Can I apply for ACA coverage if I’m a dependent?
Am I eligible to get my own ACA plan if I’m listed as a dependent on my parents’ insurance?
Yes, you are eligible to get your own ACA Marketplace plan, even if you are currently listed as a dependent on your parents’ health insurance. The Affordable Care Act (ACA) allows individuals, including young adults, to obtain their own health coverage through the Marketplace. However, there are some important factors to consider before making the switch. Here’s what you need to know:
1. Eligibility for Your Own ACA Plan
If you are a dependent on your parents’ health insurance plan, you can still apply for your own ACA plan as long as you meet the basic eligibility requirements:
You must be a U.S. citizen or lawfully present immigrant.
You must live in a state that offers ACA Marketplace coverage.
You must not be eligible for Medicare.
As a young adult, you can stay on your parents’ plan until the age of 26, but you also have the option to explore other coverage, including ACA plans, if you prefer your own plan.
2. Financial Assistance (Subsidies)
Whether or not you qualify for financial assistance (such as premium tax credits and cost-sharing reductions) depends on your household income and tax filing status:
A. Household Income:
If you are considered part of your parents’ household for tax purposes, their income will be used to determine whether you qualify for premium tax credits and other subsidies.
If you are filing your own taxes, only your income will be considered when determining eligibility for subsidies.
B. Age and Income Considerations:
Individuals whose income falls between 100% and 400% of the federal poverty level (FPL) may qualify for premium tax credits. For example, for 2024, this would be $14,580 to $58,320 for an individual.
If you are under 26 and listed as a dependent on your parents’ tax return, their income will affect your eligibility for subsidies, even if you apply for your own ACA plan.
3. Can You Stay on Your Parents’ Plan Until Age 26?
Under the ACA, you have the option to remain on your parents’ health insurance plan until you turn 26, regardless of whether you are a student, live with your parents, or are financially dependent on them.
However, if you prefer to have your own coverage or if your parents’ plan does not meet your healthcare needs (such as network limitations), you can enroll in an ACA plan at any time during the Open Enrollment Period or if you qualify for a Special Enrollment Period.
4. When Can You Apply for Your Own ACA Plan?
You can apply for an ACA plan during the Open Enrollment Period or, in certain cases, through a Special Enrollment Period (SEP):
A. Open Enrollment Period:
The ACA Marketplace Open Enrollment Period typically runs from November 1 to January 15. During this time, you can apply for coverage starting the following year.
B. Special Enrollment Period (SEP):
You may also be eligible for a Special Enrollment Period if you experience a qualifying life event, such as moving to a new state, losing other health coverage, or turning 26 (if you age out of your parents’ plan).
5. Why Consider Getting Your Own ACA Plan?
While staying on your parents’ insurance is an option until age 26, getting your own ACA plan might be beneficial if:
Your healthcare needs differ from your parents’ plan: If your parents' plan has limited coverage in your area (for example, if you're living away from home), an ACA plan with a local provider network might better meet your needs.
You want to be financially independent: If you're ready to manage your own health coverage, getting your own ACA plan can give you control over your healthcare costs and choices.
You want to qualify for subsidies: If you are no longer claimed as a dependent on your parents' tax return and have your own income, you may qualify for premium tax credits to reduce your monthly premium costs.
6. How to Apply for an ACA Plan
You can apply for an ACA plan through tsunamihealth.com during Open Enrollment or if you qualify for a Special Enrollment Period.
During the application process, you’ll need to provide information about your household income and family size to determine your eligibility for financial assistance, such as premium tax credits.
Once approved, you can compare plans based on monthly premiums, out-of-pocket costs, and provider networks to select the plan that best fits your needs.
7. What Happens If You Age Out of Your Parents' Plan?
Once you turn 26, you are no longer eligible to stay on your parents' health insurance plan. This will trigger a Special Enrollment Period, giving you 60 days before and after your 26th birthday to enroll in your own ACA plan without waiting for the next Open Enrollment Period.
You can apply for an ACA plan during this time to ensure you don't have a gap in coverage.
Key Takeaways:
You can apply for your own ACA plan even if you are currently listed as a dependent on your parents’ insurance, as long as you meet the basic eligibility requirements.
Your eligibility for premium tax credits will depend on whether you file your own taxes and your household income.
You can apply during the Open Enrollment Period or qualify for a Special Enrollment Period if you experience a qualifying life event.
For personalized help with applying for your own ACA plan or determining whether it's the right choice, schedule an appointment with a Tsunami Advisor here: Schedule an Appointment.
