first of Aug, but turns out she had to work a full month before it starts (it is paid for by her employer). Her policy from college expired Aug 1. She was fine.
The plan he is on now (my husband’s employer) kicks them off at midnight the day of their 26th birthday. We did this already with S1. I did remember COBRA benefits and a pile of paperwork being waved about, but it didn’t apply in that situation.
His current employer’s HR “department” is one person, who confidently asserts that he can’t claim a “life event” of aging out until he actually does turn 26. I too am skeptical about this. I tasked him with going back to that person with more questions about how they handle life event coverage.
He can enroll at any point during the month of open enrollment, which is unluckily the same month he turns 26. But for all employees who sign on during open enrollment, the coverage doesn’t begin until the 1st of the following month.
My son’s birthday is on the first of the month, and I’m 99% certain that he was covered under my husband’s plan for the entire month the year he turned 26.
When coverage ends varies by employer and insurance carrier. My kid’s coverage ended on midnight of her birthday. So did my son’s (same insurance and employer).
We had friends whose policies covered until the end of the month.
This parent says…the kid is covered only until his birthday.
Really…the easiest thing would be to get an individual policy starting the day if his birthday…he can do this because his coverage is ending otherwise.
Then when his company picks him up…just drop the other coverage.
I am just surprised some policies would end on a particular date and not at end of month. I think every plan I have been on was on monthly. I recently left a company mid month and my insurance went to end of month. I have even taken a chance not to pay cobra for a month before I started a new job because I had 45 days to sign up for cobra - if I had to submit a claim I could alway back pay premium so I could be covered. If it is indeed true your son’s insurance on the midnight of his 26th birthday then he should be able to get on his company insurance as soon as he turns 26.
Because S would have his family coverage end during his SR year of college (his ended when he reached 22), we bought him school coverage for that school year and when the policy was going to end, got him month to month from the date school policy ended (mid-aug after he graduated) to 12/31. The ACA increasing the family coverage to age 26 kicked in after that, making him covered by H’s family policy again.
The insurer candidly said it made perfect sense for him just to stay under our excellent family plan rather than getting his own employer subsidized coverage, so that’s what he did.
Turning 26
If you’re 25 and are covered under a parent’s health plan, it’s important to know that your current coverage will end when you turn 26. The Affordable Care Act says 26 is the age at which individuals must be responsible for their own health insurance. Of course lots of birthdays fall outside the Open Enrollment period, which is why that 26th birthday is a qualifying life event. Once you turn 26, you’ll have 60 days to sign up for a health insurance plan that meets your needs and suits your wallet. If you enroll before your 26th birthday, coverage can start as soon the first day of the month you lose your current coverage. If you enroll during the 60 days after your birthday, coverage can start the first day of the month after you pick a plan.
Just going through this. Even though my small companies HR person told me my son would be off the day he turned 26, he was actually covered until the end of the month in which he turned 26. You should ask for the specifics, because that might be the case.
Your son’s HR person is wrong as if he is kicked off your husband’s policy as of Nov. X, that IS a qualifying life event and he should be covered by the new company policy before the open enrollment period.
If the new company absolutely refuses to cover him until open enrollment (or your son doesn’t want to push the issue), he can be covered under COBRA at your husband’s company for that one month period. The downside is that you would have to pay the full cost of the coverage - what you are paying now PLUS the employer contribution.
The other option is to get him covered under the ACA for that brief period. In our case, I am covering him under COBRA for up to two months, although an ACA plan likely would have been less costly. I didn’t really know or think about that until it was too late.
And now that I read Oldfort’s comment, I may have been able to avoid paying for his COBRA by not triggering it unless needed. Too late now.
My nephew was on his mom’s policy until he turned 26. He works for his dad, who was moving his small business’s insurance at the time his son aged out. He didn’t purchase any kind of insurance right away, figuring his son would be fine for a short time. Of course, during that time, his son had a totally unexpected health issue that landed him in the hospital (a staph infection). I have some knowledge in this area - I told him to get COBRA coverage right away, since his son was still in the 3-month required period for coverage. Whew - thank heavens for that option, because it saved them a huge hospital bill.
My son is 3 weeks younger than his cousin & aged out around the same time. I got COBRA for him right around the end of the time period, just in case he was able to get a job with insurance benefits during that time frame. While he did get a new & better job, it didn’t come with insurance benefits right away. This is the 6th month of COBRA payments - we won’t let him go uncovered, even though he was leaning toward that. Good thing, too, because he now has a health issue that involved tests and specialists. He is supposed to be getting insurance through work the first of the year. Fortunately, the COBRA payment is not bad.
To add another winkle, COBRA does not apply to all employer plans. There are several state exceptions, allowing COBRA-like extended coverage for small employers, but generally COBRA only applies to larger employers.
As noted above, the decision as to when to enroll depends on a lot of factors, like when coverage ends, and what other options are available, and at what cost for what benefits they offer.
But there are other issues to think about especially late in the year - issues like deductible carryover credit are becoming more and more important to think about as many plans administer deductibles on a calendar year basis, while some operate on a plan year or an enrollment year basis. Signing up for a new ACA plan or even getting onto the employer’s plan may look cheaper than COBRA, based on the price tag, but when you factor in the lower benefits, sometimes it is not worth it - especially when the deductible has been reached. Since my niece was taking some very expensive ($1500/month) medications, she found staying on COBRA allowed her prior claims to help satisfy her deductible on her COBRA plan, but if she had picked an IVL plan on exchange - even with the same carrier - she would have had to satisfy a whole new deductible even for just a few months.