Turning 26 comes with an important change to your health insurance coverage. Under federal law, young adults can generally stay on a parent's health plan until age 26. Once you reach that age, you'll need to choose your own health insurance to avoid a gap in coverage. The good news is that you have options. Here are some answers to common questions about what happens next and how to find coverage that fits your needs and budget.

When does my coverage end?

The timing varies by plan.

If you have Sanford Health Plan’s employer-sponsored group coverage:

Dependent coverage ends the last day of the month you turn 26.

If you have Sanford Health Plan’s individual and family plan (both on and off the Marketplace):

Dependent coverage continues through Dec. 31 of the year you turn 26.

If you are covered by a plan other than Sanford Health Plan:

Check with your health plan to confirm when your coverage will end.

When can I enroll?

If you’re losing coverage under a parent’s health plan, you don’t have to wait for the annual Open Enrollment Period. Losing coverage is considered a qualifying life event, which means you may qualify for a Special Enrollment Period. This period provides a limited window before and after your current coverage ends to choose and enroll in a new plan.

What are my options?

Depending on your situation, you may be able to get coverage through:

• An employer-sponsored health plan
• An individual and family health plan purchased directly from a health insurer, like Sanford Health Plan 
• A Marketplace plan through the Health Insurance Marketplace
• Student health coverage offered through a college or university
• Medicaid, if you meet eligibility requirements

Why does it matter if I have coverage?

Health insurance helps protect you from unexpected medical expenses and provides access to preventive care, routine checkups, prescriptions and additional services.

Help with unexpected costs: Health insurance can help cover unexpected medical expenses. Even if your plan requires some out-of-pocket costs, having coverage can reduce the financial impact of an injury, illness or hospitalization.

Lower prices for the same services: Insurance companies negotiate with healthcare providers to offer discounted rates for medical care. Without coverage, routine office visits and other treatments can be significantly more expensive.

Easy access to care: As a health plan member, you have access to quality services through a network of healthcare providers. When you’re covered, it’s easier to get the treatment you need for medical emergencies and chronic conditions. You can also receive regular checkups and preventive care, often at no cost. Even if you're healthy today, health insurance can help you prepare for the unexpected while supporting your long-term health and financial well-being.

How can I get started?

As you approach age 26, take time to:

1. Confirm when your current coverage will end. 
2. Review the available health plan options.
3. Compare monthly premiums, deductibles and covered services.
4. Verify that your preferred doctors and hospitals are in network. 
5. Enroll before your current coverage ends to help avoid a gap in coverage.

What if I need help choosing a plan?

Our Sanford Health Plan team is here to help you understand your options and find a plan that’s right for you.

Call us at (888) 535-4831 (TTY: 711) or shop and compare plans to learn more about available coverage and enrollment opportunities.

Don't wait until your coverage ends. Explore your options today so you can confidently transition to your next health plan.