Health Insurance For Single Adults

How Long Can You Stay On Your Parent’s Insurance?

The rules for how long you can stay on your parent's health insurance plan depend on several factors, including your age, your parent's insurance plan, and changes in your life circumstances. 

Age Limit: Under the Affordable Care Act (ACA), you can stay on your parent's health insurance plan until you turn 26 years old, regardless of whether you are married, financially independent, or living with your parents. This is true even if you're eligible for other coverage, such as through your employer or a spouse's plan.

Marriage and Dependents: If you get married before turning 26, you might still be eligible to remain on your parent’s plan. However, your spouse and children (if you have any) would not be eligible to join the same plan; they would need separate health coverage.

Employer-Sponsored Plans: If you have access to health insurance through your employer and it offers a high level of coverage, you may decide to choose to switch even if you're under 26 and eligible for your parent’s plan.

Special Circumstances: Certain life events, like losing eligibility to stay on your parent’s plan due to age, or changes in your parent's employment status, may qualify you for a Special Enrollment Period. This allows you to enroll in a health insurance plan outside of the annual open enrollment.

How Much Is Health Insurance For A Single Person?

The cost of health insurance for a single person varies depending on several factors, including the individual's age, location, tobacco use, the metal level of the plan chosen, and financial help eligibility.

Additionally, the plan deductible, copays, coinsurance, and out-of-pocket maximums are factors that directly impact single-person health insurance costs. Understanding how these components work together is important for managing healthcare expenses.

• Deductible: The amount an individual must pay out-of-pocket before their health insurer begins to help pay for the cost of care. Higher deductible plans typically have lower monthly premiums, making them attractive for individuals who are healthy and don't expect to use medical services frequently.
• Copays: A fixed amount that an individual pays for specific medical services, such as a doctor's visit or prescription medication. A copay is a set fee paid by the member at the time of service and does not always count toward the plan deductible. Copays provide predictability for the cost of routine healthcare services.
• Coinsurance: A cost-sharing arrangement where the member pays a percentage of the total cost of a medical service, and the insurer pays the remaining percentage of the cost. Coinsurance is typically applied after the deductible has been met.
• Out-of-Pocket Maximum: The maximum amount a member would be responsible to pay for healthcare each year varies depending on the specific plan and insurance company. However, under the ACA, there are annual limits on the in-network, out-of-pocket maximums for plans through Covered California. These limits are adjusted annually. Healthcare.gov states that for the 2024 plan year, “the out-of-pocket limit for a Marketplace plan cannot be more than $9,450 for an individual and $18,900 for a family.”¹

Understanding your upcoming healthcare needs and potential medical expenses can help you find a plan that best aligns with your financial situation.

Factors To Consider When Comparing Health Insurance Plans

Comparing health insurance plans as a single adult requires consideration of several factors to ensure that you choose coverage that aligns with your health needs and budget.

1. Coverage and Benefits: Review the coverage offered by each plan, including doctor visits, hospital stays, prescription drugs, preventive care, and specialist visits. Consider if the plan covers any specific medical services and treatments you anticipate needing.
2. Costs: Assess the monthly premium, deductible, copays, coinsurance, and out-of-pocket maximum that accompanies each plan. You’ll also want to check if you qualify for financial help, known as subsidies, to help offset your monthly premium costs.
3. Network of Providers: Check if your preferred doctors, specialists, hospitals, and clinics are part of the plan's network. Going out of your plan’s network for care can result in higher costs.
4. Special Programs and Services: Some plans offer wellness programs, telemedicine, nurse hotlines, and other services that can be beneficial to supporting your health.
5. Coverage in Emergency Situations: Review how the plan covers emergency services, especially if you're concerned about unexpected medical situations.
6. Long-Term Considerations: Think about your long-term health needs and whether the plan can accommodate potential changes in your health and lifestyle.

Comparing different types of health insurance plans based on these factors can help you make an informed decision about the coverage you need and aligns with your financial circumstances.

Where Can I Buy Health Insurance On My Own?

When shopping for and enrolling in health insurance on your own, you have two primary options: On-exchange plans offered through Covered California, and off-exchange plans offered directly by the insurer. 

Covered California 

Covered California was established by the Affordable Care Act (ACA) where you can compare and shop for individual and family health insurance plans available from various private insurers. Plans offered by Covered California must cover essential health benefits, including preventive care, prescription drugs, and hospitalization. For those who qualify, financial help is available to help lower the cost of coverage.

You can shop for and purchase an individual and family ACA health insurance plan through Covered California during the annual Open Enrollment Period. Certain life events, such as getting married, having a baby, losing health coverage, or moving to a new area, qualifies you for a Special Enrollment Period to enroll in health coverage outside the Open Enrollment Period.

Private Insurers

Private insurers provide off-exchange health insurance plans that may offer a wider range of plan options, including different coverage levels, provider networks, and costs. These plans are specifically suited for those individuals and families who don’t qualify for financial help.

You can purchase an off-exchange health plan directly from an insurer by visiting their website or contacting a representative to help you navigate the available options.

Before choosing a health insurance plan, carefully review plan details, compare options, consider your healthcare needs, and assess your budget. Both the Health Insurance Marketplace and private insurers offer avenues for securing single person health insurance coverage depending on your personal circumstances and preferences.