One of the first articles of the Affordable Care Act in 2010 was allowing young adults to stay on their parents plan until age 26.
As a parent, are you explaining the benefits to your adult children? Whether they are leaving for college for the first time, graduating to go out on their own or living elsewhere and working, young adults need to understand their health, dental and vision benefits that YOUR employer or the individual coverage you are enrolled in. What should they know?
Find your Benefit Summary, previous year’s election review booklet or contact your Human Resources department and request a Summary of Benefit and Coverage (SBC) for each benefit the young person is covered by. Then…. Talk to them and review it.
Here are some important topics to discuss:
- NETWORKS –How to find doctors and dentists in their area. If you have an HMO network a ‘guest membership’ may be necessary for ‘routine’ services in their area.
- COPAYMENTS – What are they for Primary Care, Specialist and ER visit costs they can expect.
- Rx – Copays or other costs for different cost tiers of prescriptions. Also, are there preferred pharmacies? Where are the closest pharmacies to the college or where the young person is living?
- Do they need to establish a primary care provider in their area?
- For college students, explain using the Health Center on Campus first. You ARE paying for it within tuition so make sure they know where it is and operating hours. If more care is needed where they should go. Are they required to use a particular medical system? For example, that may mean Mercy or UnityPoint specifically.
- Are you going to have them pay the copay or bill? If so, they need to provide their local home address. If you, the parent will be taking care of costs, then explain a mailing address and how they would tell the provider’s office. Rx is always paid at the counter, so they must be prepared to pay the copay at time of purchase.
- Does your plan require them to obtain preventive care (well woman visit, annual physical, routine dental exams) in their ‘home’ area if they are college students?
Young adults or those over age 19 can stay on their parents’ coverage without the restriction of higher education and to age 26. Make sure you take the time to review so YOUR young person understands the benefits they have access to.
A little more about us:
The Business Warrior group has some of the industry’s top experts in all the areas your business needs to be successful. Amongst the contributors is Janis VanAhn, owner of Health Insurance Advisor, LLC. For 19 years Janis has worked in and around the health insurance industry initially providing service to agents and employers related to employee benefits, individual healthcare and Medicare, while more recently becoming appointed as an individual agent with various quality carriers to provide this service to individuals through her own business.
Four years ago Janis was ‘blessed’ with being let go from her job at an insurance ageny. Staying within insurance was her path…but in what capacity. 2010 was the year Janis began her career as an independent insurance agent specializing in health insurance. Finding quality, cost-effective healthcare for individuals and families under age 65 as well as working with those who are Medicare eligible truly was her passion. She has made this a true specialty and positioned herself as someone to work with whether it is a financial professional or property & casualty agent with a client that needs assistance, to a group of seniors turning 65 and they keep receiving Medicare information and are confused about what to do.
Janis enjoys the one on one contact with clients as well as looking forward to speaking to groups about healthcare. Her excitement for this industry is what drives her to stay in tune with Healthcare Reform and what is currently happening and what will happen with coverage from now to past 2014.
‘Educating individual and Medicare consumers to make informed choices’ is her mission because if people are educated and understand, they will make informed choices that they are comfortable with.