Insurance Choices

What are my choices regarding health insurance that I should consider before turning 26 and I am single?
I am already 26 or older OR I am not able to be covered under my parent’s insurance and I am single, what are my choices regarding health insurance?
If I am married, what are my choices regarding health insurance?

What are my choices regarding health insurance that I should consider before turning 26 and I am single?

Apply to stay on your parent’s insurance as a disabled dependent 

This is a lengthy process that needs to begin prior to turning twenty-six. After turning twenty-five, call your parent’s insurance provider and ask them what their policy and procedures are for completing this process. Every health insurance company has varying rules and regulations, and if the insurance company provides this service, you will have to follow their rules in order to continue receiving coverage. Also, some insurance companies require the process to be completed through the parent’s employer. 

For more information, check out The Process.

Even if you have Medicaid, it is beneficial to stay on your parent’s insurance if possible. If you are able to stay on your parent’s insurance, it will be your primary insurance as Medicaid is always secondary when one has a second source of healthcare.

Apply to stay on your parent’s insurance for additional months at an additional premium

Even if you do not have a disability that deems you a dependent and therefore you are not able to continue being covered under your parent’s insurance, you can apply to get an extension to continue being covered for a specific amount of months (depending on the insurance company). However, this extension will cost you and your parents an additional premium

Make sure you compare the coverage and cost of the additional premium versus that of state insurance to get the best coverage at the best cost for your specific needs. 

For more information, check out the process.

Apply for or continue to solely be covered by Medicaid

As a person with a disability, if you qualify for Supplemental Security Income (SSI), you also qualify for Medicaid. If you do not have a disability or SSI, you could still possibly qualify for Medicaid based on your income.

If you need in-home care, it is important to apply for and/or continue Medicaid to keep this in-home care. Without Medicaid, you may not have in-home care coverage. You can still qualify for in-home care, however, without Medicaid, you will be required to pay for it out-of-pocket

Some private insurances do cover in-home care but you are required to be homebound and cannot be an employee or student that leaves the house.

Medicaid is based on your income. As a single person, you may not need to pay a premium for your coverage; this is if you are disabled and make $783.00 per month or less. If you need in-home care, you can qualify for a Medicaid waiver and make up to $2,349.00 per month without losing your Medicaid benefits. However, whatever your income limit is, you still have an asset limit of $2,000.00.

For more information go to Washington Medicaid Income and Asset Limits for In-home Long-term Care.

If you make over $2,349.00 per month, you may qualify for Healthcare for Workers with Disabilities (HWD). This means you will be required to pay a premium for your coverage but this allows you to work, save over $2,000.00, invest in assets, and keep your in-home care as well as other healthcare benefits.

For more information, check out the process.

Purchase your own insurance private or state

Purchasing your own insurance can be through either a private provider or via the state. 

You are always welcome to purchase your own insurance. Private insurance is typically more expensive than state insurance, but having private insurance does not limit your income or assets. If you are employed, your employer may offer benefits. Check into all of your options.   

For more information, check out the process.

State insurance is based on your income, and in Washington State, if you are an independent without an income, an Apple Health plan will most likely be free for you.

If you are employed and disabled in Washington State and in need of Medicaid, you may qualify for Healthcare for Workers with Disabilities (HWD). Or if you are employed in another state, you may qualify for that state’s Medicaid buy-in program.

I am already 26 or older or I am not able to be covered under my parent’s insurance and I am single. What are my choices regarding health insurance?

Apply for or continue to be covered under Medicaid
Purchase your own insurance

Apply for or continue to be covered under Medicaid

As a person with a disability, if you qualify for Supplemental Security Income (SSI), you also qualify for Medicaid. If you do not have a disability or SSI, you could still possibly qualify for Medicaid based on your income.

If you need in-home care, it is important to apply for and/or continue Medicaid to keep this in-home care. Without Medicaid, you may not have in-home care coverage. You can still qualify for in-home care, however, without Medicaid, you will be required to pay for it out-of-pocket

Some private insurances do cover in-home care but you are required to be homebound and cannot be an employee or student that leaves the house.

Medicaid is based on your income. As a single person, you may not need to pay a premium for your coverage; this is if you are disabled and make $783.00 per month. If you need in-home care, you can qualify for a Medicaid waiver and make up to $2,349.00 per month without losing your Medicaid benefits. However, whatever your income limit is, you have an asset limit of $2,000.00.

For more information go to Washington Medicaid Income and Asset Limits for In-home Long-term Care.

If you make over $2,349.00 per month, you may qualify for Healthcare for Workers with Disabilities (HWD). This means you will be required to pay a premium for your coverage but this allows you to work, save and keep your in-home care as well as other healthcare benefits.

For more information, check out the process.

Purchase your own insurance

Purchasing your own insurance can be through either a private provider or via the state. 

You are always welcome to purchase your own insurance. However, private insurance is typically more expensive than state insurance. If you are employed, your employer may offer benefits. Check into all of your options.   

State insurance is based on your income, and in Washington State, if you are an independent without an income, an Apple Health plan will most likely be free for you.

If you are employed in Washington State and in need of Medicaid, you may qualify for Healthcare for Workers with Disabilities (HWD). Or if you are employed in another state, you may qualify for that state’s Medicaid buy-in program.

If I am married, what are my choices regarding health insurance?

Be covered under your spouse’s insurance
Apply for or continue to be covered under Medicaid
Purchase your own insurance

Be covered under your spouse’s insurance

You can be covered under your spouse’s private insurance plan at an additional cost. Each private plan is different, so your spouse will need to contact their insurance company to determine if you can be added and what the additional cost will be.

You may want to compare the additional cost of you being added to your spouse’s insurance and what the private plan offers with that of the cost and coverage of state insurance to determine what plan is best for you. However, remember that income of both you and your spouse determines if you qualify for state insurance benefits.

Apply for or continue to be covered under Medicaid

This may be easier said than done.

In Washington State, Medicaid allows a married couple to earn $1,175.00 per month and have combined financial assets of $3,000.00 whether both spouses or just one spouse is applying. However, it is different for Medicaid waivers. If both spouses are applying for Medicaid, each can make up to $2,349.00 per month and have a combined asset limit of $3,000.00. If only one spouse is applying for Medicaid, the applicant can only make $2,349.00 per month and have an asset limit of $2,000 but the non-applicant spouse can have an asset limit of $128,640.00. 

For more information go to Washington Medicaid Income and Asset Limits for In-home Long-term Care or check out The Process.

Purchase your own insurance

This can either be through your own employer or the state. You will want to weigh your options with that of the price and coverage of your spouse’s insurance

Remember that state insurance is based on yours and your spouse’s income, even if your spouse will not be covered under this plan. In Washington State, if you and your spouse do not have children and neither of you needs in-home care, together you both can only have a combined income of up to $1,175.00 per month for you to qualify for state insurance. 

Assets are another thing of which to be aware. In Washington State, you and your spouse can have combined assets of up to $3,000 to qualify for state insurance. 

For more information, check out The Process.