January 16, 2015
2 minute read

Do Your Adult Children Need Their Own Health Plan?

Since it took effect in 2010, the provision of the Affordable Care Act (ACA) allowing parents to insure children under age 26 has helped thousands of young adults maintain health coverage. But keeping your kids on your health plan isn’t always the most reliable – or affordable – way for them to access quality care.

Let’s consider some situations in which your adult children might be better off with their own health insurance, even if they’re eligible to use yours.

Your child is eligible for an ACA subsidy

Some young adults under age 26 are eligible for health insurance subsidies under the ACA. To be eligible, these young adults must meet the following conditions:

  • They are not claimed as dependents on their parents’ tax returns.
  • Their incomes fall between 100 and 400 percent of the federal poverty level.
  • Their employers do not provide health coverage.

If all of those conditions describe your child, letting him or her purchase an individual policy could be a smarter, more affordable option.

Your child lives outside your coverage area

Many health plans limit members to in-network providers clustered within a specific geographic area. Young adults who work or study far from home may not benefit from staying on their parents’ health insurance when their local providers are outside the coverage network.

Ultimately, you could end up paying for health coverage your children can’t use.

If you find yourself in this situation, the following questions will help you determine whether it makes sense to keep your child on your health plan:

  • Does my child have health conditions that require frequent doctor visits and/or prescription drugs while he/she is outside the coverage area?
  • Can my child schedule doctor appointments for times when he/she is visiting home?

Does having in-network providers nearby warrant purchasing a different health plan for my child?

Depending on your answers to these questions, purchasing a separate coverage for your child ­(or having your child purchase it) could make the most sense.

Your child receives coverage through an employer

Adult children who have primary coverage through an employer can still use your health insurance for secondary coverage until they reach age 26. But is continuing to cover them worth it?

The answer will depend on what your child’s health plan covers – and what it doesn’t. In some cases, staying on your health plan for secondary coverage may fill in the gaps where your child’s plan comes up short. However, if your insurance and your child’s insurance provide similar or identical coverage, you might consider removing them from your plan and saving money on your monthly premium.

Keep in mind that all health plans sold in the United States include the minimum essential coverage mandated by the ACA. If nothing else, your child’s plan must include the essential health benefits as required by law.

The decision to remove an adult child from your health plan will depend on your personal circumstances. Talk to HealthMarkets Insurance Agency about your insurance situation to find the best plan for all of your children. It’s 100% free of charge, to you and there’s no obligation. Call (800) 827-9990 today to speak with a licensed insurance agent.

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© 2022 HealthMarkets Insurance Agency. All rights reserved.

To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1- 844-704-7357), 24 hours a day/7 days a week, to get information on all of your options.

Attention: This website is operated by HealthMarkets Insurance Agency, Inc. and is not the Health Insurance Marketplace® website. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency in all 50 states and DC. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in an insurance plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.

HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces.

This information is not a complete description of benefits. Call the Plan’s customer service phone number for more information.

TSM000048

© 2022 HealthMarkets Insurance Agency. All rights reserved.

To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1- 844-704-7357), 24 hours a day/7 days a week, to get information on all of your options.

Attention: This website is operated by HealthMarkets Insurance Agency, Inc. and is not the Health Insurance Marketplace® website. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency in all 50 states and DC. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in an insurance plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.

HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces.

This information is not a complete description of benefits. Call the Plan’s customer service phone number for more information.

TSM000048

© 2022 HealthMarkets Insurance Agency. All rights reserved.

To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1- 844-704-7357), 24 hours a day/7 days a week, to get information on all of your options.

Attention: This website is operated by HealthMarkets Insurance Agency, Inc. and is not the Health Insurance Marketplace® website. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency in all 50 states and DC. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in an insurance plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.

HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces.

This information is not a complete description of benefits. Call the Plan’s customer service phone number for more information.

TSM000048