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Young Adults

When you are young and healthy, you may not think you need health insurance. But life is unpredictable. Anyone can get sick or get in an accident and need emergency care. If you do, it can cost a lot. Plus, with health insurance you can get the care you need to stay healthy, like regular check-ups, specialist care (like physical therapy), and mental health services. It’s important to get covered and stay covered!

And remember, the Affordable Care Act (ACA), also called ObamaCare, requires most people to have health coverage or pay a fee at tax time.

You have options:

Get insurance online or over the phone through the NY State of Health

You can apply for insurance through NY State of Health, the Official Health Plan Marketplace.

  • Depending on your income, you may qualify for insurance for as low as $20 a month or even free through the Essential Plan or Medicaid.
  • You may be able to get a tax credit that will save you money on private health insurance.  You can get a tax credit even if you owe little or no taxes.
  • If you are under age 30, you can buy a lower-cost plan designed especially for young adults.  Called a ‘catastrophic plan’ it protects you from very high medical costs, so you don’t go into debt if you need a lot of expensive care. Click here for some quick facts on catastrophic plans.

Visit nystateofhealth.ny.gov or call 1-855-355-5777 to learn more or sign up for insurance through NY State of Health. Call 311 to find free, in person help to apply from someone in your community.

Get insurance through one of your parents

If one of your parents has insurance through an employer or on their own, you may be able to get coverage through him or her until age 26 or age 30, depending on your situation.

  • All employers that offer family coverage to their employees have to let most children stay on their parent’s plan through age 25, even if the child is married and has a job of his or her own.
    • The federal health care law requires employers to do this.
  • In New York, some parents may be able to keep some of their children on their employer’s plan longer – up to age 30.
    • NYS law requires that insurers allow employers to keep children on family coverage up to age 30, although not all children can stay on the plan – for example, the child cannot be married.
    • If the employer does not do this (the employer has the choice), the young adult can still stay on the plan, but he or she must pay the full price for single/employee-only coverage. This is like COBRA, but you don’t have to pay the small administrative fee that is usually part of COBRA coverage.
    • COBRA may be available to you after you lose coverage as a dependent, but you must pay 100% of premiums and an administrative fee.

Get insurance through one of your school

If you are a student in college, your school likely offers a health insurance plan.

  • You may pay less for your school’s plan than you would if you got insurance on your own, directly from the insurer.  That’s because insurers can set their prices for school plans based on covering only college students (who tend to be younger and healthier) rather than the general population.
    • Compare your options – especially with plans available in NY State of Health, where you may qualify for financial help that may make insurance there even cheaper than your school plan.
    • Look at the plan’s provider network. It will likely be the student health center, provided that it meets requirements in terms of capacity and health services provided.
    • Make sure you check with your health services office to see what plans are offered and select the most appropriate one for you.

Learn More about Public Insurance Options

There are a number of public health insurance options available for young adults who qualify for them:

  • Medicaid – provides free health insurance for eligible children, teens, and adults. Young Adults between 19-20 years of age may be eligible for Medicaid at higher income levels.
    • Pregnant women and teens can get Medicaid regardless of immigration status.
    • Young adults who aged out of foster care between 18 and 21 may be eligible for Medicaid until age 26, no matter how much income they earn. Former foster young adults can call the Human Resources Administration (HRA) Helpline at 1-888-692-6116 for more information or visit a Medicaid Office to apply.
  • Essential Plan – provides low cost or free insurance to adults who have lower income but don’t qualify for Medicaid. You can get the same benefits as private health plans on NY State of Health, but at a lower cost.
  • Child Health Plus – provides free or low-cost health insurance for individuals under the age of 19 who are not eligible for Medicaid. New York State residents are eligible for Child Health Plus regardless of their immigration status, or that of their parents, if they meet the other program requirements.

Visit the NY State of Health to apply for Medicaid, Essential Plan and Child Health Plus.

  • Family Planning Benefit Program (FPBP) -  provides free, 100% confidential sexual and reproductive health services to teens, women, and men who meet certain eligibility requirements. The program is available to you if you are uninsured, privately insured, or covered by Child Health Plus afnd want to keep your sexual and reproductive health needs and services confidential.

Return to information on NY State of Health

Quick Facts about Catastrophic Plans

If you are under the age of thirty, you may qualify for a catastrophic health plan, which protects you from the extremely high medical costs that you could face if you get very sick or have an accident.  Catastrophic plans are available in NY State of Health.

  • With a catastrophic plan, you can go to doctor for primary care three times during the year and receive preventive care at no cost to you.
  • If you get sick or need more care, you’ll have to pay several thousand dollars before insurance kicks in. The monthly cost for this plan is lower than for other plans because of this high deductible.

When you apply to purchase a plan in the Marketplace, if you qualify for a catastrophic plan, it will be listed as an option for you to select.

Return to information on NY State of Health

 

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