Marrying, moving out, finishing school, or taking a job with benefits doesn’t end your child’s place on your work health plan, because federal rules keep them eligible until 26. Before an adult child switches to a spouse’s or employer’s plan, compare what keeping them on yours costs with what the new plan would cost them.
Take a 24-year-old who marries in June and joins a spouse’s work plan, sure the wedding ended their place on a parent’s family plan. It didn’t. They walked away from coverage they could have kept until 26.
HealthCare.gov’s list of what doesn’t end eligibility also includes having a baby, no longer being your tax dependent, and turning down a job’s coverage. Under Labor Department rules, a work plan that covers children can’t make that coverage depend on marriage, school, residence, employment, or financial support. It also can’t charge more for a 24-year-old than for a 14-year-old.
The rule protects only your child. Your plan doesn’t have to cover their spouse or children, who need their own coverage. Marketplace plans, bought on HealthCare.gov or a state-run site, add a condition, too. If a tax credit lowers your premium, your child has to be your tax dependent to be on your application.
Before your child enrolls in their job’s plan, add up the premium and deductible on each option. On your plan, the premium to count is the extra you pay to keep your child on it. If dropping them would move you to a cheaper coverage level, such as from family to employee plus spouse, that’s the gap between the two premiums. If it wouldn’t, it’s nothing.
Then check the network. If your plan is an HMO, it usually pays for out-of-network care only in an emergency, so confirm it has in-network doctors where your child lives.
Know the end date before it arrives. Federal rules require work plans to keep a child only until the 26th birthday, though your plan or state can extend that. Marketplace coverage lasts through Dec. 31 of the year they turn 26. Either way, your child can pick a Marketplace plan anytime from 60 days before the coverage ends to 60 days after, so price one against paying the full premium to stay on yours.
If your child already left your plan, run the same comparison now. If yours wins, add them back at your employer’s next open enrollment.
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