1. Understand Why
You Need Health Insurance as an Adult
If you’re losing healthcare coverage under your parents’ plan, you may be wondering what the point in
getting a new health insurance plan would be. Maybe you’re rarely sick. You may have never experienced a major illness or accident that required a hospital stay.
There’s no penalty for
not
getting health insurance in the U.S. But if you lose coverage and don’t secure it, you could run into bigger issues in the future.
Why does health insurance matter if you’re healthy?
Health Insurance Helps You Avoid Debt
Many people don’t realize the true cost of healthcare without health insurance in the U.S. For example,
Healthcare.gov reports the average cost of a 3-day hospital stay is around $30,000. Comprehensive cancer care can reach up to hundreds of thousands of dollars. According to
KFF, those without health insurance pay at least 40% of healthcare out-of-pocket, and hospitals charge higher rates for uninsured patients.
High medical bills can lead to debt quickly. In 2023,
“USA Today” reported medical debt was a top reason people declared bankruptcy. If you don’t
get health insurance coverage, you could be putting yourself at risk for serious future financial challenges.
Health Insurance Helps You Maintain Optimal Health
Unfortunately, people who don’t have health insurance aren’t as likely to get medical care when they should. According to
KFF, uninsured adults are far more likely than those with health insurance to postpone healthcare or to not get it altogether because of cost concerns. Minor health issues that seem minimal could turn into bigger issues if they go undetected and aren’t addressed quickly.
Health insurance gives you the ability to get preventive care, routine health screenings and treatment when you’re sick. In the event you get seriously ill, how quickly you seek medical care can significantly impact the outcome. Health insurance gives you peace of mind you can maintain optimal health and get valuable treatment whenever you need it.
2. Determine When You Lose Health Insurance Coverage as an Adult
AZ Health Insurance Brokers can help you with all your health insurance needs, but first, it’s important to understand what’s required of you, when and why.
If you’re still 25 years old, the first step is to find out exactly
when
you lose coverage. On some plans, your coverage automatically stops on your 26th birthday. Other plans will extend coverage until the end of your birthday month. Other health insurance plans may even let you stay on your parents’ plan until the end of the tax year. Find out when your health insurance coverage ends.
It's best to begin researching your
health insurance options
before you turn 26 so you can seamlessly continue health insurance coverage. Understand when your coverage ends, then learn about your health insurance options once it does end.
3. Find Options for Health Insurance When You Turn 26 Years Old
You have a few options for securing healthcare coverage when you need it as an adult. These include:
Get Individual Health Insurance
If your employer doesn’t offer healthcare coverage, you can get health insurance through:
- An insurance broker or agent
- The federal health insurance marketplace, also known as the Affordable Care Act (ACA) exchange
Buying individual health insurance through a broker or agent
A reputable health insurance broker can guide you through the entire process of getting affordable health insurance that meets your healthcare needs. It doesn’t cost anything to work with a broker. They’re paid commissions from health insurance companies, so they don’t charge clients for their services. This means, you can have a health insurance expert manage most of the comparison shopping for you, at no extra cost to you.
Buying individual health insurance through the ACA marketplace
The
Health Insurance Marketplace, also known as the “exchange”, is a service that helps people shop for and enroll in health insurance. Some states run their own marketplaces, but
Arizona health insurance uses the federal marketplace.
You can use the exchange to compare plans and prices on individual health insurance plans. You’ll also provide income and household information that may qualify you for tax credits and other savings that make insurance more affordable.
If you buy
health insurance through the ACA exchange, your special enrollment period lasts for 120 days – the 60-day period before you turn 26, through the 60-day period after your 26th birthday.
Private Health Insurance vs. the ACA marketplace: Which Is Better?
Both private health insurance brokers and the ACA marketplace may provide good health insurance plans for a variety of budgets.
Consider using a qualified
Arizona health insurance agent or broker if you:
- Want personal attention and guidance:
An
individual health insurance agent or broker will do most of the work of signing up for insurance for you. They make it easy to compare your options. Once you’ve selected a plan, they can help you get coverage right away.
- Don’t qualify for a government subsidy: If you don’t qualify for discounts for federal insurance, you could find better and more affordable plans through an insurance agency.
- Want to keep your doctor, but they’re not covered by an ACA health insurance plan: An individual health insurance agent can help you find a plan you can afford that’s accepted by your doctor of choice.
Consider using the ACA marketplace if you:
- Qualify for a government subsidy:
If you make between 100% and 400% of the
federal poverty level income,
health insurance could be cheaper for you if you go through the federal exchange.
- Don’t care which doctor you see: Many ACA plans come with a narrow in-network list of doctors. If that’s fine with you, a plan through the ACA exchange may work for you.
Enroll in Your Employer’s Group Health Insurance Plan
Typically, you can only enroll in an
employer’s group health insurance plan during what’s known as “open enrollment”, which is a special time period where you can sign up for a new healthcare plan or
change your current health insurance plan. Losing health insurance coverage when you turn 26 years old is a qualifying event that gives you access to a special enrollment period, meaning you can sign up for health insurance during this time, even if it’s
outside of open enrollment. Employment-based plans must provide you with a special enrollment period of at least 30 days after you lose coverage because you turned 26 years old.
If your employer offers health insurance, talk to your human resources representative about their offerings. They can give you the information you need to research their plans and costs, and help you sign up. If you don’t enroll in a plan during the special enrollment period, you’ll have to wait until the next open enrollment period begins.
Important to note:
Some employers cover their employees generously when it comes to
employer health insurance, and some put more of the financial responsibility on you. Just because your employer offers health insurance, doesn’t mean you have to sign up for it. You may get a better deal by buying your own private plan. Compare your out-of-pocket costs with insurance from an employer to buying your own private insurance. See which has better coverage and costs for your comfort.
Get Help From AZ Health Insurance Brokers
Health insurance is an essential part of a healthy lifestyle, but figuring out the details can be stressful. If you’re about to lose health insurance because you’re turning 26, or you already have lost your health insurance coverage, contact AZ Health Insurance Brokers. We can answer any questions you have, explain your health insurance coverage options and provide you with a free quote.
Call us at 602.617.4107,
contact us online or email
quotes@azhealthinsurancebrokers.com for information.
