Frequently Asked Questions about the Affordable Care Act (ACA)

Click on any of the frequently asked questions about the Affordable Care Act below to see an answer from HealthKY.com.

Cost-Sharing Reductions (4)

I can’t afford to pay much for deductibles and co-pays. Is there help for me in the Marketplace for cost sharing?

Yes. If your income is between 100% and 250% of the federal poverty level, you can also qualify for cost sharing reductions. These will reduce the deductibles, copays, and other cost sharing that would otherwise apply to covered services. The … Continue reading

If I use my premium subsidy for a Bronze plan, I can save even more money on the premium. Can I also get my cost-sharing reduction through a Bronze plan?

No, you can only get cost sharing reductions by enrolling in a Silver Marketplace plan. You will not receive cost sharing reductions if you enroll in a Bronze, Gold, or Platinum plan. Note that this is different from the rule … Continue reading

How much are the cost-sharing subsidies?

That depends on your income and where you live. To give a general idea, a typical Silver plan might have an annual deductible of $2,000 to $3,000 and an annual out of pocket limit on all cost sharing of $6,350. … Continue reading

If I mis-estimate my income and end up earning more than 250% of the federal poverty level next year, will I have to pay back the cost sharing subsidies?

No. Unlike premium tax credits, which are reconciled each year based on the income you actually earned, cost sharing reductions are not reconciled.

Help Paying Private Health Insurance Premiums (13)

Who is eligible for Marketplace premium tax credits?

Premium tax credits will be available to U.S. citizens and lawfully present immigrants who purchase coverage in the Marketplace and who have income between 100% and 400% of the federal poverty level. Premium tax credits are also available to lawfully … Continue reading

Can I get premium tax credits for health plans sold outside of the Marketplace?

No. Premium tax credits are only available for coverage purchased in the Marketplace.

Can I use the premium tax credit to reduce the cost of any Marketplace health plan?

You can apply the premium tax credit to any Bronze, Silver, Gold, or Platinum plan offered through the Marketplace. Premium tax credits cannot be applied to Catastrophic plans or to stand-alone dental plans. If you are also eligible for cost … Continue reading

How do the premium tax credits work?

Premium tax credits reduce your premium for most Marketplace policies. The amount of the tax credit you may receive depends on your income and the cost of Marketplace health plans in your area. The Marketplace will determine the expected contribution … Continue reading

How do I apply for premium tax credits?

On the health insurance Marketplace web site, you will find an Application for Health Coverage and Help Paying Costs. Filling out the application online is the fastest, though you can also submit a paper application or call your Marketplace call … Continue reading

When can I apply for Marketplace premium tax credits when other coverage is available?

In general, if you have any of the following types of coverage, you would be ineligible for premium tax credits through the Marketplace: Employer-sponsored coverage, unless the coverage is unaffordable (your required contribution to premium for self-only coverage costs more … Continue reading

I’m single and I’m offered health benefits at work. Can I try to find a better deal in the Marketplace?

Usually no. If you are offered health benefits at work and your required contribution costs no more than 9.5 percent of your household income, you will not be eligible for premium tax credits through the Marketplace. If you are required … Continue reading

I’m married. I work full-time for a large employer that offers me health benefits, but won’t cover spouses. Is that allowed? Can my wife apply for coverage and subsidies in the Marketplace?

Beginning in 2015, large employers will be required to offer health benefits to full-time workers and to their dependent children, or face a penalty. A large employer is one that employees at least 50 workers. Once the provision takes effect … Continue reading

My family and I are offered health benefits through my job, but we can’t afford to enroll. My employer pays 100% of the premium for workers, but contributes nothing toward the cost of adding my wife and kids. Can we try to find a better deal in the Marketplace?

You can always shop for coverage on the Marketplace, but your family members won’t be eligible for tax credits to help pay the premium. When people are eligible for employer-sponsored coverage, they can only qualify for Marketplace premium tax credits … Continue reading

If I’m eligible for other coverage but haven’t enrolled in it yet, can I qualify for premium tax credits in the Marketplace?

For certain types of coverage, if you are eligible but not enrolled, then you can still qualify for premium tax credits. These include: Retiree health coverage offered by a former employer COBRA coverage Student health plan coverage Medicare Part A … Continue reading

My kids are eligible for the Children’s Health Insurance Program. Can I enroll them in our Marketplace health plan and get premium tax credits for them instead?

You can add your children to your Marketplace plan, but because they are eligible for your state’s Children’s Health Insurance Program (CHIP), they are not eligible for premium tax credits. The exception to that is if you live in a … Continue reading

How much can I earn and qualify for premium tax credits in the Marketplace?

Premium tax credits are available to people who buy Marketplace coverage and whose income is between 100% and 400% of the federal poverty level.

Will I qualify for lower costs on monthly premiums?

When you get health insurance coverage in the Marketplace, you may be able to get lower costs on monthly premiums. This depends on your income and family size.

Individual Responsibility To Have Health Coverage (8)

I got a cancellation letter, what does it mean?

There are three options: Your plan is still available but there’s a fine. Your provider is informing you that your health plan is still available through them but it doesn’t meet the “minimum essential benefits” required by law. You will … Continue reading

I lost coverage March 15 and didn’t get new coverage until April 1. Am I considered uninsured for the month of March because I lacked coverage for part of the month?

No, if you are covered even one day during a month, you are considered to be insured for that month. Similarly, a person who is considered exempt from the individual responsibility requirement for even one day during a month is … Continue reading

How do I apply for an exemption?

For some types of exemptions, you must apply through the health insurance Marketplace; for other types, you must apply when you file your taxes; some types of exemptions can be claimed either way. The religious conscience exemption and most hardship … Continue reading

I’m uninsured. Am I required to get coverage in 2014?

Everyone is required to have health insurance coverage – or more precisely, “minimum essential coverage” – or else pay a tax penalty, unless they qualify for an exemption. This requirement is called the individual responsibility requirement, or sometimes called the individual mandate.

How do I prove that I had coverage and satisfied the mandate?

When you file your 2014 tax return (most people will do this by April 15, 2015) you will have to enter information about your coverage (or your exemption) on the return. You should get a notice from your insurance provider … Continue reading

If I owe a penalty, when and how do I have to pay it?

If you do not maintain minimum essential coverage in 2014 and you don’t qualify for an exemption you will need to pay a “shared responsibility payment” to the IRS on your 2014 tax return. If you are like most people, you … Continue reading

What if someone doesn’t have health coverage in 2014?

If someone who can afford health insurance doesn’t have coverage in 2014, they may have to pay a fee. They also have to pay for all of their health care. The fee is sometimes called the “individual responsibility payment,” “individual … Continue reading

How does the health care law affect me?

If you already have health insurance, you now have access to expanded preventative services like checkups, cancer screenings, mammograms and contraception at NO additional cost. Young adults can now remain on their parents’ health insurance plan until the age of … Continue reading

Job-Based Insurance (3)

I’m eligible for health benefits at work but want to see if I can get a better deal in the Marketplace. Can I do that?

You can always shop for coverage on the Marketplace, assuming you meet other eligibility requirements, but if you have access to job-based coverage, you might not qualify for premium tax credits.

What if I have job-based insurance?

If you have coverage from a job (or a family member’s job), you’re considered covered and won’t have to pay the fee that uninsured people must pay.

What if I’m losing job-based insurance?

If you lose your job and with it your job-based health insurance coverage, you may buy an individual plan through the Marketplace. You may also have the option of keeping your health insurance for a limited time through a program … Continue reading

Marketplace Eligibility, Enrollment Periods, Plans and Premiums (13)

When can small employers enroll in coverage through the SHOP Marketplace?

Small employers can buy coverage for their employees through the SHOP Marketplace at any time during the year.

I signed up for a Bronze plan with a high deductible during Open Enrollment. Now, six months later, I need surgery and would rather be in a different plan with a lower deductible. Can I change plans?

No, in general, once you sign up for a plan, you are locked into that coverage for 12 months, or until the next Open Enrollment period. A change in health status doesn’t make you eligible for a special enrollment opportunity.

When can I enroll in Medicaid through the Marketplace?

You can enroll in Medicaid or CHIP at any time during the year, not just during Open Enrollment.

When can I enroll in private health plan coverage through the Marketplace?

In general, you can only enroll in non-group health plan coverage during the Open Enrollment period. This year the Open Enrollment period begins October 1, 2013 and extends through March 31, 2014. After that, the Marketplace Open Enrollment period will … Continue reading

Can I buy a plan in the Marketplace if I don’t have a green card?

If you are not a U.S. citizen, a U.S. national, or an alien lawfully present in the U.S., you are not eligible to buy a plan on the health insurance marketplace. However, you can shop for health insurance outside of … Continue reading

Who can buy coverage in the Marketplace?

Most people can shop for coverage in the Marketplace. To be eligible you must live in the state where your Marketplace is, you must be a citizen of the U.S. or be lawfully present in the U.S., and you must … Continue reading

I notice Marketplace plans are labeled “Bronze”, “Silver”, “Gold” and “Platinum”. What does that mean?

Plans in the Marketplace are separated into categories — Bronze, Silver, Gold, or Platinum — based on the amount of cost sharing they require. Cost sharing refers to health plan deductibles, co-pays and co-insurance. For most covered services, you will … Continue reading

I also notice “Catastrophic Plans” that look even cheaper. What are those and can I buy one if I want?

Insurers can also offer “Catastrophic” plans. Catastrophic plans have the highest cost sharing. In 2014, Catastrophic plans will have an annual deductible of $6,350 ($13,700 in family plans). You will have to pay the entire cost of covered services (other … Continue reading

What is the new Health Insurance Marketplace?

The Marketplace, also known as the insurance “exchange,” is a new way to find health coverage that fits your budget and meets your needs.

How do I choose Marketplace insurance?

There are 5 categories of Marketplace insurance plans: Bronze, Silver, Gold, Platinum, and Catastrophic. The categories help you choose a plan that’s right for you.

How can I save money with the Health Insurance Marketplace?

You can potentially save money on monthly premiums when enrolling in a private health plan because ALL plans will cover essential health benefits and pre-existing conditions. You can also reduce health care costs because you may be eligible for a … Continue reading

Can I get dental coverage in the Marketplace?

In the Health Insurance Marketplace, you generally can get dental coverage as part of a health plan or by itself through a separate, stand-alone dental plan.

Marketplace Verification and Appeals (4)

The Marketplace said I must submit additional information to document my eligibility (to buy coverage or to qualify for premium tax credits). They gave me 90 days. I won’t be able to gather the information that quickly. Can I request an extension?

Yes. You must request any extension before the 90-day deadline runs out. You can request the extension in writing or through the Marketplace call center. In your request you should include your name, a description of the supporting documents requested, … Continue reading

The Marketplace said I must submit additional information to document my eligibility (to buy coverage or to qualify for premium tax credits or to receive and exemption). They gave me 90 days, but I missed the deadline. Can I request an extension?

If the Marketplace hasn’t received the requested information within 90 days and you didn’t already ask for an extension, the Marketplace will make a determination based on the information it has.

How do I appeal a Marketplace decision?

You can request an appeal of any Marketplace decision, including decisions about Your eligibility to buy coverage in the Marketplace Your eligibility for, or the amount of, premium tax credits or cost sharing reductions Your eligibility for an exemption from … Continue reading

How long will the appeal take?

This will depend on the reason for your appeal and the documentation needed to decide your appeal. Contact the Marketplace for more information about your appeal.

Medicaid (2)

When can I enroll in Medicaid through the Marketplace?

You can enroll in Medicaid or CHIP at any time during the year, not just during Open Enrollment.

Do I qualify for Medicaid?

You qualify for Medicaid based on income and family size. If you’re eligible, you get free or low-cost care and don’t need to buy a Marketplace plan.

Minimum Essential Coverage (6)

What kinds of coverage count as Minimum Essential Coverage to satisfy the requirement to have health insurance?

Most people with health coverage today have a plan that will count as minimum essential coverage. The following types of health coverage count as minimum essential coverage: Employer-sponsored group health plans Union plans COBRA coverage Retiree health plans Non-group health … Continue reading

Do private insurance policies have to be labeled to show whether they are Minimum Essential Coverage?

All health insurers and employer-sponsored group health plans must provide people with a Summary of Benefits and Coverage, which uses a standard format to outline the benefits, cost-sharing and coverage limits of plans. The Summary of Benefits and Coverage must … Continue reading

An agent offered to sell me a policy that pays $100 per day when you’re in the hospital. Does that count as Minimum Essential Coverage?

No. Some types of coverage do not qualify as minimum essential coverage. These include hospital indemnity policies (that pay a fixed dollar amount per day when you are hospitalized), discount plans, short-term nonrenewable policies, or plans that provide coverage only … Continue reading

What is a grandfathered plan? How do I know if I have one?

Grandfathered plans are those that were in existence on March 23, 2010 and have stayed basically the same. If you buy coverage on your own and you first purchased your policy prior to March 23, 2010, it may be a … Continue reading

I notice short-term policies are for sale outside of the Marketplace and they are much cheaper than many other policies. What is a short-term policy? If I buy a short-term policy, does that satisfy the requirement to have Minimum Essential Coverage?

As the name implies, a short-term health insurance policy offers coverage for a period of less than 12 months (e.g., many offer coverage for just 6 months) and are renewable at the option of the insurance company. Though you may … Continue reading

Non-traditional Households (4)

My partner and I are unmarried and we have two children. How do we count our household size and income when we apply for subsidies in the Marketplace? Can we buy one policy to cover the whole family?

Assuming you are eligible for premium tax credits, the amount of your credit will be calculated based on how you file your taxes. If for example, you each claim one of your children, you each will be considered as a … Continue reading

We are a same-sex married couple. We moved from the state where we married and now live in a state that doesn’t recognize same-sex marriages. How should we count our household when we apply for Marketplace subsidies?

Assuming you plan to file your federal income taxes as a married couple, yes you can apply for premium credits as a married couple. It does not matter if you no longer live in the state where your marriage was … Continue reading

My partner and I are unmarried. Can we buy a policy that covers us both? Are we counted as a household of two?

Because you are not married, you will be considered two separate households for the purposes of determining eligibility for premium tax credits and Medicaid. Assuming that neither of you are claiming any dependents on your tax returns, you will each … Continue reading

What if I am gay, lesbian, bisexual, or transgender (LGBT)? Will that affect my health insurance coverage and options?

The Affordable Care Act (ACA) and other new federal policies put in place important new protections for LGBT individuals and their families. Health insurance marketplaces, which are new organizations set up in every state to create more organized and competitive … Continue reading

Retirees (7)

What if I’m retired but not eligible for Medicare?

If you’re retired without coverage, you may use the Health Insurance Marketplace to buy health insurance. If you don’t have coverage you may have to pay a fee.

I’m a retired Veteran collecting VA pension and benefits. Are those benefits counted in determining my eligibility for subsidies in the Marketplace?

Yes, VA pension benefits, like Social Security benefits, are counted as income in determining eligibility.

I’m 62 and already collecting Social Security. Are my Social Security benefits counted in determining my eligibility for subsidies in the Marketplace?

Yes, Social Security benefits are counted as income in determining eligibility for premium tax credits in the Marketplace.

I’m 63 and enrolled in a retiree health plan from my former employer. Can I look for better coverage and subsidies in the Marketplace?

Yes, as long as you do so during the Open Enrollment period. People with employer-provided retiree health benefits should know that most early retiree health plans are considered qualified health plans, and thus meet an individual’s requirement for coverage. If … Continue reading

I’m 63 and about to retire. I’ll be offered a retiree health plan. Can I look for better coverage and subsidies in the Marketplace instead?

Yes. Most early retiree health plans are considered qualified health plans, and thus meet an individual’s requirement for coverage. However, if you want to obtain coverage through the Marketplace, you may do so, and if your income is at or … Continue reading

My spouse is an early retiree with affordable retiree health benefits from his former employer, but I’m not eligible to be on his plan. Can I apply for coverage and subsidies in the Marketplace?

Yes, assuming you meet the other requirements, you can apply for health plans and premium tax credits in the Marketplace. Your spouse’s eligibility for early retiree coverage will not affect your ability to seek coverage and financial help in the … Continue reading

I’m 63 and my husband is 65 and on Medicare. Our income is less than 400% of FPL so I need help affording the premium in the Marketplace. Can we count what my husband has to pay for his Medicare premiums and supplemental and Part D premiums against what I will be required to contribute toward coverage in the Marketplace?

No. Your eligibility for premium tax credit subsidies and the amount of your premium tax credit will be based on your family income. The amount your husband pays for his Medicare, Part D, and supplemental insurance premium costs will not … Continue reading

Women's Health (19)

I am purchasing health insurance in my state’s health insurance Marketplace. Is my plan required to cover contraceptives without cost?

Yes, your plan must cover the full range of FDA-approved contraceptive methods, but can impose some restrictions on the contraceptives offered at no cost to you. For example, the plan may require that you choose a provider within the network, … Continue reading

I would like to get an IUD. Is my plan required to cover birth control without cost sharing?

If your plan is “grandfathered” then it is not required to pay for contraceptives without cost-sharing. If you are in a non-grandfathered plan, however, your contraceptive costs should be covered. Your plan must cover at least one type of IUD, … Continue reading

I have employer-based coverage and I know my plan is not “grandfathered”. Yet, when I recently filled my prescription for birth control pills, I was charged a co-payment. Aren’t those plans required to cover all contraceptives without cost sharing now?

Yes, all non-grandfathered plans (plans that started or made changes after March 23, 2010) must provide contraception with no cost sharing. If there is a generic alternative to your birth control pills, you can be charged a co-payment for the brand … Continue reading

I get insurance from my employer, which is a large Catholic University. Is my plan required to cover contraceptives without co-payments?

Yes, your insurance company is required to cover contraceptives without co-payments. Your employer may have applied for an accommodation which allows your employer not to pay for contraceptives. Your insurance plan will still cover contraceptives at no cost to you, … Continue reading

I was told that my college insurance plan does not pay for contraceptives. Can that be right?

If your college has a self-funded health plan, then it is not subject to requirements under the Affordable Care Act, including covering contraceptives with no cost sharing. Ask your college if the plan is self-funded. If it is self-funded, it … Continue reading

I’ve been uninsured and just enrolled in a health plan through my Marketplace. I’ve been getting my birth control at a Family Planning Clinic. Will I still be able to go there to get my birth control for free?

You should check if your Family Planning Clinic is listed in the network for your new insurance plan. If the Family Planning Clinic is listed in the network you will be able to continue to go there for your birth … Continue reading

My husband would like to get a vasectomy but when I checked with our insurer, they told me that the plan would cover my sterilization without cost sharing but we would have to pay part of the costs for his procedure. What is the reason for that?

Contraceptives, including sterilization, are covered only for women as preventive services. Since sterilization for men is not considered a preventive service under the Affordable Care Act, plans are not required to cover and can charge a co-payment for vasectomies.

I am currently uninsured and plan to purchase coverage through the health insurance Marketplace. Do the insurance plans in the Marketplace cover abortions?

It depends on where you live and the specific plan you choose. Some states allow plans in the Marketplace to cover all abortions and some states prohibit or limit plans’ coverage of abortion to certain cases. In about half the … Continue reading

Does Medicaid cover abortions?

In general, Medicaid coverage for abortion is very limited.  In most states, Medicaid covers abortions only when the pregnancy is the result of rape or incest or if the woman’s life is endangered because federal law limits the use of … Continue reading

Do I need a referral to go to my OBGYN if I am enrolled in a non-grandfathered plan?

If you are enrolled in a non-grandfathered plan, then you must be allowed to see your OBGYN without a referral. Women in grandfathered plans and Medicaid may be able to schedule a visit with an OBGYN without a referral. Check … Continue reading

What services do plans have to cover for pregnant women?

Although most employer plans were already required to cover maternity care prior to enactment of the ACA, most individual plans did not cover maternity care. Starting in 2014, new plans in the nongroup market, including those available through the Marketplaces, … Continue reading

I just found out that I’m pregnant and my baby is due in June 2014. Can I enroll in a plan through the health insurance Marketplace?

Yes, you may enroll and your plan will be required to cover maternity services. You may also qualify for a premium subsidy, depending on your family income and your eligibility for employer coverage, or, depending on your income you might … Continue reading

I am pregnant and plan to breastfeed my baby. How does the ACA affect breastfeeding services?

The ACA requires that all new private plans, including those in the employer market, individual market, and health insurance Marketplaces, cover lactation counseling and breast pump rental without any charge. Check your plan details to find out the specific number … Continue reading

I have been trying to get pregnant. Will the plans on the exchanges cover infertility services?

This will vary by state. Some states have requirements that plans cover some infertility services, but there is no national requirement for coverage of infertility services. If you need these services and are shopping for coverage, check the plan details … Continue reading

Does pregnancy trigger a special enrollment opportunity to buy or change coverage?

No it does not. However, when the baby is born you will be eligible for a special enrollment opportunity. You can enroll your baby in coverage at that point. You (and your spouse) can also change health plans during this … Continue reading

How do I project my household size/income for next year if I’m pregnant now? I’m married and this pregnancy will be our first child. We want to find subsidized coverage in the Marketplace.

This fall you and your husband will apply as a household of two. When the baby is born, you can update your family information with the Marketplace to reflect that you have become a household of three. At that point, … Continue reading

I heard that plans have to cover preventive services without cost sharing. Is this every preventive service and are there any limits to what is covered?

If you are in a non-grandfathered, or a new private plan, including those available through health insurance Marketplaces, then your plan is required to cover a wide range of preventive services and may not impose cost-sharing charges (such as copayments, … Continue reading

Are there any preventive services for women specifically?

The ACA includes a number of preventive services for women that “non-grandfathered” private plans are now required to cover without cost sharing. For example, these include counseling and screening services including prenatal and preconception care; breast and cervical cancer screening; … Continue reading

I am 35 and I have a family history of breast cancer. What services are covered?

If you are considered to have a family history that makes you at high risk for certain genetic mutations that are associated with increased risk of breast cancer (BRCA1 and BRCA2) and are enrolled a non-grandfathered plan, then your insurance … Continue reading

Young Adults and Students (19)

What is a student health plan?

“Student health plan” refers to a special policy of health coverage that colleges and universities make available to their enrolled students. Typically the student health plan is different from the employer-sponsored group coverage that colleges and universities offer their faculty … Continue reading

Does my student health plan have to cover contraceptives?

Generally, yes it does, if it is a fully insured plan. A fully insured plan is one that your college or university purchases from a health insurance company. These plans are required to provide, without cost sharing, access to all … Continue reading

Does a student health plan have to cover essential health benefits?

It does if it is a “fully insured” student health plan. A fully insured plan is one that your college or university purchases from a health insurance company. If your student health plan is fully insured, it must cover essential … Continue reading

I’m a part-time student. Does my college have to let me enroll in the student health plan?

It is up to the college or university to establish eligibility rules for student health plans.

If I’m eligible for the student health plan but haven’t signed up yet, do I have to take that or can I apply for coverage and subsidies in the Marketplace?

Eligibility for a student health plan does not make you ineligible for Marketplace coverage and subsidies. Even if you are eligible for student health coverage, you can get coverage through the Marketplace. In addition, if your income is between 100% … Continue reading

I’m enrolled in student health coverage now, but now I think I can get a better deal in the Marketplace. Can I drop student health plan coverage and go to the Marketplace instead?

If you are currently enrolled in a student health plan, you can still qualify for Marketplace policies and subsidies if you apply during Open Enrollment. During Open Enrollment, you can sign up for a Marketplace plan and, if your income is between … Continue reading

I’m a foreign student studying in the U.S., Does the requirement to have health coverage apply to me?

In general, yes. There is no group exemption for international students to the individual responsibility to have health coverage. However, you might qualify for another exemption to the requirement.

I’m an American college student and I plan to study abroad next semester. Am I required to have U.S. health insurance while I’m living in another country.

Yes, unless you qualify for another exception. In general, U.S. citizens with a tax home outside the U.S. and who are residents of a foreign country for the entire taxable year are exempt from the requirement to have health insurance … Continue reading

I’m about to turn 19 and I’m covered under my parent’s health plan as a dependent. How long can I stay covered as a dependent?

Health plans that offer dependent coverage must cover dependents up to their 26th birthday.

I’m going to a college that offers a student health plan. Can I stay covered as a dependent on my parent’s policy or do I have to take the student health coverage?

Yes. Eligibility for student health coverage does not make you ineligible to be covered as a dependent on your parent’s policy up to the age of 26.

I just got a job that offers health benefits, but my parent’s policy is better and less expensive to me. Can I stay on my parent’s policy?

Generally yes. Eligibility for group health benefits through your own job does not make you ineligible to be covered as a dependent on your parent’s policy up to the age of 26. One exception to this rule applies to grandfathered … Continue reading

I’m 24 and I used to be covered as a dependent on my parent’s policy. I dropped off last year when I found other coverage, but now I’ve lost that other coverage and want to get back on my parent’s policy. Can I do that?

Yes. You are still eligible to be covered as a dependent. Your parent’s plan must offer you a special opportunity to re-enroll because you lost other coverage. That special enrollment opportunity must last at least 30 days from the date … Continue reading

Do my parents have to claim me as a tax dependent for me to be on their health plan to age 26?

No. You do not need to be a tax dependent of your parents to continue to be covered as a dependent on their health plan.

Do I have to live in my parents’ home to be covered as a dependent under their policy?

No, living in your parents’ home is not a requirement for eligibility to be covered as a dependent under their policy.

Can I be covered under my parent’s plan if I’m married?

Yes, as long as you are younger than 26. Being married does not affect your eligibility to be covered as a dependent under your parent’s plan.

I’m covered as a dependent under my parent’s plan and I’m pregnant. Will my parent’s plan cover my prenatal care and delivery? Will my parent’s cover my baby after he’s born?

Your parent’s plan is required to cover your maternity care and delivery. However, after that, the plan is not required to cover your child as a dependent. You will be responsible for obtaining coverage for your baby. Depending on your … Continue reading

I’m covered as a young adult dependent on my parent’s policy now, but my 26th birthday is next summer, at which point I won’t be eligible for dependent coverage any longer. Should I apply for Marketplace health plans and subsidies now, during Open Enrollment?

You can remain covered as a dependent on your parent’s policy until you turn 26. Once you lose eligibility as a dependent, you will qualify for a special enrollment opportunity. At that point, you will also be able to apply … Continue reading

Can children stay on a parent’s plan until age 26?

If a plan covers children, they can be added or kept on the health insurance policy until they turn 26 years old. Children can join or remain on a plan even if they are: married not living with their parents … Continue reading