So, you’re officially leaving the nest of your parents’ (or guardians’) health policy. Maybe your 26th birthday’s coming up — and with it, the U.S. Department of Health & Human Services‘ deadline to get your own plan.
Or maybe you’re younger but ready to shop for your first policy. Either way, congrats on the #adulting milestone!
If you’ve already looked around, you’ve likely found options galore. But which one is right for you? What does health insurance after 26 even look like? Here’s what every 20-something should know.
1. You Don’t Have to Wait Until Open Enrollment
You might have heard that you can’t buy insurance outside of a special window called open enrollment. But if you’re 26 and losing coverage from a parent’s plan, you get an exception. It’s called a “Special Enrollment Period,” and it’s for people who lose access to their insurance through a change of jobs, marriage or — in your case — turning 26!
2. A Catastrophic Plan Might Make Sense If You’re Otherwise Healthy
You know that having health insurance is a smart move, but you may wonder: Why dish out all that money if I’m healthy? If that sounds like you, consider a catastrophic plan, which has a higher deductible (that amount you have to reach before most coverage kicks in) and lower premiums (the monthly or yearly payment for the plan).
Catastrophic plans cover you during, well, catastrophes — like if you get in a car wreck or break your wrist during a kickball tournament. Yep, both can happen, and you’ll want protection when they do.
But you’ll pay more out of pocket when you need care, due to that high deductible. And you won’t get much, if any, help with preventative care or treatment for minor ailments. If that high deductible scares you, a catastrophic plan may not be the best fit.
3. Checkups Are Free
Thanks to the Affordable Care Act, preventative care is fully covered by most comprehensive insurance plans. Preventive care includes annual physicals, flu shots and, for women, pelvic exams. You don’t have to meet the deductible before you get access to that coverage because it’s included with your premiums.
4. Your Preferred Doctors May or May Not Be In Your Network
If you want to keep your current doctor, make sure your plan includes them in your policy’s in-network list of providers. This means your doctor (or their practice) has a prearranged relationship with your insurance company to care for patients at a negotiated rate.
You can still see your current doctor if they’re out of network, but it’ll cost more — and your total out-of-pocket expenses may exceed your deductible in the end.
5. You’ll Need a Separate Plan for Vision and Dental
Health plans don’t typically include vision and dental insurance, so shop for those policies, too. They’ll come with the same structure as health insurance, including premiums, deductibles and network providers. But even if you don’t have glasses or contacts — or hate going to the dentist — don’t skimp out on these benefits. You never know when you might have a toothache or eye problem.
6. Supplemental Insurance Can Help With Costs
If a rising stack of health bills scares you, consider supplemental coverage, like fixed indemnity plans, to accompany your regular health policy. These plans will pay you a fixed cash amount if you experience a covered illness or injury. You’ll get that cash in addition to getting insurance coverage from your existing plan — so for some people, that backup is a win-win.
Of course, turning 26 or coming out from under your parents’ wing is about so much more than health insurance. But with the information above, you’ll be ready to focus on getting going with the rest of your life.