Young adults don't always have the same access to affordable employer-sponsored healthcare that their parents do. For this reason, the Affordable Care Act loosened restrictions for children seeking to remaining on a parent's health insurance. A child doesn't need to live at home to qualify, but there are other restrictions and limitations.
Child Health Coverage Basics
Per the Affordable Care Act, children can rejoin or remain on a parent's health insurance even if they don't live with their parents. In fact, the child can be married, attending school or financially independent and still qualify. Even if the child is eligible for health insurance through an employer, she can still opt to stay on a parent's plan. This can be advantageous if the parent's plan is more generous or inexpensive compared to the one offered through the child's employer.
The primary restriction for children on a parent's plan is age. At the time of this publication, children can only remain on a parent's health insurance plan until they are 26 years old. When a child turns 26, they have a special enrollment period of 60 days to enroll in health insurance. The special enrollment period applies for employer-sponsored plans regardless of open enrollment timing. For example, a child that turns 26 in September can enroll in an employer plan in October even if the open enrollment period isn't until March.
You may encounter limitations or restrictions for your child depending on your specific health insurance plan. If you can only make changes to your employer-sponsored plan during an open enrollment period, you'll have to wait for open enrollment to add your child. Also, health insurance plans aren't obligated to cover dependents Even if the plan does cover dependents, your employer isn't necessarily obligated to subsidize coverage for them. In this situation, an adult child may find a more competitive rate through on the open market.
Individuals who didn't have health coverage the entire year may have to pay a fee when filing their annual tax returns. If your child is planning on rejoining your plan, try to minimize gaps in coverage as much as possible. As long as your child was covered on your plan or another plan and had no gaps of more than three months in coverage, he won't incur a fee. If your child is independent and files his own tax return, he can check the box on Form 1040 that indicates he had insurance.
- HealthCare.gov: Health Coverage For Children Under 26
- HealthCare.gov: How Health Coverage Affects Your 2014 Federal Income Tax Return
- U.S. Department of Labor: FAQ -- Young Adults and the Affordable Care Act
- Kaiser Family Foundation. "Medicaid and CHIP Eligibility, Enrollment, and Cost Sharing Policies as of January 2020: Findings From a 50-State Survey." Accessed Sept. 13, 2020.
- InsureKidsNow.gov. "Frequently Asked Questions." Accessed Sept. 13, 2020.
- U.S. Centers for Medicare & Medicaid Services. "The Children's Health Insurance Program (CHIP)." Accessed Sept. 13, 2020.
- U.S. Centers for Medicare & Medicaid Services. "If You’d Like to Change to a Marketplace Plan." Accessed Sept. 13, 2020.
- U.S. Centers for Medicare and Medicaid Services. "Premium Tax Credit." Accessed Sept. 13, 2020.
- U.S. Centers for Medicare and Medicaid Services. "How to Get or Stay on a Parent’s Plan." Accessed Sept. 13, 2020.
Based in San Diego, Calif., Madison Garcia is a writer specializing in business topics. Garcia received her Master of Science in accountancy from San Diego State University.