If you’re a forthcoming graduate, getting off your parents’ health insurance soon, or moving out of your home state after college, you’re probably wondering what your responsibility is about health insurance in the light of the Affordable Care Act. Avoid wasting money paying the fine you’d incur by going without health insurance. Here are some key questions and answers that can help.

A few definitions/acronyms to know:
ACA – Affordable Care Act
ESI – Employer sponsored insurance. NOTE: Most offers of employer healthcare coverage are affordable and adequate, as defined by the ACA. Affordable employer insurance is defined as “less than or equal to 9.5% of the household income for self-only coverage.” (The cost of adding a spouse and children is not included.) Adequacy is determined by minimum value standards.
MEC – Minimum essential coverage • See what counts as MEC
SEP – Special enrollment period – a time outside of open enrollment when you have an opportunity to sign up for health insurance

How long can I stay on my parents health insurance? Until you turn 26—even if you have an offer of insurance through your spouse or employer.

If I move out of their home or out of state, can I still stay on their insurance, and if so, to what age? Graduating or moving out of your parents’ home doesn’t necessarily count as a qualifying life event (also referred to as a triggering event.) You can stay on their insurance until you’re 26 (or enroll in ESI if that is available to you.)

I don’t live with my parents, and I’m not on their health insurance. At what age am I responsible to have my own health insurance? Essentially, it’s not about age. In the event a child is fined, the tax filer (either a parent or other) is responsible for paying the fine. If you are a tax filer, you will be asked about having health insurance when you file taxes, and if you could have afforded health insurance and went without it, then you or whoever is the tax filer will be fined. If you did not have an affordable offer of health insurance and went without it, then you qualify for a hardship exemption. Ideally if you are working and qualify for ESI, you must enroll in that.

What are the timeframes for an SEP and the fine? You can apply for ACA insurance up to 60 days before your qualifying life event. Then you’ll have 60 days after your qualifying life event as your SEP to enroll in a healthcare.gov Marketplace plan or secure other health insurance. Remember, if you go 3 months or more in a calendar year with no health insurance, you will probably incur a fine when you file your annual Federal taxes. The sooner you can get on top of this after you know you will not have coverage, the better so you can avoid the fine and/or having to wait until the next year for open enrollment to secure a Marketplace plan.

Anything else I should know? If you have affordable and adequate insurance available to you through either your parents’ policy or through your job, you will not get tax credits (a discount on the plan) on a Marketplace plan if you apply for one. Knowing when your current coverage will end and if you have another offer of affordable coverage available to you will help as you choose new health insurance.

For more information: See https://www.healthcare.gov/sitemap or call 1-800-318-2596. Find local help through people and organizations in your community who can help you apply, enroll, and answer your questions. Also, this Reference Chart will provide more information about events that can allow/begin an SEP.

Thanks again to Rachel Clifton at the Tennessee Justice Center for help with the information in this article.

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