Young Adult's (age 19-30) Guide to Health Reform

The Affordable Care Act (ACA) - often called Obamacare - is a new law helping more Americans get health insurance.

Once you're 19 years old, you can enroll in a health insurance policy on your own, without a parent. Use this guide to learn how the law impacts young adults under the age of 30.

Costs are going up, but your's might be going down

• Changes to how plans are priced for younger people. Before ACA, insurance companies charged very little monthly premium for young, healthy adults. They might have charged older adults five times more than you for the same coverage just based on age. 

The new law changes that. Now, insurance companies can only charge older adults three times more than younger adults. Many younger adults might see big premium increases under ACA because of the new rating system. 

• Qualify for discounts on your health insurance. Even though retail costs for your health insurance is going up in most areas, you might qualify for lower rates based on family size and household income. 

If your household income is beneath 400% Federal Poverty Level (FPL) - which is about $45,000 a year for a family of one or about $94,000 a year for a family of four - you'll qualify for a tax subsidy. A tax subsidy is the amount paid by the government directly to your brand-name, private insurance company to lower your monthly insurance premium or healthcare costs. 

• Medicaid is expanding. ACA expanded Medicaid to include more people - before the household income cut-off was 100% FPL, but now it is 138% FPL. Medicaid varies state-by-state, so not all states went forward with the expansion. 

If your state did not expand Medicaid, you can enroll in a private plan for as little as $1 per month with a brand-name insurance company of your choice based on household income and family size instead.

• If you're under 30 years old, you'll have a "catastrophic" plan option. In addition to the four basic plan choices (Platinum, Gold, Silver, Bronze), you'll have a fifth choice - a "catastrophic" plan - which has a much lower monthly premium but much higher out-of-pocket costs when you use your plan. 

• If your under 26 years old, you can be covered on your parent's health insurance plan. ACA has lengthen the amount of time that young adults can be covered on their parent's health insurance plan. Until your 26th birthday, you can be covered under your parent. You do not have to be a full-time student, you can married, and your parents do not have to claim you as a dependent. 

• Don't forget: You're required to have health insurance, or pay a penalty. Unless you qualify for an exception, you're required to have health insurance or pay a penalty starting in 2014. Qualified insurance could be job-based coverage (your's, your spouse's, or your parent's), private health insurance, Medicaid or another government-sponsored insurance plan. You might decide it's better to go with the low-cost catastrophic plan to avoid the penalty and the potential for bankruptcy if you got bad sick.

Improved Benefits

• You can't be turned down for pre-existing conditions anymore. On all new plans, you are guaranteed acceptance no matter if you have a pre-existing condition or if you use your health plan very often. And no insurance company can drop you just because you get sick. 

• You can't be charged extra premium for pre-existing conditions, gender, profession, or how often you use your plan. Also, premiums are changing so that older individuals cannot pay more than three times what a younger person pays for health insurance.  

• All plans cover Essential Health Benefits with no yearly or lifetime limits. All plans must include coverage for a set of benefits with no yearly or lifetime limits, so you can never run out of insurance for core care. Essential Health Benefits includes doctor office visits, hospitalization, prescriptions, preventive care, and more. 

• Is your family growing? All new plans must include coverage for maternity. If you're pregnant now, you cannot be turned down by any insurance company. And when the baby arrives, you'll get free well checkups and immunizations for your baby. 

• Dental and vision care for children under age 19. Is your child overdue for a dental cleaning? Is she squinting to see the board at school? Good news! Dental and vision care for children is included in all new health plans. 

• Children up to age 26 can be covered on a parent's health insurance. ACA allows for children up to age 26 to be covered under a parent's health insurance plan. It does not matter if your child is married, a student, or if you claim them as a dependent, or not. They can be covered with under your plan until they turn 26 - no questions asked. 

• Free preventive care. Health insurance isn't just for when you get sick - it's also for keeping you well so you don't get sick. All new plans include 100% coverage for preventive care - things like physicals, labs, screenings, pap smears, mammograms, PSA tests, colonoscopies, and more. Preventive care for children is included, too. 

You still have the power of choice

• Choose your insurance company. Even if you accept a tax subsidy -  where the government helps pay your health insurance costs so your plan stays affordable - you still have the power of choice. 

These plans are not issued by the government, but instead, they are issued by private, brand-name insurance companies like BlueCross BlueShield, United Healthcare, Humana, Kaiser Permanente, and more. 

Like a particular insurance company? Don't like a different one? No problem! You choose where you want to use your tax subsidy from the participating insurance companies in your area. 

• Choose your benefits. Whether you qualify for a tax subsidy or not, you'll be choosing from four categories of plans: Platinum, Gold, Silver, or Bronze. 

If you are less than 30 years old (or none of the other plans are affordable), you'll have a fifth plan choice - a "catastrophic plan" - where you'll pay more when you use your plan but pay less each month for the premium.

Keep in mind that subsidies are calculated based on the second lowest cost Silver plan in your area. So if you want to pay less monthly premium, you could enroll in a Bronze plan instead. You'll pay more when you use your plan, but you'll pay much less each month for insurance. 

Be sure to check out our GUIDE to help you choose between the Platinum, Gold, Silver, or Bronze plans.

And if you're overwhelmed, don't worry, we're here to help. We are tried and authorized to walk you through your options.