Losing coverage on your parent’s plan

If you have coverage in your own name when you turn 26, it won’t be affected. But if you’re a dependent on your parent’s plan, you may lose coverage under that plan either at the end of your birth month or end of the calendar year. Please refer to your Evidence of Coverage (EOC) or have your parents check with their employer. Now is the time to explore your options for a Kaiser Permanente plan of your own.

Your parents can discontinue your coverage under their plan at any time.

You have plenty of options to stay covered, including:

• A Kaiser Permanente individual or family plan — which you can buy directly through Kaiser Permanente or your state’s health benefit exchange

• Medicaid (Kaiser Permanente may not offer a Medicaid plan in all Kaiser Permanente regions)* and other federal and state health programs

• COBRA (continuation of coverage under your parent’s employer-sponsored plan

• Coverage through another employer-sponsored plan (such as through your own job)

*If you qualify for Medicaid in your state, you may be eligible to receive your Medicaid health care with Kaiser Permanente.

COBRA continuation coverage, including continuation coverage under state law, may be available to you to continue employer-sponsored coverage for a limited time.

• COBRA continuation coverage is generally only offered through employers with 20 or more employees.

• Federal COBRA continuation coverage usually lasts for 18 months if you lose coverage under your parent’s plan. Maximum duration for state continuation coverage varies under state law. Check with your parent’s employer for details.

• You pay the full plan membership bill every month, plus a small administrative fee, so it can be a costly option.

To learn more about your COBRA continuation coverage options available from Kaiser Permanente, contact your parent’s employer.

Depending on your coverage option, that date can vary:

• If you buy a Kaiser Permanente individual or family plan through Kaiser Permanente or the health benefit exchange, coverage may start the first day of the month after you lose your coverage.

• If you elect COBRA coverage, your employer-sponsored coverage will continue without a break in that coverage.

• If you apply for Medicaid and are eligible for coverage, coverage may start either on the date you apply for Medicaid or the first day of the month you apply, depending on your state’s Medicaid rules.

Depending on your family size and income level, you may be able to get help in a number of ways. You may qualify for:

• Federal financial assistance to help pay your monthly membership bill or reduced out-of-pocket costs for care. If you’re eligible for a subsidy, you must enroll in a plan through the health benefit exchange to receive the subsidy.

• Coverage through Medicaid, the Children’s Health Insurance Program (CHIP), or other government-funded programs

• Financial assistance through Kaiser Permanente’s Medical Financial Assistance and Charitable Health Coverage programs (not available in all Kaiser Permanente regions)

To find out if you qualify:

• Check healthcare.gov or your state’s health benefit exchange to see if you qualify for Medicaid, CHIP, or other government-funded programs.

• To learn about Kaiser Permanente’s Medical Financial Assistance and Charitable Health Coverage programs, visit kp.org/mfa and kp.org/chc.

Depending on your circumstances, the deadline to enroll varies. If you have a major life event — known as a qualifying life event — like losing coverage on your parent’s plan when you turn 26, getting married or divorced, or having a baby, you can apply for coverage for a limited time outside the yearly open enrollment period. This is called a special enrollment period.

• If you’re applying for an individual plan, you have a special enrollment period that typically lasts 60 days from the date of your life event, but in some cases extends from 60 days before to 60 days after the event.

• If you’re applying for employer-based coverage, you also have a special enrollment period, but in this case it lasts at least 30 days from the date of your life event — duration varies by employer.

• If you opt for COBRA coverage, you can sign up within 60 days of the date you lose coverage or the date you get your COBRA election notice — whichever is later. For state COBRA coverage, sign up by the date specified in your COBRA election notice. Check your election notice to confirm your deadline.

• If you qualify for Medicaid, you can apply anytime — with no time restrictions.

You’ll want to act quickly: If you don’t apply by your deadline, you’ll usually need to wait until the following year’s open enrollment period to apply for new coverage.