Ask the Health Insurance Expert
QI recently took a job out of state and will be eligible for insurance through my employer soon. Can I place my daughter on my plan? She is under 26 years old, but going to school in another state.
The Affordable Care Act (ACA) allows young adults under age 26 to remain on a parent’s health insurance policy even if the child is:
- Not living with their parents
- Attending school
- Not financially dependent on the parents
- Working and eligible to enroll in an employer’s health plan
If your new employer’s health insurance plan allows you to add dependents – and not all do -- you can put your daughter on the policy and keep her there until she turns 26. However, if she is out-of-state, she may find that none of her local medical providers participate in your insurance network.
If your daughter has to go to out-of-network doctors or hospitals, her costs for care may be very high. Depending on your particular plan, using medical services that are out-of-network could mean paying a larger percentage of the costs or the total cost.
Out-of-network providers haven’t agreed to any rates set forth by your insurance company and usually require larger co-pays, deductibles, and co-insurance. Also, some plans don’t cover out-of-network care at all – and that would leave your daughter paying the full cost of any medical care she received.
If the out-of-network issue makes using your health insurance plan cost-prohibitive for your daughter, she should look at other ways to obtain health insurance.
The open enrollment period to buy individual health insurance is over for this year, but if your young adult loses her health insurance due to your job change, it opens up a special enrollment period.
She can then shop for an individual health insurance policy from top-rated health insurers or an insurance marketplace (where she may qualify for a subsidy). Depending on her income and where she lives, she also may be eligible for Medicaid.