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24: Turning 26? Your Guide to Getting Health Coverage

July 11, 2019

In Point of Health episode 24, “Turning 26? Your Guide to Getting Health Coverage," Amy Schraufstetter, Licensed Benefit Consultant for BlueShield of Northeastern New York outlines how young adults can prepare for getting their own health insurance coverage.

Episode Highlights

What are some key definitions I need to know to understand health insurance? (2:05)

Premium: The amount a member will pay on a monthly basis to get coverage. 

Deductible: The amount a member is responsible to pay before the health plan assists with costs. 

Copay: A flat amount to be paid after your deductible is met. After you pay your copay, your health plan covers the rest of the cost. 

Out of pocket costs: Anything a member is paying that isn’t a premium towards healthcare. This includes the deductible, copays, and coinsurance. 

Coinsurance: A percentage a member must pay for remaining costs along with the healthcare provider. 

If I'm young and healthy, do I really need health insurance? (6:43)

Most health plans carry preventive care coverage to make sure that you stay healthy. Our plans cover annual wellness visits and mammograms with a $0 copay. It is also important to have health insurance in case you are injured in a car accident. Having insurance protects you from financial trouble if you need emergency medical care.  

When do I get off my parent's plan and what are my options? (8:23)

Most employer group coverage will last until the end of the month of your 26th birthday. For 60 days, you have a window to select a new plan. If you are employed by a company that offers health insurance, speak to your Human Resources department to find the best plan for you. If you are not employed by a company that offers health insurance, take your time to look over your options. You can receive health care coverage from your university, New York State, or off the exchange. Exchange coverage has different medal levels that reflect the costs covered by your premium. 

What is the most important thing to remember when choosing health insurance? (14:05)

When selecting a health plan, you need to consider your individual care needs. Look into your options and see if you qualify for federal assistance. Make a plan for your health insurance coverage before you turn 26 and pay premiums in a timely fashion. 

Wellness Resources


Did You Know?

Members who are eligible to receive a wellness debit card can use it toward wellness centers, therapy, spa services, and more. Learn where you can redeem your card today!