You are a Young Adult: How the ACA Affects Those Under 26

Do I Have to Have Insurance?

Under the ACA, most people had to have health insurance starting in 2014. This includes children, teenagers, and young adults. People who do not have health insurance must pay a tax.

You will not be required to pay a tax if:

To read more about the insurance requirement, click here.

How Can I Get Health Insurance?

There are many ways young adults can get health insurance.

Different Types of Insurance for Young Adults

Dependent Coverage

Under the ACA, you can stay on your parent’s health plan until you turn 26. This is called dependent coverage. It doesn’t matter whether you are married, single, in school, or working.

This coverage ends on your 26th birthday. However, you will qualify for a Special Enrollment Period. This allows you to get insurance through the Health Insurance Marketplace even if it is not an Open Enrollment period. Your Special Enrollment Period will end 60 days after your birthday. To learn more about the Health Insurance Marketplace, click here.

Medicaid

Before the ACA, states had different rules about who qualified for Medicaid. It depended on if you had children, if you had a disability, if you were male or female, your age, and how much money you made. The ACA makes it easier to qualify for Medicaid. This is called Medicaid expansion.

However, only some states are expanding their Medicaid programs. If your state expands its Medicaid program, you may qualify for Medicaid. To read more about Medicaid expansion, click here.

Health Insurance Marketplace

The Health Insurance Marketplace was created by the ACA as a way for people to buy health insurance. The Marketplace is like Travelocity or Orbitz, except you can buy health insurance rather than book travel and hotels.

Each state has its own Marketplace. To find the Marketplace in your state, go to: https://www.healthcare.gov/get-coverage/

Catastrophic Insurance

If you are under 30 years old, you can buy catastrophic insurance. Under the ACA, catastrophic insurance will pay for three primary care visits and preventive care. After you meet a deductible ($5,950 for an individual and $11,900 for a family), catastrophic insurance will also cover 60% of essential health benefits. For more information about essential health benefits, click here.

What if I Have Health Problems?

Beginning in 2014, a health plan cannot deny benefits, limit benefits, or deny coverage to anyone with a “pre-existing condition.” They also cannot charge you more for your insurance if you have a pre-existing condition. A pre-existing condition is a health problem that developed before you joined the health care plan.

However, this does not apply to grandfathered health plans. For more information about grandfathered health plans, click here.

Will the Affordable Care Act Affect Me in Other Ways?

The Affordable Care Act contains several parts that will help young adults:

Where Can I Find More Information?

HealthCare.gov has a brief section on young adults and the Affordable Care Act: https://www.healthcare.gov/young-adults/

Interact for Health has a short summary of how the Affordable Care Act affects those under 30: http://reform.healthfoundation.org/i-am-under-30