Details on Health Care Law’s Under-26 Coverage Rules

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StudyingAs you may recall, the health care bill that was recently signed into law included provisions for the extension of dependent health insurance to those under 26. Specifically – “Young adults will be able to stay on their parents’ health plans until the age of 26. Many health plans currently drop dependents from coverage when they turn 19 or finish college.”

This week the government released the details of how this would work.

Health Plans that cover Dependents: If your health care plan currently covers dependents, the rules takes effect on or after Sept. 23, 2010. The rule would now require that the policyholder’s children be covered until the age of 26 unless they have access to an employer-sponsored plan. If they were previously dropped, they can re-enroll as long as they don’t have access to an employer-sponsored plan. The child does not need to live with the parent and does not need to be claimed as a dependent on the parent’s tax return. If the health insurance plan’s open enrollment period isn’t in the fall, the plan must give dependents 30 days to decide whether or not to enroll.

So far, 65 insurance companies have allowed students graduating from college to remain on their parent’s plans. (you read this list on the 4th and 5th page of the White House release.

Health Plans that don’t cover Dependents: If your health care plan doesn’t cover dependents, then it won’t be required to cover children until Jan. 1, 2014, when a child can re-enroll if they do not have access to an employer sponsored plan. The rules are the same, the implementation date is just further out.

How much will it cost? “The health department estimated that the average cost to cover each new enrollee would be $3,380 in 2011, $3,500 in 2012 and $3,690 in 2013.” (from NYT)

The White House also shared some sobering statistics – 30% of young adults are uninsured, making it the largest percentage of any age group. They don’t share the source of this statistics but I remember, when looking for a job, that health insurance was the biggest concern. Before the recent law, I wouldn’t have health insurance under my parents once I graduated. I didn’t know how much it cost on the private market and I was fortunate not to have any pre-existing conditions, but the prospect of being uninsured was a little daunting. It’s like being on a ship without having a life preserve under your seat, 99.99999% of the time you’re fine, but that slim chance of disaster is still scary.

(Photo: lenifuzhead)

{ 139 comments, please add your thoughts now! }

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139 Responses to “Details on Health Care Law’s Under-26 Coverage Rules”

  1. Sampson says:

    I love my children But I DO NOT want to pay their insurance till they are 26…

    In my eyes at 18 you are a LEGAL adult and you can get your ass out there and get a job and get your own insurance and not suck off your parents forever.!!

    I’m middle aged and the problem with this is , If I pay my childs insurance till they are 26 , I’ll be past retirement and stil paying thier insurance …Thats a crock of SHIT!

    That’s 10 More years .. I will be retired and still paying my childs insurance .

    Sweet justice if my children have their own children at 30, you’ll be almost 60 when they come off..So the ball and chain is on you too..
    So have fun with that idea…!

    • lonnie ferguson says:

      This sure does help me and my wife out. Both of our children will graduate college this Spring. The way the job market is this day and time for college grads, I’m thankful that I’m still able to provide some protection for our children with their Health Care.

      If there is somthing I can do for my kids in order to help them out, I will till the day I die.

      • Anonymous says:

        i think its great what you are doing.

        • Colly says:

          Does Tricare have this? I don’t know how to sign up because they booted the 22 year old off our plan due to being on summer break. She starts up again in fall. How does she/I apply?

          • Bill says:

            TriCare does not cover this. Just found out this week when my 21 year old went to the doctor for an appointment, assuming he was still covered because of the AHCA, but guess what, although the rest of the country is covered by this, again, the military gets the shaft. You can sign them up for $200 for prime, oh, that’s 200 per month, so if you have two or three that fit into that catagory, not much of a benefit. And the 22 year old will get booted off when she turns 23 even if she is attending school as a full time student.

            Good luck, but in my case, I’m going to my congressman to express my frustrations of being left out once again.

    • DEE says:

      Please help your children, sounds like you do not beleive in paying for your childrens college or health insurance after they turn 18.Unless they join millitary, what future do they have.These days it’s much tuffer then when you were 18.It does not cost much more to have dependants on your policy, but if they go on there own to buy coverage it is very expensive. Help them to get a good start in life, you don’t want them to be a taxpayers burden or be working poor for the rest of there life.

      • Annonymous says:

        That’s the problem these days. Everyone is giving their children so much “help” that they don;t knwo how to stand on their own two feet anymnore. It isn’t that much harder now then it was then. In fact right now it is easier to get a job as a fresh graduate becuase companies like hiring young workers for lower wages and less benefits and the kids don;t knwo the difference. My point is they can get a job and htey can pay their way. Do I beleive in helping my kids. Absolutely, but I use the true sense of the word. I help them, I dont; allow them to stay in my house and eat my food for free while they sit and play video games all day and don;t work becuase “It’s so hard these days”. It’s an excuse and the problem is too many parents are not helping their kids at all by allowing their children to take advantage of them. Remember, the baby bird has to be ready to fly before Mom kicks them out of the nest. BUT, you know what? That baby bird will NEVER leave it’s nest on it’s own. No one WANTS to work or be responsible, it’s just something that we have to do and I think there are too many parents out there that are not preparing their children well enough and making them be responsible for themselves so that they CAN lead a succesful and fullfilling life.

    • bla says:

      Well maybe you should have your children pay the insurance but keep them on yours so its available. If you have to get health insurance not through a job its very expensive and the deductables are extremely high.

    • marisa says:

      This really shows your ignorance. Its so hard for young adult to receive health insurance. And some jobs, EXSPECIAL PART-TIME JOBS, dont offer employees insurance. And besides you cant even really get a great job or a good enough job with benefits until you graduate from College and then you child would be atleast 21. I was diagnosed with cancer at 20 and without my mothers insurance i wouldnt have gotten any help. i probable would be dead now. so stop being so selfish and help you children out. you had them so your a parent for the rest of you life who cares if your retired. i bet when your in need they want say your retired dad. you dont need my help.
      Have a blessed day!!!!!

      • Annonymous says:

        really? ha ha that is crazy. Wait until you have children and they have grown up and are 18. then you can have a conversation about this topic and know what you are talking about. You are right I will always be a parent, BUT I am only financially responsible for my kids until they are 18. After that they need to stand on their own two feet. That’s what I had to do and that’s what I did. No reason why they can;t. The jobs are there, if you look hard enough. Most kids just sit and play video games or sit on Faceboiok all day and say “its too hard” to find a job. Whatever, if you are willing to work and spend the time and effort to finding work, whatever it may be. it’s out there. My son just had a GREAT job, $14/hour benefits and everything. But it was “Too Hard” so he quit. lol dumbass..

        • Johnz says:

          Thats YOUR son which means its YOUR fault for making him a wimp. Not all kids are lazy, although I agree that ALOT are! Just because a kid is 18 doesn’t mean they know it all, we still need to teach them. Once again- jobs don’t offer benefits! and if they do, it’s not free. Older generations entered the work force with no education, but got paid, recieved benefits and don’t forget you could buy a brand new car for under $10,000! The price of EVERYTHING is a lot higher now and kids don’t get great jobs even after college..and don’t forget that ugly college debt……

        • Annonymous says:

          Well we can tell YOU never went to college and lack intellectual brain cells. 0-18 are the easy years.. its after 18 when all the hardships begin, and you want to bail on your child because you think they are adult enough to take care of themselves? Nothing before 18 even gives them a pin point of insight into the real world. You are a pathetic excuse for a parent and that’s probably why your child will fail in life.

          • Michelle says:

            and as far as having no previous insight to life you are wrong, i lived with a single mom who wasnt always able to put food on the table, keep our water on, or even keep our electricity on. and yes i have a rare life but i had to grow up fast, i never got to be a “teenager” i didnt have a job but that is only because i was helping arround the house and helping care for my baby sister who was dieing of cancer. so i would say that ive known for a long time that life is hard and it isnt fair but we all have to move on and get over it

        • Michelle says:

          Annonymous,yes i agree that some of my generation is lazy and ignorant, but that is the same with ALL generations. I do not think that you should just compleetly cut your children off at 18. yes you have a right and yes you have your reasons, but as an 18 year old my self i have been from home to home finaly ending up at a friends house and it is nearly impossible to find a job. i finaly managed to scrape up a temporary job at a slaughter house. i get a few hours a week because i am a college student and yes although i am managing i wish i still had my parents to depend on. with my hours i have little time to study and my grades while they are good it is only a low b average sadly not good enough to keep my schlorships. with all that beeing said i will not cut off my children unless they never try.

      • Debbie says:

        You’re obviously a kid.

    • Victor says:

      The law says you CAN include your child until he is 26. It doesn’t say that you must do such thing. It is like you can drink alcohol but nobody obliges you to do so.

    • Storms says:

      If that annoys you, wait until you realize the implications… Not only are you going to be responsible for the monthly premiums, you are also going to be held personally liable for ANY bill incurred by your adult child including such things as co-pays, extended hospital stays, hospice care, elective surgery, “family planning services,” and counselling services….. PLUS, due to HIPAA rules, when you call to find out why you are being billed several thousands of dollars in medical expenses, YOU DON’T HAVE THE RIGHT TO KNOW OR QUESTION WHY THOSE MEDICAL PROCEDURES WERE PERFORMED! You cannot even argue as to whether they were “medically necessary” since your child’s right to privacy trumps your responsibility to pay the bill.

      • storm says:

        How do we repeal this law or join in on the lawsuit… I have no problem with supporting our daughters with the addditional 250 a month charge however the rest needs to be theirs, period. I think once you are 21 you are an adult and can be tried as an adult and not us at 50 still supporting you and taking the hit for the co-pays. if there is acrisis and it costs amillion dolars and it can, we now owe at least 100,000.. for your choices.. that is completely unconstitutional!

    • Rick says:

      Well well well…..I am 60 and im going throught the child has been dropped from a policy heres my twist he has a medical condition that has just sent me to the poor house…Dr. visits went from $35.00 to $225.00 the meds he needs to go from day to day went from $30.00 to $1,300 for a 3 month supply and in my book THATS A CROCK OF SHIT so when you get it stuck from the other side of the fence the you can whine and cry……and the bad part is his condition no one want to hire him because of his condition…….so what are we supposed to do have him put to sleep like a dog because he has medical porblems…….

    • Ina says:

      And whos fault is it that decided to have their kids at a later age? deal with it..

    • Johnz says:

      I TOTALLY understand wanting your kids to be independant but most jobs don’t offer insurance anymore – even if they are educated and are starting at entry level. I’m 35 and hear everyone who is older than I, saying the same thing. You need to realize: THINGS HAVE CHANGED!!! Jobs don’t offer benefits ANYMORE!! A person works for a wage -THAT’S IT! So, if we don’t want these young adults to go unisured or be part to the welfare system, figure it out. Have your kids get jobs and pay YOU thier part of the insurance… Still making them responsible for themselves.

      • Samantha says:

        What sort of jobs don’t offer any health insurance? Even as an 18 y/o part time worker at McDonalds I had the option to purchase healthcare. It wasn’t good insurance, granted, but it was available. And now I’m 25, I’ve been on my own for seven years, but the government still believes I’m unable to care for myself? Sorry to burst your “protect the children” bubble, but we can do just find with a bit of motivation and a lot of hard work. The only people who can’t are those who won’t.

    • Anonymous says:

      Why did you wait so long to have children? Most parents are willing to help there children!

      • Anonymous says:

        Why did they wait so long? What does that matter? Who knew there was an age requirement on having children?

        In fact, the under-26 thing is going to be even more problematic in the future because more and more people are waiting to get married and have children until they’re older, more educated, and more secure in their career. If the insurance companies have to cover more people, then they’re going to have to charge more. The higher insurance payments can certainly become more problematic to people who see a large reduction in their income because they retire.

    • IAmMe says:

      I really don’t think you should expect to pay extra for your child’s healthcare, but at their age, it can be pretty hard to go to school and find a job that offers healthcare. What you should do (if you care whether they have healthcare coverage while trying to start their adult life out) is have THEM pay the difference it would cost you to put them on your plan. Just like you would have them pay the difference to add them to your car insurance. Then they pay co-payments to see the doctor etc. on their own. It’s not that hard to figure out…

    • IAmMe says:

      I really don’t think you should expect to pay extra for your child’s healthcare, but at their age, it can be pretty hard to go to school and find a job that offers healthcare. What you should do (if you care whether they have healthcare coverage while trying to start their adult life out) is have THEM pay the difference it would cost you to put them on your plan. Just like you would have them pay the difference to add them to your car insurance. Then they pay co-payments to see the doctor etc. on their own. It’s not that hard to figure out…

    • Callie says:

      Agreed! As a parent you’re not responsible for your child’s financial needs for the rest of their days.

    • vinny says:

      wow what a wonderful person u must be.

  2. Anonymous says:

    Everyones circumstances are different. I don’t mind providing health Insurance for my 21 year old but I cannot afford to pay her copays and the portion that our insurance does not cover. I’m just wondering how that will be billed. Will the policy holder be billed or the adult child?

  3. Catherine Williams says:

    It’s my understanding that the parent is responsible for any copay, and balance due, after insurance, on Dr. visits and Hospital stays.

    If you have a bad relationship with your child due to drug or alchol problems, and they enter a rehab program, the parent is responsible for payment that insurance doesn’t over. If they are in an auto accident and are hurt badly, or injure someone else, you are repsonsible as the “parent” for any balance due after insurance. This will bankrupt most people, and could even cause them to lose the home they have worked their entire life for. Check with yur Insurance Co, and see what your liability is, to cover your children.

  4. Diana Guinn says:

    My daughter got married this year. Someone told her that she could still be covered under our health insurance since she is not 21. I don’t mind helping out because I still have other children on our plan. She has always paid her part. They both are students and only work part time. So, is this true.

  5. Missy Hanks says:

    I would like to know just as Diana Guinn asked. My daughter is in college and 23. She will graduate 12/12 and is planning a June wedding. She will be married before she graduates, so can she stay on our plan till she’s 26? His job does not have great insurance. Once she graduates, if she can find a job, it will more than likely have good insurance. She is a great daughter and pays her phone and auto insurance and buy groceries every now and again and like Diana, we have other kids so it’s not an additional cost to us and we don’t mind helping her some.


    How can I find out more on extending my health care insurance on my daughter after she graduates from college? And how does the Health Care Law’s under 26 coverage rules a
    applies to her.

  7. M F Mobley says:

    Can my child be covered under my wife insurance, this would be her stepchild that lives with us.

  8. Donnal says:

    does that mean that evenif the child is married with children of thier own you can cover them? Is that really legal??

  9. Stephanie says:

    Wow. I am a senior in college (woo hoo!) and sadly my parent’s insurance coverage dropped me when I was 19. Since my dad has HMO coverage through his employer, he would have to pay extra to keep me on and pay me back. To the parents that expressed that they would do anything to help their child…it is so refreshing to here that. My parents never taught me how to drive, how to financially budget,…I want to make it clear that I love my parents, but there are things I wish they helped me do. Thankfully, I am academically successful but you have NO IDEA how hard it is for your parent not even WILLING to help get insurance…co-sign a student loan…and let me make this clear, I have always had a job…worked 2-3 at one time…and I am graudating college in 4 years!!! From a student’s perspective, all we want is to see how far you will go to help us succeed…we know finances are tough, but it’s the willingness. With some of the comments read, I truly feel sorry for those parent’s kids because I know exactly how it feels. And for the parent’s who want to help their kids, more power to you!

  10. holly says:

    if my 17 year old drops out of school and does not live with us are we still responsible for her health insurance?

  11. burt says:

    well now I am not opposed to helping my kids out but there is a limit. i have two kids and just found out today that if your kids are not working and have no ins you have to keep them on your ins. there is no ifs ands or butts your ins can not take them off unless they have a ins option to them. now that being said my daughter is going to college and sis headed in the right way. my son well he is a problem not doing anything and stealing,in jail,and so on. I for myself am retired and teying to make every penny work for me.I am responsible for every co pay and anything outside of what ins covers because they are on my plan which I can not take them off.Now for my daughter have no problem keeping her on bur when you have a kid that does nothing and yells and calls you names and so on u cant take him off. He could go into rehad a 100 dollar co pay everyday and my ins will bill me cause i am responsible for it cause hes on my plan. now does this seem fair.

  12. Diana says:

    My employer wants to drop my 18 year old daughter from my insurance plan so that they can save some money. Is this legal to do? I want to keep her on.I currently pay 30% of my premiums and they pay 70%.

  13. Denied Parent says:

    I want to know if my son turning 18 is a qualifying event to take him off of my insurance. He has refused to speak or see me for the last 4 years. I do not see why I should have to pay for coverage for him for another year when he wants nothing to do with me.

    • Rick says:

      I bet if every one talks to the insurance company you might find out there is an exception to the rule

    • KB says:

      Hello Denied Parent,
      My husband is also a denied parent. His son, who wants nothing to do with his dad, but only to be a bank to him (the mom has groomed him this way and also to be lazy and not work). She has collected $800 a month in child support for this one child as well. Now that child support is ending, the son is 18 and just graduated from high school, the mom is begging to allow him to remain on our health insurance. We are cutting him OFF. She has a plan for him (Medicaid) and we refuse to cover him anymore and be the “bank”. All the while he doesnt want to talk to dad or see him. Mom does not involve dad in decisions at all and all we see are medical bills in our mailbox. She makes poor decisions and lies to us all the time. So, we are DONE covering him. My husband is exercising his right to choose to drop him. And, how is this for an idea…..get a job and figure it out yourselves!! Stop sitting around playing XBOX all day and sponging off your dad. The mom does the same mooching….we are DONE. So drop your child if they are 18 yrs old and you have stopped paying child support. Legally you are done, too, if you choose….

      • elies says:

        Granted a certain level of responsibility should be established, but why would an individual consider having kids if they have no solid plan for their life, whether or not they constitute to your standards? How can an imperfect individual judge another imperfect individual? that is like stevie wonder teaching ray charles to drive. ultimately, I believe individuals are not seeing the bigger picture and understanding your government is fucking you up the ass raw without a condom and establishing laws based upon this concept and everyone blindly accepting without a rebuttal. They charge you a substantial amount of taxes without providing health care or any benefits for those same individuals, but will turn around give subsidies to millionaires and billionaires and bailout intermediate institutions that has been discretely raping society and if you blindly allow and accept these formalities you minus well accept it coming from your own blood

  14. Melissa says:

    Pretty soon the age of emancipation will be 40! If my kids want me to pay their way then it’ll be under MY direction…they want me to pay for college? I’ll choose the college and courses, they want me to pay for health care then I’llchoose the treatment and doctors…otherwise you’re on your own. All of you who think your kids “deserve” things just for existing is DISGUSTING! It’s why we’re here now. Go ahead teach your kids that life is ALLLL ABOUT THEM…but be prepared for them to grow up into adults that think life is allll about them!!!! You people for this are the problem! Your adults!!! ACT LIKE IT!

  15. dmarrill says:

    This is great, I am very grateful for this to be in effect. I myself have been working since I was 17 years old I’m now 43, I have never had a job that even offered health insurance. My last job was at an Insurance brokerage company, when my employer read that all company’s with full time employees would be required to offer health insurance to their employee’s he stated that I guess you will all be working part time, within 2 weeks we were cut down to 30 hours per week. This corporate greed is ruining our county, I’m glad that their is some one in office to stand up for the working people that are denied benefits.

  16. dmarrill says:

    The corporation my daughter works for simply cannot afford to offer my daughter health insurance that’s the response she has got from them. She works 50 hours a week and that’s minimum requirement for her position. She is not lazy she does not expect anything for just existing. She continues to look for work that does offer health insurance to no avail. Unfortunately their are many full time jobs that do NOT have health insurance available to their FULL time employee’s. I have recently got a job that I do have health insurance and have gladly added my daughter to our policy and thank god I have the option to do so. Thank you Obama.

  17. John says:

    I have a young daughter 20 years old who just had a baby, she has not personal insurance. My insurance will pay up to all except for $531 of a 12,000 plus bill. The boy is suppose to be responsible but it is doubtful he will pay anything when the state attempts to collect. She has absolutely no income at the present time. I would like to know if medicaid will pay the difference. If not how do I deal with the Hospital on her behalf? I have no intention of paying the bill, because I think the father has a responsibility in this case as well.

  18. Emily says:

    After reading all of the comments, I would like to say that I am 23, have 2 college degrees, and am working at a job that, if not for my parents helping me out, I would be just scraping by. It took me almost a year after I graduated to find a full time job and I searched the entire country for one. I did manage to find a part time job before that and even then it took 4 months to find that. There are no jobs available for young people because I was either over qualified or did not have enough experience. I am on my parents insurance and I pay for everything under theirs because it is so much cheaper than getting insurance myself. So whoever says that kids are lazy and they are just mooching off their parents, that may be true for some but the economy really is in shambles right now and we all need a little more help than we used to.

  19. Debbie says:

    My 21 year old son is on our health insurance. He will not pay his co-pay, er visits, or hospital stay portion that our policy doesn’t cover. Am I legally responsible for this? The bills keep coming.

  20. Sam says:

    Can a child be covered under his parents plan if he/s is full time student, has NOT graduated from college but has reach 26?

    Thank you

  21. Susie says:

    Geez, we have given and given and given. Now Obama and his cronies want us to give more. Every single insured person is paying a higher premium to keep this “kids” on their parents plan. If your plan is a group plan sponsored thru your employer, every one of those enrolled are paying the price for your “kid”. Your employer is also paying based now on “tiers”. So yes, everyone pays for your little “darlings”. So so stupid.
    Did any of your read the policy? By keeping these “kids” on your plan, you are responsibile for the bills. Stupid stupid people. Now your “kid” even though they are legal adults can have YOUR credit ruined since you placed them on your insurance. If they don’t pay the bills, the providers will be knocking on your door. People, come on, read the policy. Its not getting any better, it will only get worse.

  22. nitehawk says:

    Our son double coursed, graduated early and within a month found the job he loves at age 20. Still loves it and has advanced at 22. He was dropped from our ins. due to his employer offering ins. But he pays double a month of what our dependent am”t cost and for the same ins. company ans same with our daughter who has climbed ladder quickly, while working 50 plus hrs. a week. We are all on the same cell phone plan to keep costs down. So why not ins.? They ea. pay over 1200 yr. for same ins. Yet thru us as dependents was 700 to carry both! So 700 vs 2400. They haven’t even used it yet as a child always used ins.(ear aches/fractures).

  23. leafgirl says:

    So I am a step dad and have been allowing my two adult step sons to stay on my health insurance as a “secondary” insurance. Their Mom has them as a “primary” insurance. Same with the dental. Is it wrong to ask them for SOME money to cover a portion? I am going to retire and it’s going to cost more. Can they stay on their Moms insurance only? My monthly payment is $1400 a month for the family plan when it’s only my wife and I. One son is married and the other isn’t (but his girlfriend) is pregnant!

  24. nanner says:

    If parents want to provide coverage for their “children” until age 26, they should guide those “children” through the enrollment process, pull out their wallet and pay for it themselves. But to REQUIRE it of everyone is terrible. My niece’s husband has two “children”, 19 and 21. Neither is in school, and they live with their mother. He has provided insurance all along, never once defaulting on payments. The older “child” just birthed her second baby out of wedlock in 15 months. Why should he still be on the hook, supporting this kind of defiance from his daughter. And we can only pray the son does not actually spawn anything, though we know he is giving his best effort to take advantage of as many opportunities as he can find. Covering young adults until they finish college is a worthy effort, but a minefield during those prime reproductive years. Yes, the daughter HAS HAD birth control provided but is irresponsible about it. Allowing a year off for “good behavior” she could still easily give birth to 3 or 4 more babies at her rate. Enough is enough! “Children” up to age 26 will NEVER take responsibility as long as they can get away with it. And our government needs to stop forcing parents to remain as enablers.

  25. Arlene says:

    Just got a bill from an ER visit under Tricare standard for a child who received care a month AFTER she turned 21. Not in college, not married. Also does not reside with us and her address is not the same in the Tricare system, but we still received the bill at our home in HER name. Who pays?

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