When a young adult reaches age 26, they are often no longer considered to be an eligible dependent on their parent’s health plan. This means most young adults at age 25 who are still insured as a dependent under their parent should begin preparing to obtain their own coverage.
How to prepare
Step 1: Determine when your coverage will terminate. Some plans terminate coverage on the birthday, while others offer a grace period. Depending on when your parent’s coverage ends, you will want to either use the special enrollment period that your qualified life event (i.e., turning 26 and aging off the plan) provides you, or you can utilize your employer’s annual open enrollment.
Step 2: Once you decide when you will need to elect coverage, you should familiarize yourself with common insurance terminology:
- Deductible – the amount you must pay out-of-pocket for appointments, treatments, and medications before the insurance company you chose will start covering expenses.
- Copay – the specific amount you will pay for a type of service or appointment, whether you have met your deductible or not. For example, when you had an annual check-up with your doctor, you likely paid a copay.
- Coinsurance – the percentage of the cost you are responsible for after you meet your deductible.
Step 3: When you have an understanding of the terminology, you will be ready to review your employer’s benefits offerings. Be sure you understand the requirements of the medical plans. Some require primary care providers, referrals, or the use of specific networks. Be sure to compare the available plans with your personal needs to determine the best fit for you.
Choosing benefits that fit your needs can be difficult and confusing, especially when you’re electing for the first time. If you need help understanding your options, contact our ESR team. They are available Monday through Friday from 7:30 AM to 6:00 PM and can provide you with the information and resources you need to prepare for your upcoming election.