Dependent Coverage

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Young adults, ages 19-26 (in some states, an individual may be considered a young adult up to age 29) are one the largest and fastest growing groups of the uninsured. In 2007, 10.3 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. Full time students are much less likely to be uninsured than non-students—19 percent versus 39 percent--and fewer than one in five young adults are full time students.[1]

In response, states have pursued a 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 an 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.

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.


[1]Holahan, John and Kenney, Genevieve. “Health Insurance Coverage of Young Adults: Issues and Broader Considerations,” The Urban Institute, 2008.