6 tips for getting health insurance for the first time

Turning 26? Here’s what to know about getting your own health insurance plan.

You’re almost 26. But before you cut into your birthday cake, don’t forget to check your health insurance plan. If you’re currently enrolled on your parent’s plan and will be turning 26 this year, you’ll need to enroll in your own health plan soon. Waiting too long could be costly, so get a head start on your search with these helpful tips.


Know when your coverage will end

The Affordable Care Act lets you stay on your parent’s health insurance plan until age 26. After that, you’ll need to enroll on your own.

Typically, you can only enroll in a health insurance plan during certain times of the year. Special enrollment periods are exceptions to these dates. Losing coverage under your parent's plan is considered a qualifying event, which signals the start of a special enrollment period. Most special enrollment periods last for 60 days after a qualifying event.

If your parent gets health insurance through their employer: The date you'll need your own plan may depend on your parent’s insurance provider. Most likely, coverage under their plan will end on the last day of the month that you turn 26, but it could end as soon as your birthday.

If you are disabled: You may be able to stay on your parent’s plan. Check with the health insurance company to be sure.


Learn how health insurance works

Before you decide which health plan you'll need, it's important to know how health insurance works. Brush up on key terms, like your premium, deductible, coinsurance and copay. Being familiar with what is or isn't covered can help you to save time and money after enrollment.


Consider your health needs

Think about how much you'll need to use your insurance.
If you don't need to visit your doctor often, or only for your yearly wellness visits: A low premium, high deductible plan might be best. Your monthly premium is usually lower, but you pay more health care costs yourself before the insurance company starts to pay its share (your deductible).

If you know you’ll need to use your insurance benefits frequently: A high premium, low deductible plan may be ideal. You’ll pay more each month, but you’ll also meet your deductible faster, meaning your insurance carrier will contribute sooner.

Your doctor could change. Most health plans allow you to search their provider directory to see which doctors are a part of their network before signing up for benefits.


Review your health insurance options

Before your coverage ends, do some research to find the plan that's best for you. You have three main options:

Insurance through your employer. If your employer offers health insurance, you will most likely be allowed to enroll in a plan when your coverage ends. Contact your employer's Human Resources Department for more details.

Insurance through the Health Insurance Marketplace. If your employer doesn't provide health insurance or if you're unemployed, Covered California is a good place to start. Covered California is the state's Marketplace: a free resource that can help you enroll in health, dental and vision insurance. Covered California offers financial help, and Sharp Health Plan's options are available for as low as $0 per month, based on eligibility. You can use the Shop and compare tool to find out if you qualify for financial help.

Insurance through Medi-Cal. Medi-Cal offers free or low-cost health insurance to those with low incomes. Applications are accepted all year.


Shop for a plan based on quality

Not all health plans are created equal. Check out a plan's ratings before making a decision, which can help you to determine the quality of care you'll receive. Sharp Health Plan received 5 out of 5 stars from Covered California for 2022 and was the only plan to achieve a 5-star members' care experience rating.1


Don't wait to get covered

Health insurance is a requirement in California. If you don't enroll in a health plan, you could face steep fines when you file your state income tax return. Try to start your application sooner than later to avoid any penalties.

Learn more about finding a health plan

Sign up for a free health insurance enrollment lab: You'll learn how to choose the right plan and can find out if you'll qualify for financial help. Sharp Health Plan's certified enrollment specialists are also available to guide you through enrollment. Contact them by phone or email for more information.

1 CMS scores qualified health plans (QHPs) offered through the Exchanges using the Quality Rating System (QRS) based on third-party validated clinical measure data and QHP Enrollee Survey responses. CMS calculates ratings yearly on a 5-star scale. QHP issuers work with HHS-approved survey vendors that independently conduct the survey each year. QRS ratings and QHP Enrollee Survey results may change from year to year.

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