How long can a child be covered under parents health insurance

How Long Can You Stay On Your Parent’s Health Insurance? – Forbes Advisor

Published: Nov 2, 2022, 7:00am

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If you have health insurance through your parents, you can typically stay on their plan until you turn age 26, though there are exceptions.

Losing your parent’s health insurance doesn’t mean you should forgo coverage, but that’s what many 26-year-olds decide. The U.S. Census says 18% of 26-year-olds are uninsured, which is nearly 4 percentage points higher than 25-year-olds, and is the highest uninsured rate of any age.

There are plenty of ways to get your own health insurance once you turn 26, including through your employer, a subsidized plan through the Affordable Care Act (ACA) marketplace or a government program like Medicaid.

How Long Can You Stay on Your Parent’s Insurance?

Young adults are allowed to stay on a parent’s health insurance policy until they turn 26, according to the Affordable Care Act (ACA). In most cases, you can remain on your parent’s health insurance plan even if you:

• Get married
• Give birth or adopt a child
• Start or leave school
• Live elsewhere
• Aren’t claimed as a tax dependent by your parents
• Can qualify for employer-sponsored coverage at a job

Depending your parent’s health insurance, you may lose coverage the moment you turn 26, the end of that month or the end of that calendar year. If your parents have health insurance through their employer, you could be removed as a dependent on your 26th birthday (but it depends on the state and plan).

If your parent’s coverage is through the ACA marketplace, you won’t lose coverage right away. You can remain on a parent’s ACA health insurance plan through Dec. 31 of the year you turn 26. That means if you turn 26 in the middle of the year, you will still have coverage until the end of that year.

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How Can I Stay on My Parent’s Health Insurance Until I’m 30?

Some states, like New York and Florida, allow young adults to stay on a parent’s health insurance plan until age 30. Many states also allow disabled dependents to remain on their parent’s health plan indefinitely.

Each state has its own requirements for children over age 26 who want to stay on their parent’s health insurance. Below are the states that allow dependent children to stay on a parent’s health insurance past age 26 and the eligibility requirements.

States where you can stay on your parent’s insurance past age 26

Florida	30	Children must be unmarried and have no dependents of their own, and live with their parents or are students.
Georgia	No age limit	Disabled dependents not capable of self-sustaining employment can stay on their parents’ health insurance indefinitely.
Idaho	No age limit	Disabled dependents can stay on their parents’ health insurance indefinitely.
Illinois	30	Applies to veterans only.
Indiana	No age limit	Disabled dependents not capable of self-sustaining employment can stay on their parents’ health insurance indefinitely.
Iowa	No age limit	Disabled dependents and full-time students can stay on their parents’ health insurance indefinitely.
Massachusetts	No age limit	Disabled dependents not capable of self-sustaining employment can stay on their parents’ health insurance indefinitely.
Minnesota	No age limit	Disabled dependents can stay on their parents’ health insurance indefinitely.
Missouri	No age limit	Disabled dependents not capable of self-sustaining employment can stay on their parents’ health insurance indefinitely.
Nevada	No age limit	Disabled dependents not capable of self-sustaining employment can stay on their parents’ health insurance indefinitely.
New Jersey	31	Children must be unmarried and have no dependents of their own.
New York	30	Children must be unmarried and a resident of New York. There is no age limit for unmarried, disabled dependents not capable of self-sustaining employment.
Ohio	No age limit	Disabled dependents not capable of self-sustaining employment can stay on their parents’ health insurance indefinitely.
Oregon	No age limit	Disabled dependents can stay on their parents’ health insurance indefinitely.
Pennsylvania	30	Children must be unmarried, have no dependents of their own, and be a Pennsylvania resident or a full-time student.
Rhode Island	No age limit	Disabled dependents can stay on their parents’ health insurance indefinitely.
South Carolina	No age limit	Disabled dependents not capable of self-sustaining employment can stay on their parents’ health insurance indefinitely.
South Dakota	29 or no age depending on situation	Full-time student until the age of 29. Disabled dependents not capable of self-sustaining employment can stay on their parents’ health insurance indefinitely.
Wisconsin	27	Children must be unmarried and don’t have the option to get health insurance through their employer.
Source: National Conference of State Legislatures

Health Insurance Options for 26-year-olds

There are multiple health insurance options if you’re losing your parent’s health insurance coverage. Your coverage options after age 26 depends on factors like your employment status, income and budget.

Health insurance through an employer

One of the easiest ways to get health insurance as a 26-year-old is through your employer if your company offers group health insurance as an employee benefit.

One of the biggest benefits of group health insurance is that it’s usually more affordable than an individual health plan unless that plan is heavily subsidized. In most cases, your employer pays a large portion of the monthly premium (or the entire premium), and the rest gets taken out of your paycheck.

Companies pay an annual average of $6,440 for single coverage premiums, while employees pick up $1,299 a year on average, according to the Kaiser Family Foundation. That’s an average of $108 a month.

Health insurance through the ACA marketplace

When the Affordable Care Act (ACA) was passed in 2010, it led to the formation of the health insurance marketplace, where individuals and families can compare available health insurance plans. You can also qualify for premium tax credits and subsidies to reduce your costs if your income is below 400% of the federal poverty level. That’s $54,360 for an individual, $73,240 for a couple and $92,120 for a family of three.

Without those subsidies, ACA marketplace plans can be costly. The average unsubsidized ACA plan costs $386 monthly for a 27-year-old and $412 for a 30-year-old.

Most adults can only enroll in a marketplace plan during open enrollment, which is Nov. 1 to Jan. 15 in most states. Turning 26 and losing coverage through a parent is a qualifying life event that also allows you to purchase a plan via a special enrollment period (SEP) at any point during the year.

Health insurance outside the ACA marketplace

It’s possible to purchase health insurance outside the ACA marketplace, directly through a health insurance company. Some insurance companies sell individual health insurance plans directly to consumers. The same health plans may or may not be available through the marketplace, too.

Finding a health insurance company that sells private individual plans can be challenging. You may need to work with an insurance broker to find a company that sells private health insurance policies in your state. But you can’t qualify for premium tax credits and subsidies if you buy a plan outside the ACA marketplace.

Catastrophic health insurance

Catastrophic health insurance plans can be an affordable way for young adults to get health insurance after age 26. These plans are sold through the health insurance marketplace.

Catastrophic plans aren’t available to everyone. Catastrophic health plans are only for people under age 30, or people over age 30 who have a hardship exemption or affordability exemption and can’t afford a marketplace or job-based plan.

Catastrophic health plans have low premiums, but the deductibles are extremely high. You must meet your deductible before your plan will start covering certain medical services, so you end up paying for most of your medical care out-of-pocket. On the plus side, some routine and preventative care is covered for free before your deductible is met.

The average monthly cost for catastrophic health insurance is $247 for a 27-year-old and $267 for a 30-year-old.

COBRA health insurance

COBRA health insurance, which is an acronym for the Consolidated Omnibus Budget Reconciliation Act, is a federal law that allows you to keep your group health insurance plan if you experience certain life events, such as getting laid off. Examples of qualifying events include:

• Losing your job (voluntary or involuntary)
• Leaving your job
• Reduction in the number of hours you work
• Losing coverage through death or divorce

COBRA usually allows you to keep your health benefits for 18 or 36 months, but it depends on the qualifying event. Not all group health insurance plans are COBRA-eligible, such as health plans from small employers.

The premiums can be very expensive since COBRA premiums aren’t subsidized. You instead usually pay the full monthly premium yourself. For instance, using the average $7,739 annual cost for overall premiums for single coverage in the employer-sponsored health insurance market, you would pay an average of $645 monthly with no help from the employer and that doesn’t include a 2% administrative fee that the COBRA law allows.

Medicaid

Medicaid is a health insurance program that is jointly funded by states and the federal government. Medicaid benefits are available to low-income individuals and families, pregnant women and people with disabilities. If you meet the income requirements in your state, you can apply for Medicaid through the health insurance marketplace or your state’s Medicaid agency. Medicaid costs are based on household income.

Medicaid plans cover a variety of medical services, including hospitalization, doctor’s visits, diagnostic testing and imaging, home health services, prescription drugs and physical therapy. All Medicaid plans provide dental coverage for children under 21, but not all plans have dental coverage for adults.

Short-term health insurance

Short-term health insurance can help you get temporary coverage during a transitional period, like turning 26 and losing coverage through your parents, or waiting to start a new full-time job with health benefits.

Short-term health insurance can be a cheap option for people who don’t expect many health care needs, but there are a few downsides. Pre-existing conditions aren’t usually covered, deductibles are usually high and short-term health plans often don’t cover many services that are basic in an ACA plan like prescription drugs and mental health.

Health insurance cost comparison for 27-year-olds

Employer-sponsored health plan	$108
Catastrophic health insurance	$247
Unsubsidized ACA health plan	$386
COBRA health insurance	$645
Employer-sponsored and COBRA plans don’t base costs on age, so these averages are overall for group coverage. The COBRA average doesn’t include a possible 2% administrative fee.

When a 26-year-old Needs to Apply for Their Own Health Insurance Plan

If you’re currently on your parent’s’ health insurance plan and are about to turn 26, you’ll need to start applying for your own health plan unless you’re in a state that allows you to stay on the plan longer.

One exception is if your parents get coverage through the ACA marketplace. In that case, you have until the end of the calendar year to get other health insurance.

If you enroll in your own marketplace plan during open enrollment, you must apply before the end of the year to get coverage starting Jan. 1 of the following year. For example, you must enroll in a marketplace plan by Dec. 15 to get coverage that starts on Jan. 1.

It’s a different story if your parents’ have group health insurance through their employer. In that case, you may lose coverage when you reach age 26 or at the end of the month when you turn 26. In this case, you can qualify for a special enrollment period, which gives you 60 days after you lose coverage to enroll in your own marketplace plan.

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How to Compare Health Insurance Plans

Purchasing your own health insurance plan for the first time can be challenging, especially if you’re unfamiliar with the plan types, terminology and cost structure. Once you have a general understanding of how health insurance works, you can compare providers to find the best option for your needs.

When you get a plan, you’ll pay a monthly health insurance premium, which is the cost of having a health plan. Most plans also have out-of-pocket costs, like a deductible, coinsurance and copayments. Plans with higher premiums usually have lower out-of-pocket costs, meaning your insurance company pays more of your qualifying medical expenses.

If you’re looking to spend less on health insurance and don’t expect to have many health care needs, a high-deductible health plan (HDHP) may be a wise decision. On the ACA marketplace, Bronze plans typically have the highest out-of-pocket costs and lowest premiums, so they might be a good bet.

Related: Bronze, Silver, Gold or Platinum Health Insurance

Most health insurance plans work with a network, which is a large group of doctors, specialists (like dermatologists and cardiologists) and hospitals. Depending on your health insurance plan, you may only get coverage for medical services received in-network.

Preferred provider organization (PPO) plans allow you to go out-of-network, but you may pay higher premiums and more for out-of-network care than in-network care.

Some plans like health maintenance organization (HMO) plans require you to work with a primary care provider and get a referral to see a specialist.

There are many different health insurance plans available. Here are some of the most common plans and their key features:

• HMO: An HMO limits coverage to in-network providers and requires a referral to see a specialist. These are often cheaper than PPOs.
• PPO: A PPO allows you to get care in-network or out-of-network (usually at a higher cost), and referrals are not required.PPOs are often the most expensive types of health plans because they offer fewer restrictions.
• EPO: An exclusive provider organization (EPO) plan only allows you to get coverage in-network, and you must get a referral to see a specialist. EPOs are similar to HMOs, but EPOs typically have a larger network.
• POS: A point of service (POS) plan lets you visit doctors in-network or out-of-network, but referrals are required if you want to see a specialist.

Regardless of the type of plan, emergency services are always covered, and you won’t be charged more for going to an out-of-network hospital or clinic for emergency care.

How Long Can You Stay on Your Parent’s Insurance FAQ

Can you have two health insurances?

Yes, it’s possible to have two health insurance plans. For example, if you’re under age 26 and your parents cover you in two separate plans, one acts as the primary plan and the other acts as the secondary plan.

When you receive medical care, the primary insurance company submits the claim, and the secondary insurance company covers its portion (if the medical service is covered). Having two health insurance plans doesn’t provide double the benefits.

You don’t get to choose which plan is primary and which one is secondary. The health insurance companies’ coordination of benefits decides which plan is primary and which is secondary. That includes the so-called birthday rule when both parents cover you on separate plans. In that case, the health plan of the parent with the earlier birthday within the calendar year is considered primary.

Can I have my own insurance and be on my parent’s policy at the same time?

Yes, you can have your own health insurance plan while staying on your parents’ policy. This is called having dual coverage.

If you have two health insurance plans, one health plan is designated as the primary plan and the other is the secondary plan. If you have your own insurance, that policy is usually the primary plan and your parents’ plan is the secondary plan.

Can I stay on my parents insurance if I file taxes independently?

If you file your taxes independently, you’re still allowed to stay on your parent’s health insurance plan until age 26 (or the age limit in your state). Your ability to stay on your parents’ health insurance is only based on your age and is separate from your tax filing status.

Is health insurance mandatory?

Health insurance is not mandatory at the federal level. Prior to 2018, uninsured individuals paid a tax penalty, but that’s no longer in effect.

But there are states that require health insurance. Residents of California, District of Columbia, Massachusetts, New Jersey, Rhode Island and Vermont are mandated to maintain health insurance coverage throughout the year per individual state laws.

Do young people need health insurance?

All young people can benefit from health insurance. Even when you’re young and healthy, accidents can still happen.

Between routine care, like vaccines and annual checkups, and potentially more serious situations, like an unexpected trip to the emergency room, paying for your medical expenses without insurance can get very expensive.

Health insurance plans help you pay for these expenses and provide financial peace of mind. If you needed surgery or wound up in the hospital, your health insurance plan would cover a large portion of the bill once you reach your deductible. That can help you avoid medical debt.

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Information provided on Forbes Advisor is for educational purposes only. Your financial situation is unique and the products and services we review may not be right for your circumstances. We do not offer financial advice, advisory or brokerage services, nor do we recommend or advise individuals or to buy or sell particular stocks or securities. Performance information may have changed since the time of publication. Past performance is not indicative of future results.

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Elizabeth Rivelli is a freelance writer with more than three years of experience writing about insurance. She has extensive knowledge of various insurance lines, including life insurance, property insurance, car insurance, and health insurance. In addition to her contributions to Forbes Advisor, Elizabeth’s writing has appeared in many online publications, including Investopedia, Money Under 30, Bankrate, and NextAdvisor. She has also published content for several insurance carriers, like Ethos Life.

The Forbes Advisor editorial team is independent and objective. To help support our reporting work, and to continue our ability to provide this content for free to our readers, we receive compensation from the companies that advertise on the Forbes Advisor site. This compensation comes from two main sources. First, we provide paid placements to advertisers to present their offers. The compensation we receive for those placements affects how and where advertisers’ offers appear on the site. This site does not include all companies or products available within the market. Second, we also include links to advertisers’ offers in some of our articles; these “affiliate links” may generate income for our site when you click on them. The compensation we receive from advertisers does not influence the recommendations or advice our editorial team provides in our articles or otherwise impact any of the editorial content on Forbes Advisor. While we work hard to provide accurate and up to date information that we think you will find relevant, Forbes Advisor does not and cannot guarantee that any information provided is complete and makes no representations or warranties in connection thereto, nor to the accuracy or applicability thereof. Here is a list of our partners who offer products that we have affiliate links for.

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Dependent Health Coverage and Age for Healthcare Benefits

Table of Contents

• Table: State Laws Relating to Dependent Coverage
• Coverage Beyond the Federal ACA (7 states)

Contact

• Health Program

The Patient Protection and Affordable Care Act (ACA) mandates that all health insurance carriers in every state that offer coverage to both adults and their dependents must allow dependents to remain on their parents or guardians’ “family” plans until the dependents are 26 years old.

The issued regulations state that young adults are eligible for this coverage regardless of any, or a combination of any, of the following factors: financial dependency, residency of the young adult, student status, employment status, or marital status. This applies to all plans in the individual market and to almost all employer plans (small group, large group, including self-funded or so-called ERISA plans) created after March 23, 2010. 

PPACA & HCERA; Public Laws 111-148 and 111-152: Consolidated Print

‘‘SEC. 2714. EXTENSION OF DEPENDENT COVERAGE.

‘‘(a) IN GENERAL.—A group health plan and a health insurance issuer offering group or individual health insurance coverage that provides dependent coverage of children shall continue to make such coverage available for an adult child until the child turns 26 years of age. Nothing in this section shall require a health plan or a health insurance issuer described in the preceding sentence to make coverage available for a child of a child receiving dependent coverage. [As revised by section 2301(b) of HCERA]

‘‘(b) REGULATIONS.—The Secretary shall promulgate regulations to define the dependents to which coverage shall be made available under subsection (a).

‘‘(c) RULE OF CONSTRUCTION.—Nothing in this section shall be construed to modify the definition of ‘dependent’ as used in the Internal Revenue Code of 1986 with respect to the tax treatment of the cost of coverage.”

• NCSL Fact Sheet
• White House Fact Sheet
• Commonwealth Fund:  Rite of Passage: Young Adults and the Affordable Care Act of 2010
• Kaiser Family Foundation Summary

The States’ Role

The extension of coverage for young adults under their parents’ or guardians’ health insurance plans, like many of the ACA’s provisions, originated in state legislatures. Prior to the implementation of the ACA, at least 31 states required carriers to extend coverage to young adults. The age at which insurers were no longer required to provide coverage to young adults under their family plans varied by state. Additionally, some states required certain conditions to be met by young adults in order to be eligible for coverage under their guardians’ plans. For example, a number of states required that young adults be unmarried in order to qualify.

States may continue with current state law requirements for extended dependent coverage unless they prevent the application of the ACA. As with other state health insurance statutes, the state mandate language enables the state insurance departments to educate the public, and to implement and enforce those laws directly, including use of state courts and state-specific penalties.

State and local governments, as employers and sponsors of coverage plans, are required to notify those under the age of 26 whose coverage has ended or who were denied coverage under their plans before turning 26, of enrollment opportunities. 

State Actions

The federal ACA law applies to young adults in all states. 

As of 2012, (before the ACA was fully in effect)  the following 37 states had already extended the age that young adults can remain on their parents' health insurance plan:  Colorado, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin and Wyoming.  

There is considerable variation among state laws in terms of eligibility requirements. At least 30 states have extended dependent coverage, regardless of student status. Most states require that a young adult be unmarried and financially dependent on their parents in order to qualify for extended dependent coverage. 
States may continue to apply current state law requirements for extended dependent coverage except to the extent that the requirements prevent the application of the Patient Protection and Affordable Care Act (ACA). [Reviewed/updated 2016]

The box allows you to conduct a full text search or type the state name.

Coverage Beyond the Federal ACA | 2016 update

Six states, including Florida, Illinois, New Jersey, Pennsylvania, South Dakota and Wisconsin have enacted laws that require or authorize carriers to cover young adults beyond age 26. New York and Ohio previously enacted such laws, however those provisions are no longer in effect.

Who Pays?

The cost of notifying families about new enrollment opportunities is shared between insurance providers and employers. The cost of covering the young adults who take advantage of the extension is shared between employers and the families of newly covered young adults. For families with no employer health coverage, the cost may fall on the parents.  Those families that qualify for States, as sponsors of coverage plans for state employees, also share the costs with families. A qualified young adult cannot be required to pay more for coverage than similarly situated individuals who did not lose coverage due to the loss of dependent status.

IRS Notice 2010-38 provides guidance to extend the general exclusion from gross income for the reimbursements for medical care under an employer provided accident or health plan to any employee's child who has not yet attained age 27 as of the end of the taxable year, making the benefit tax-free.

*The information on this page is intended for state policy makers. It is not intended as legal or medical advice or guidance to individual insurance enrollees.. 

Source: NCSL legal research, 2016; State Health Facts by KFF. Legal review, 2011-2015: Richard Cauchi, NCSL Health Program.
Update 2016 research: Ashley Noble, J.D., NCSL Health Program

How to get an injury insurance payment

12/29/2021

When we buy an insurance policy, we hope that nothing will happen. But if trouble happened and you got injured, you need to do everything right. If you follow simple instructions, then receiving an insurance payment will not be a problem.

Contacting doctors

Your injury must be recorded in order to receive payment. Therefore, do not self-medicate. If the injury is mild, go to the nearest emergency room. According to the legislation of the Russian Federation, you are required to be accepted there, even if you do not have a policy or other documents with you. If the injury is serious and it is difficult to move, call an ambulance. It is important that your injury is officially registered and described. All examinations, including x-rays and MRI, must be prescribed by a doctor. Follow all doctor's orders during treatment. Getting an insurance payout is important, but recovering from an injury is a must.

Insured event

Before applying for an insurance claim with a company, it is important to understand whether your injury relates to an insured event that is covered by your policy. You can specify this in your contract. If you do not have a policy on hand, then download a new copy from your Personal Account.

Insured event — an event that occurred during the period of insurance and is specified in the insurance policy. After an insured event, the obligation of the insurance company to pay compensation to the insured person, his representative or another person (the Beneficiary) appointed by the contract

If you find your injury on the list, it's time to apply for an insurance payment.

Procedure for receiving an insurance payment

Step 1: Notify the company

Contact us to report your injury.
How can this be done?

• Through Personal Account
• By phone 8 495 981-2-981
• Via notification on website
• Through your financial adviser

Important to know!
You must report the incident to the insurance company as soon as possible. Insured events have a statute of limitations. And if no one reported an injury in a certain period, the company may refuse to pay.

Step 2: Complete application

Application form for payment can be downloaded here Download form .

To make it easier to fill out, use the sample Application for payment

Step 3: Prepare the required documents

• A copy of the insurance contract;
• Application for insurance payment;
• Copy of the passport of the Russian Federation: all pages with marks and seals;
• A copy of the power of attorney confirming the authority to conduct business in the insurance company on behalf of a relative and another person or on the basis of a birth / adoption certificate, if the parents represent the interests of the children. In the event that the guardian represents the interests of the client, documents from the guardianship authorities will be required;
• Original or copy of medical records certified by a polyclinic or hospital indicating the diagnosis, anamnesis of the disease and the period of treatment;
• Original or copies of sick leave certificates (including electronic ones), certified by a polyclinic or hospital;
• Copies of documents in case of temporary disability;
• A copy of the act of an accident at work in the form of H-1, certified by the seal of the employer organization.

Please note!

The list of documents may differ for different cases. You can clarify the documents required to receive an insurance payment in a special section on the website.
Also, the list of documents required for payment is specified in the insurance rules or policy conditions. You can always download a copy of it in your Personal Account.

Important to know!

The insurance company has the right to request information about the incident from medical institutions, law enforcement agencies and other institutions. And also organize a medical or other examination at your own expense.

Step 4. Send documents to us

You can send documents by mail or bring them yourself to the address: Russia, 115114, Moscow, Derbenevskaya embankment, 7, building 22, floor 4, office 13, com. eleven marked in "Department of insurance payments and expertise" You can also submit documents through employees of regional offices.

When is the payment due?

For each case, the period for consideration of the application is individual. We have already written that the company, before paying out money, can make requests to various government agencies to clarify the circumstances of the insured event. This may increase the duration of the insurance payment. The status of the application can be checked in the Personal Account. At the end of this period, you will be informed whether you will receive a payment.

Under what conditions can an insurance payment be denied

There are a number of reasons why an injury claim may be denied, for example:

• Violation of the terms of the contract. This is the most common reason.
• Providing false information or forged documents.
• Late or incomplete payment of insurance premiums by the client.

The client can apply to the court, where he will have to prove that, according to the terms of the contract, he should receive compensation. Payment may be denied for good reasons, so before going to court, you need to get legal advice. You can also contact the financial ombudsman.

We are ready to answer your questions at any of the stages of processing the insurance payment. You can contact us in a way convenient for you:

Via Personal Account

+7 495 9812981

Telegram @renlife_bot

By phone: 8 (495) 981-2-981

Through the contact form on the website

Family health insurance in Germany

What are the conditions for free inclusion in family health insurance in Germany?

An indisputable advantage of state health insurance in Germany is the possibility of including a spouse and children in the contract without additional fees. Under certain conditions, it is allowed to insure free of charge even grandchildren.

The only contribution of one employee provides family insurance.

Conditions for including a family in medical insurance

In private health insurance, each additional family member increases the monthly fee. In the state, on the contrary, relatives receive a full range of German medicine services for free.

A child or spouse is included in the insurance if he:

• lives legally in Germany, registered at a German address.
• does not fall under the terms of compulsory insurance due to the presence of its own income in excess of the established limits.
• is not a civil servant.
• is not self-employed for more than 18 hours per week.
• does not receive unemployment benefits.
• is not insured in the private box office.

Family member income limits

Spouse or child, in order to remain insured in family health insurance, cannot earn above the norm. The amount of the limit depends on the form of employment.

Income limit in 2022, allowing working family members not to take out their own insurance - 470€ per month. But it is not gross salary that counts, but earnings minus labor costs. Therefore, it is allowed to deduct the costs of finding a job from the salary - a minimum of 1000 € per year. Therefore, the real allowed earnings are 553.33 € per month.

Those working under the terms of the Minijob - the minimum employment in Germany - also fall into family insurance.

Not only wages are considered income. The limit covers the total income, including, for example, renting out housing, pensions, interest on capital.

If the insured began to earn more, he is obliged to independently notify the insurance company and draw up a separate contract - in public health insurance or in private.

It is allowed to exceed the limit by any amount due to additional employment lasting no more than 2 months per year. For example, if a student decides to work as a waiter during the holidays.

Age limits for children

While the child has not started to earn money on his own, it is allowed to be in the parent's contract until the age of 23. Studying at a university or getting a profession in Ausbildung without a salary raises the age bar to 25 years.

It is possible to extend the stay in family insurance for a year if studies were interrupted by voluntary military or volunteer service.

Without age restrictions, it is allowed to remain in the parent's state insurance for dependent disabled people who require constant care and supervision.

How to apply for family insurance

If the conditions for enrolling in family insurance are met, the contributor asks the cash desk for permission to pay. The insurance company sends a questionnaire, also a pdf of the form is available for download on the company's website.

A completed and signed application must be sent to the address of the insurance company or upload a scan on the website in your personal account. The form is accompanied by a German translation of the marriage and birth certificates included in the contract, and passport-sized photographs.

The cash desk will check the application and send an insurance policy in the form of a card to each new client.

When both spouses work and pay separate fees to the state fund, the question of whom to bring the child in must be decided independently. The size of the salary does not play a role.

Once a year, the fund sends a questionnaire to the employee paying the family contribution with questions about compliance with the rules for the presence of relatives in family insurance. The paper must be filled out, signed and sent back.

Our insurance services

Our insurance broker helps to insure in Germany in Russian with an individual approach to the situation of each client. Complete the questionnaire to find an insurance contract. The service is completely free.

QUESTIONNAIRE

Family where one of the spouses is in private insurance

It happens that in a family one spouse is in state insurance, and the other is in private insurance.

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