How and When To Add Your Parents to Your Health Care Plan

Discovering suitable health insurance options for your parents can become complex quickly. Learn how to find them the most affordable coverage tailored to their needs with these helpful suggestions.

Members of the “sandwich generation,” adults who are actively supporting their elderly parents while also raising their children, often encounter intricate financial issues, especially regarding healthcare. Navigating the complexities of the US healthcare system can seem like a daunting task, particularly when dealing with a seemingly straightforward question: Can The Positive Parent be added to my health insurance plan?

If you are contemplating whether it is feasible to expand your coverage to either or both of your parents, you may find that the answer is not straightforward.

“The primary challenge in terms of including parents in your health insurance plan lies in the necessity for extensive research to ascertain if your circumstances permit coverage,” states Jan Stone, an experienced, autonomous patient advocate based in Austin, Texas. “Health plans are not obliged to provide coverage for parents, so determining eligibility will necessitate significant proactive efforts on your part.” Here is essential information for adult children contemplating adding their parents to their health insurance coverage.

Medicare and Medicaid Options

The primary consideration revolves around the age of the parents. If they are 65 years old or above, they qualify for Medicare. “Being eligible [for Medicare] will prevent them from being on your plan,” Stone explains. “In such cases, you can assist them financially by covering their premium.”

Medicare and Medigap

Medicare Part A, the hospital insurance, is provided at no cost to individuals who have contributed to Medicare taxes for a minimum of 10 years. However, Part B, which includes coverage for healthcare provider visits, preventive services, and more, requires a premium.

It is advisable, according to Stone, to explore options such as a prescription drug policy and a Medicare Supplement Insurance (Medigap) policy. She emphasizes that these policies can cover costs that Medicare does not, leading to significant savings. Many are unaware that Medicare lacks an out-of-pocket maximum, resulting in ongoing expenses. A supplement policy can provide substantial assistance in such situations.

Early Medicare

If a parent is younger than 65, they may still be eligible for Medicare based on their health condition. Early Medicare can be available if they have end-stage renal disease or have been receiving Social Security Disability benefits for 24 months.1

Medicaid

If parents are younger than 65 and low-income, they may qualify for free or low-cost coverage under Medicaid. The eligibility requirements vary by state.

Regrettably, 2.2 million low-income individuals in 12 states that have not implemented Medicaid expansion are in a situation known as a coverage gap. These individuals have an income below the poverty threshold but do not meet the criteria for Medicaid or premium subsidies under Marketplace insurance.

Adding a Parent To Your Plan

If the parent is not eligible for Medicare or Medicaid, it is essential to understand the regulations for adding them to your plan. In case you have a private health care plan provided by your employer, consulting your HR department is recommended, according to Stone.

“Conditions for inclusion may involve factors such as parents residing with you, being listed as a dependent on your tax return, or the adult child taking financial responsibility for the parents,” Stone clarifies.

If you opt for a plan from the Marketplace, you can add parents to your policy only if you declare them as a dependent on your tax return. Before making any changes to your tax status, it is advisable to assess the expense of obtaining a separate policy for parents through the Marketplace. Their income level might make them eligible for financial aid.

When Should The Parent Be Included In Your Plan

Typically, health insurance companies allow adding dependents to a plan during the policy’s open enrollment period. Open enrollment usually runs from November through the end of the calendar year, with coverage starting in the new year.

In some cases, parents can be added to a plan at other times during the year, with coverage effective immediately. “If parents recently lost coverage, such as a spouse’s death or job loss, they may qualify for a special enrollment period outside of the open enrollment period,” says Les Masterson, an insurance analyst.

When To Seek Legal Advice

If you’re having difficulty finding affordable health care coverage for your parents, Stone suggests consulting an elder care attorney. According to her, their role is to safeguard seniors’ legal and financial well-being by addressing needs such as estate planning, Medicaid applications, long-term care issues, guardianship, and other legal concerns. It is advisable to find an attorney through recommendations from trusted family or friends.

Despite the challenges of navigating insurance terms and bureaucracy, Stone acknowledges and applauds those who are caring for their parents or older loved ones.