Turning 26: How to find the right health plan for your care needs and budget

By Regence
October 19, 2022
young adults

For young adults who have been covered by their parents’ health insurance for most of their lives, it can be a daunting task to sign up for their own insurance when they turn 26. When looking for your own plan, there are many factors to consider.

Where to find health insurance

Most people will leave their parents’ insurance plan and sign up for their own through their work. If your job provides health insurance, talk with someone in HR about your options and how to enroll. If you are married, you may be able to find insurance through your spouse’s job.

If you can’t get health insurance through an employer, you can find an individual plan on the Affordable Care Act (ACA) Health Insurance Marketplace, also known as the Marketplace or the exchange. Depending on your financial situation, you may be eligible for savings based on your income through the Marketplace. Apply online to find out if you qualify.

If you have a limited income or are pregnant, you may be eligible for free or low-cost health insurance through Medicaid or CHIP. If you have children, they may be eligible for Medicaid or CHIP coverage even if you do not qualify for Medicaid. When you complete a Marketplace application and request financial assistance, you will learn if you are eligible for Medicaid or CHIP. You can apply for Medicaid or CHIP at any time by visiting healthcare.gov since there are no open enrollment periods.

Types of plans to consider

If you have not shopped for health insurance before, terms like premiums, deductibles, copayments and out-of-pocket costs can be confusing. While looking for a new health plan, familiarize yourself with health insurance terms and definitions. This helpful page on Regence’s website is a good place to start.

After you've reviewed insurance terminology, assess your individual health requirements. Consider whether you have expected medical costs, such as a needed surgery, a chronic condition, or regular prescription medications. Consider how you intend to seek medical care. Do you already have a primary care provider? Will you need mental health support? Do you prefer virtual visits over in-person? Prioritize your health needs and then look for a plan that covers the most important ones.

When to sign up for a new plan

For work-based insurance, talk with your employer about the timeline and process for signing up. It is usually between 30 and 60 days following your 26th birthday. Turning 26 qualifies you for "special enrollment" on the Marketplace, allowing you to sign up for a plan without having to wait for the yearly open enrollment period. You can sign up two months before – and after – your 26th birthday. To make sure your health coverage begins when you need it, sign up for a new plan by the 15th day of the month prior to when you want your coverage to start. If you want your coverage to begin on June 1, for example, sign up no later than May 15.

We’re here to help

Visit regence.com to learn more about your Regence health plan options or call us at 1-888-REGENCE (1-888-734-3623) if you have questions. Current Regence members may also call our customer service team using the number on the back of their member ID card.