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Health Coverage For Children 25 And Under And The Health Care Reform Act

by admin on January 25, 2016

If you have kids who are 25 years and under and you are wondering how they are going to take care of their health coverage, you are in the right place. Quite possibly your child, or young adult is just starting out in life, is college bound or getting out of college, and bouncing between jobs, better and worse jobs, especially in this economy. He has no idea how and where to get proper health coverage to protect himself financially. Many jobs do not offer insurance, colleges demand it, and health coverage prices keep going up.

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But there is good news when it comes to baby and health coverage for children under 25. Included in the new health care law of 2010 there is a provision that will give many young adults a reprieve from needing to seek their own insurance in the individual health insurance market, but allow them to stay signed on with their parents on the family health insurance plan until the ripe age of 26. And there are a few other helpful provisions and new health and medical insurance options too.
In this article we will go over all the possible choices for a young adult, ages 19 to 26 to get health insurance for protection at this formative, critical, and risky age. We’ll consider getting health insurance benefits from their own employer at work, from their parent’s employer, in the private health insurance marketplace, from Medicaid, from the state based on income, and through the new federally instituted PCIP, pre existing condition insurance plan program.
Let’s look into the possibilities.
Getting health and medical insurance plan through a job. Even with employer’s costs rising this year for health insurance, getting an employer sponsored health insurance is still the best possible alternative for a young person. Likely, the employer will contribute part of the cost of the insurance, and offer choices between PPO, HMO and possibly other types of coverage. Despite the possible relatively high monthly premium, this is clearly choice number one for a young adult. The insurance can kick in within weeks of person’s employment.
Getting health insurance through parents work. The new health care law has extended the eligibility for children to sign on to the parents job-based health insurance till the age of 26. Also, the conditions for a parent to claim the child are very mild, so this is a viable option for young adults whose parents are working in a job with benefits. A child will be able to sign on any time during the year. An interesting benefit of any insurance obtained through work is that it can not be declined due to the pre-existing condition of the child.

Getting individual insurance policy. A young adult without pre-existing conditions can likely get a quite inexpensive insurance policy on an individual health insurance market place. However, chances are that a health questionnaire will have to be answered, and perhaps even a medical exam will be required as a condition for application. Despite the new health care law, persons ages 19-26 can be denied individual insurance if they have what an insurance company deems a pre-existing condition.
State or federal government sponsored insurances, including PCIP. Medicaid and other income-based state insurances have been available for a while and the eligibility is mostly based on income of the applicant. A good time to apply is therefore at the time between the jobs. If, due to income, or otherwise, a young adult does not qualify for Medicare in their state, and they have been declined individual coverage due to pre-existing condition, there is a way out: the new state, or federally run PCIP, or Pre-existing Condition Insurance Plan. Implemented following the new health care law of 2010, this plan provides an option whereby, at least until 2014, a person will be accepted into a reasonably-priced, high deductible, low copays health insurance plan which will not reject an applicant due to a pre-existing condition.
While long term costs and effects of these new plans are uncertain, young adults should take advantage of all of the above options that are available right now.