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Dependent Coverage
Young adults (19-29 years old) are one the largest and fastest growing groups of the uninsured. In 2004, approximately 13.7 million young adults were uninsured. The majority of the uninsured young adults earn less than 200 percent FPL (69 percent). Unless they are students, dependents typically lose eligibility on their parents' or caregivers' insurance on their 19th birthday and also lose eligibility under Medicaid or the State Children's Health Insurance Program (SCHIP) unless they are students. Once a student graduates high school or college, between 40 and 50 percent will become uninsured during the first year following graduation.
In response, states have pursued number of policy options. Some states have changed the definition of dependents and extended it beyond the age of 18 for commercial insurance for students and non-students. Policy holders who elect to maintain coverage for adult dependents will pay additional premium. States control the definition of dependent coverage in the commercial insurance market, the state employees' health insurance pool, and other public programs funded by state dollars.
The states listed in the Coverage Matrix have broad coverage requirements for young adults. Some states like Maine, New Hampshire, and Maryland have expanded dependent coverage for specific sub-sets of the population such as disabled children. Illinois and Pennsylvania allow additional dependent coverage for students who were called into military service. Finally, states can require that educational institutions offer insurance to full-time and part-time students and that all students must document proof of insurance prior to enrollment.
State |
Dependent Description |
Colorado |
In 2003, the Colorado legislature passed HB 1164, which requires carriers in the small group market to offer one of three basic health benefit plans: Basic Health Benefit Plan without specified mandates; Basic High Deductible Health Benefit Plan; or Basic High Deductible Plan without specified mandates.
Effective January 1, 2006, unmarried children are considered dependents and remain eligible for health insurance until their 25th birthday if they: a) maintain the same legal residence as the parent; or b) are financially dependent on the parent. Dependent coverage is paid for by policyholder premium.
Children previously maintained dependent status only as full-time students up to age 24.
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Delaware |
Signed by the Governor in 2006, the state passed legislation (HB 446) that requires commercial health insurance to continue coverage for unmarried adult children with no dependents under a pre-existing family policy until those children turn 24 years of age, provided that the children either live in Delaware or are full-time students. There is an additional premium charge for the continued coverage if the parents opt to cover their dependents. |
Idaho |
In March 2007, the Idaho Governor signed into law Senate Bill 1105 which expands the definition of ‘dependent.' Under the new law, unmarried non-students can remain on their parents' insurance until the age of 21 and unmarried, financially dependent, full-time students can remain on parental insurance until the age of 25. Finally, unmarried children designated as disabled can remain a dependent for insurance purposes up until any age. |
Indiana |
In May 2007, the Indiana Governor signed into law House Bill 1678 that requires commercial health insurers and health maintenance organizations to cover dependents up until the age of 24, at the policyholder's request. |
Maryland |
Enacted legislation in 2007 (House Bill 1057) allows young adults (including child dependents of domestic partners) to remain eligible for insurance until the age of 25 if the individual resides with the insured policyholder and is unmarried. |
Massachusetts |
As part of the Commonwealth of Massachusetts health reform, dependents can stay insured via their parents until their 25th birthday or for two years past dependency whichever comes first. In addition, young adults (19-26) are eligible for a specific product designed for this age bracket. |
New Hampshire |
Enacted legislation in 2007 (House Bill 790) allows unmarried New Hampshire young adults to remain eligible for insurance until the age of 26 regardless of educational status. |
New Jersey |
At the option of the insured person, a dependent may be covered up to their 30th birthday, as long as they have no dependents of their own. The insurance provider may charge a higher rate for this coverage, but the increase is not to exceed 3 percent of the premiums. (Public Act 2005 c.375) |
New Mexico |
An individual or group health policy may not terminate coverage of an unmarried dependent before the dependent's 25th birthday. This applies regardless of whether the dependent is enrolled in an educational institution. (59A-22-30.1) |
Rhode Island |
Insurance carriers must cover unmarried dependent children up until the age of 19 or until 25 if the young adult is financially dependent and is at least a part-time student. Rhode Island has special dependent provisions for disabled children. (Public Law 2006-377). |
South Dakota |
In 2005, the South Dakota Legislature passed HB 1045. It states that dependents shall have access to insurance up until their 19th birthday. If the young adult is enrolled in an educational institution, they are eligible for insurance until their 24th birthday. |
Texas |
Dependents remain eligible for insurance up to their 25th birthday. Passed in 2003, House Bill 1446 extends eligibility for health insurance to students 25 and over as long as they are full-time. |
Utah |
Passed in 1994, Utah requires insurance carriers to provide coverage for unmarried dependents until their 26th birthday. This requirement applies to dependents regardless of their educational status. |
Washington |
Any commercial health plan offering health insurance coverage must allow the option of covering unmarried dependents up until age 25. Additional premiums may be charged to cover these young adult dependents. If the dependent meets certain disability criteria, parents may continue to cover the dependent irrespective of age for the same premium as dependents under age 20. These requirements also apply to the state employee program. (Senate Bill 5930) |
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