How Medicaid Works for Young Adults Turning 26

What changes when you turn 26

When you turn 26, you age off your parent's health insurance plan. If you were on Medicaid through a parent's household, you lose that coverage on your 26th birthday — not at the end of the month or at the end of the year, but that specific day. You will need your own Medicaid coverage or another form of insurance to stay covered.

Whether you can get Medicaid at 26 depends on your income, your state, and whether you live alone or with family. Some young adults stay on Medicaid because their own income is low enough. Others lose it and have to find coverage through an employer, the marketplace, or a parent's plan if they are still a dependent. A few states have programs that bridge the gap between aging off a parent's plan and turning 26.

The process starts before your birthday. You do not automatically transfer to your own Medicaid case — you have to report your change in circumstances to your state's Medicaid office, usually through the same portal where your parent applied. Waiting until after your birthday to do this creates a gap in coverage.

Key Takeaways

• You must report your 26th birthday to your state Medicaid office before that date arrives, not after, or you will have a gap in coverage.
• Your income as an individual (not your parent's) determines whether you stay on Medicaid, and the income limit varies by state.
• If you live with your parent and they claim you as a dependent on taxes, your parent's income may still count toward your Medicaid may be able to access.
• Some states let young adults stay on Medicaid until 26 even if their income is slightly higher than the regular limit.
• If you lose Medicaid at 26, you may be able to buy coverage through the health insurance marketplace or through an employer.

Income limits for young adults on Medicaid

Your income as a single person determines whether you meet the income limit for Medicaid. The limit varies by state — some states use 100% of the federal poverty line, others use 138%, and a few use different percentages. For 2024, 100% of the federal poverty line for a single adult is about $15,000 per year. If your state uses 138%, the limit is roughly $20,700. You can find your state's exact limit by searching "[your state] Medicaid income limits" or by calling your state Medicaid office.

Income includes wages from a job, self-employment income, unemployment benefits, and some types of assistance. It does not include financial aid for school, food stamps, or housing assistance. If you receive child support or alimony, that counts as income. If your parent gives you money as a gift, it does not count.

If you live with your parent and your parent claims you as a dependent on their tax return, your state may count your parent's income toward your Medicaid may be able to access instead of just your own. This rule varies by state. Some states stop counting a parent's income once you turn 19; others count it until you turn 21 or 26. Call your state Medicaid office to find out the rule where you live.

How to report your birthday before it happens

Contact your state Medicaid office at least one month before your 26th birthday. You can do this through your state's online portal (usually the same place your parent applied), by phone, by mail, or in person at a local office. Have your Social Security number, date of birth, and current address ready.

Tell them you are turning 26 and ask whether you will stay on Medicaid based on your own income. They will ask about your current job, your monthly or yearly income, and whether anyone else lives in your household. If you are a student, tell them — some states have different rules for students. If you receive any benefits (unemployment, food stamps, housing help), mention those too.

The Medicaid office will tell you one of three things: you stay on Medicaid under your own case, you lose Medicaid and need other coverage, or you are in a gap period where you may be covered a few months longer. Ask them to put the answer in writing, and ask what date your coverage changes. Write that date on your calendar.

What happens if you lose Medicaid at 26

If your income is too high for Medicaid or your state does not cover young adults at your income level, you will lose coverage when you turn 26. You then have 60 days to find other coverage without a penalty. During those 60 days, you can buy a plan through the health insurance marketplace (healthcare.gov or your state's marketplace) or through an employer without waiting for open enrollment.

If you have a job that offers health insurance, you can enroll in that plan during this 60-day window. If you do not have employer coverage, you can buy a marketplace plan. The cost depends on your income — if your income is low enough, you may get a tax credit that reduces your monthly premium. You can also stay on a parent's plan if you are under 26, which some young adults do even after losing Medicaid.

If you do not get coverage within 60 days, you will owe a penalty when you file taxes the following year (though the penalty is small). More importantly, any medical bills you get during the gap are your responsibility.

Special situations: Students and dependents

If you are a full-time student, some states let you stay on Medicaid past 26 or have a higher income limit. A few states also have programs for young adults aging out of foster care that extend coverage to 26 or older. Ask your state Medicaid office whether you fall into either category.

If you are claimed as a dependent on your parent's tax return but live on your own, your state may still count your parent's income. This can work in your favor (if your parent's income is low) or against you (if it is high). If you are no longer a dependent — meaning your parent does not claim you on taxes — only your income counts. If you are unsure whether your parent claims you, ask them directly or check a copy of their tax return.

If you are pregnant or have a disability, some states have Medicaid programs with higher income limits or different rules. Call your state Medicaid office and mention your situation. They can tell you whether you may have access to for a different program.

Keeping your coverage after 26

Once you are on your own Medicaid case, you stay covered as long as your income stays below the limit and you report any changes. If your income goes up (you get a raise, a second job, or a bonus), report it to Medicaid. If it goes down (you lose a job or cut your hours), report that too. Most states let you report changes online or by phone.

You will also need to renew your Medicaid coverage once a year. Your state will send you a notice telling you when to renew — usually by mail or email. You renew by filling out a form with your current income and household information. If you do not renew by the deadline, your coverage stops.

If your income rises above the limit, you lose Medicaid. At that point, you have 60 days to find other coverage. If you expect your income to go up soon (a promotion, a new job, graduation), think ahead about what coverage you will use after Medicaid ends.

How to find your state Medicaid office

Search "[your state] Medicaid" or go to medicaid.gov and select your state. You will find a phone number, a website, and the address of local offices. You can also call 211 (dial 2-1-1 from any phone) and ask for your state Medicaid office. Have your state name and county ready.

When you call, tell them you are turning 26 and need to know whether you stay on Medicaid. They will ask about your income and household. If the line is busy, call back or use the online portal — most states let you check your case status and report changes online without waiting on hold.

Frequently Asked Questions

Do I lose Medicaid the day I turn 26 or at the end of the month?

You lose it on your 26th birthday itself, not at the end of the month. If you were born on March 15, your coverage ends March 15. This is why you need to report your birthday before it happens — so you know what coverage you will have starting that day.

What if I am still a student when I turn 26?

Some states have special rules for students. A few let students stay on Medicaid past 26 or have a higher income limit while enrolled full-time. Call your state Medicaid office and tell them you are a student. They will tell you whether a different rule applies to you.

Can I stay on my parent's Medicaid if I move out?

No. Once you turn 26, you cannot stay on your parent's case no matter where you live. You need your own Medicaid case based on your own income, or you need different coverage.

What if my income changes between now and when I turn 26?

Report the change to your state Medicaid office. If your income goes down, it might help you stay on Medicaid. If it goes up, it might disqualify you. Either way, Medicaid needs to know so they can tell you what to expect on your birthday.

If I lose Medicaid, can I get it back later?

Yes, if your income drops back below the limit. You can reapply to Medicaid at any time. There is no waiting period or penalty for losing coverage and coming back.