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Health insurance for child turning 26: Who pays?

An adult child’s eligibility for government assistance, such

An adult child’s eligibility for government assistance, such as Medicaid, depends on her personal income, not on whether she still lives with her parents. Credit: iStock

Last July, my 25-year-old daughter was diagnosed with leukemia. Her medical coverage was terminated six months after her diagnosis. Thankfully, she's covered under my insurance until she turns 26 in August. She was unable to work during her chemotherapy treatments, but we expect she'll soon return to part-time work. She lives with me, and I don't claim her as a dependent. Am I responsible for her medical bills once she's 26 and no longer qualifies for my insurance? If her insurance isn't reinstated, will she qualify for government assistance?


She will, unless she's a fabulously well-paid part-timer. Her eligibility for financial help is based on her income, not her illness. Under the Affordable Care Act, insurers can no longer refuse to cover or charge higher premiums for covering pre-existing medical conditions.

The likeliest immediate solution for your daughter is Medicaid, which has been significantly expanded under the new law and is now available to singles who earn up to $16,105 a year. Even though she lives with you, your income won't count in determining her Medicaid eligibility because you're no longer legally responsible for her bills.

Medicaid provides a good package of benefits for no premium and very low copays. Major insurance companies now are Medicaid providers in Nassau and Suffolk counties; there's a good chance one of their networks includes some of her doctors. If your daughter qualifies, she can enroll for coverage at any time.

What if she's ineligible for Medicaid? As a single person, she can earn up to $45,900 and qualify to buy a federally subsidized policy in New York's health insurance exchange.

The bottom line An adult child's eligibility for financial aid depends on her personal income, not on where she lives.

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