The Process

How can I stay on my parent’s insurance?
How do I sign up for Medicaid or state insurance?
How do I sign up for my own private insurance?

How can I stay on my parent’s insurance?

This ultimately depends on your parent’s insurance. You will want to give the insurance company a call and see if it is possible for you to stay on this insurance past the age of twenty-six. There are two potential possibilities that depend on whether you are a disabled dependent or not.

If you are a disabled dependent:

    1. Before turning twenty-six, call your parents’ insurance company and find out their policies and procedures.  
    2. Typically they will send you paperwork. Fill out this paperwork in a timely manner.
    3. Fulfill any other requirements, like having your doctor verify that you are indeed disabled to the point that you cannot work enough to have an employer provide medical benefits.
    4. Return your paperwork with your doctor’s verification letter to your parents’ insurance company.
    5. You may need to do this process:
      1.  For each of your parents’ health insurance providers (e.g. medical, vision, dental).
      2. If your parents change insurance providers.

If you are not a disabled dependent:

    1. Before turning twenty-six, call your parents’ insurance company and find out their policies and procedures.
    2. If the insurance company has a policy to allow you to continue on your parents’ plan:
      1. Find out how much longer you will be allowed to stay on your parents’ plan.
      2. Find out how much the additional premium will cost for you to continue.
      3. Compare the costs and benefits of both your parents’ insurance plan and state insurance to determine the best coverage for you.
    3. If you decide to continue being covered under your parents’ insurance, discuss with the insurance company what needs to be done and fulfill their expectations to continue on the plan.
    4. Pay the additional premium for the allotted time you are covered under your parents’ insurance.

How do I sign up for Medicaid or state insurance?

If you are an adult, age 65 or older, blind or disabled and/or in need of long term support and services, you can apply to Apple Health Classic Medicaid by following the prompts below:

  1. Go to Washington Connection.
  2. Select apply now and follow the prompts to sign up.
  3. You will need to indicate:
    1. Your name
    2. Date of birth
    3. Your citizenship status
    4. Social security number
    5. Income
    6. Assets/resources
    7. Housing cost and utilities
    8. Childcare costs
    9. Other
    10. If you need more information, go to Apple Health Classic Medicaid. This link will also provide you with the Washington Connection link near the bottom of the page.
  1. If you are only applying to Medicaid for yourself and are over eighteen, do not include anyone else’s information as you are “the household”.
  2. Once completing all the prompts, submit your paperwork.
  3. You should receive a phone call and/or a letter from the Department of Social and Health Services (DSHS).

For information on how Medicaid will be impacted by your employment go to Insurance & Employment. –Provide the Link to Insurance & Employment 

How do I sign up for my own private insurance?

Typically, private insurance is purchased through an employer. If your employer provides insurance, you will need to work with your employer and complete the paperwork process that is required of you to receive the benefits. You may have choices (whether multiple companies or plans within one company) and you will want to weigh your options based on the cost of the plan, the coverage of each plan as well as your own healthcare needs. In some cases, your employer may provide a liaison to assist you in making the best overall decision for you.

How do I stay on my parent’s insurance past age 26?

This is a pertinent question to ask your parent’s insurance company if you wish to stay on their plan past the age of 26. You should ask this question when you turn 25, giving you plenty of time to fulfill the insurance company’s requirements.

Every insurance company is different regarding their policies and procedures so asking them this question will allow you to know what you need to do in order to stay on your parent’s plan.

Depending on whether you are a disabled dependent or not will also determine the process you will need to follow in order to stay on your parent’s insurance. Let your parent’s insurance know if you are a disabled dependent.

What does my insurance plan cover?

Knowing what insurance plans cover can assist you in paying the least amount possible out-of-pocket on top of your insurance premium. You will want to be sure to check that the insurance you are interested in provides you with the coverage you desire. Here are examples of things you may want in an insurance plan (but it is not an exhaustive list):

  • Well visits
  • Visits for when sick
  • Specialty doctors (and what the copay will be)
  • Medications
  • Medical supplies (this is general and some insurance companies/plans do not cover every type of medical supply)
  • Durable medical equipment (check on if you can only get one type DME at a time, and if there is a limit per a certain number of years).
  • Emergency room visits, if it is covered or what your copay will be
  • Hospital stays 

If your Medicaid plan does not cover something, it may not be possible for you to get this service or product at all as many companies will not sell to any person who has Medicaid because the company cannot charge them out-of-pocket

How much does my insurance plan cost me?

There are multiple expenses to health insurance. It is important to ask each of the following questions to be able to estimate your complete expenses for your health coverage. These questions include, but are not limited to:

  1. How much will my premium be?
  2. Will I have a deductible? If so, how much will it be?
  3. How much will my copays be (for specialists, medications, general visits)?

Knowing the answers to these questions will help you to not be surprised by the total cost of your healthcare.

When should I contact my insurance company?

You are allowed to contact your insurance anytime you have a question about your coverage or a bill that you have received. Some reasons to contact your insurance company ahead of time would include, but are not limited to:

  1. If you are going to switch doctors, to make sure they are in-network.
  2. If you have been referred to a new doctor (to be sure this new doctor is in-network, and to know your copay amount).
  3. If you are going to switch medical supply or durable medical equipment companies, to make sure they are in-network.
  4. If you have been prescribed a new medication, a new type of medical supply, or a certain piece of durable medical equipment, to make sure it will be covered.

How many visits does my plan cover?

Whether you are going for a dental cleaning or physical therapy visits, it is important to know how many visits your insurance plan covers every year. The number of visits you can receive per year can also be more complex than just a number. Sometimes physical therapy and massage therapy are part of one total. Your number of visits can also be limited to less than the total number of visits allotted per year if your insurance company determines that your progress is not improving at the rate that the insurance company deems acceptable or you have met your progress goal.

Also, be aware that medical, dental, and vision can all be covered under different plans and/or from different companies which means you will need to pay a premium to each of these companies to receive coverage.

Will my current insurance plan change? And if so, how?

Insurance plans can change. Every year you need to check into how your plan may be changing. Questions that you can ask to clarify how your plan may be changing are:

  1. Will my coverage change?
  2. Will any of my doctors, medical supply companies, durable medical equipment companies, no longer be in-network? If so, what doctors etc. near me are in-network?
  3. Will the cost of my premium change? If so, how much?
  4. Will my deductible change? If so, how much?
  5. Will any of my copay amounts change? If so, how much?

If your current insurance plan will be changing and it will no longer fit your needs, you may want to consider changing plans and/or insurance companies.