We the Patients

Nicole talks aging out of health insurance at age 26

When a patient ages off their parents’ plan, how do they get care?

The Affordable Care Act (ACA) fundamentally changed how health insurance worked and did so many things for patients, it’s hard to keep track! One of the ACA’s greatest achievements, though, was letting young adults continue on their parents’ health coverage until they were 26. Nicole knew this better than most. When she turned 26, she was in her final semester of nursing school. She had also been struggling against a debilitating autoimmune disease her whole life.

For Nicole, the transition off her parents’ plan wasn’t an academic matter, it was a big deal. Without coverage, there was no way to afford the treatment she needed. Simultaneously, getting coverage — even without her condition — could be a full-time job on its own. She needed help, so she turned to Community Service Society of New York to navigate the insurance marketplace.

Ultimately, she ended up switching plans FOUR times — from her parents’ plan, to Medicaid, to Medicare, and back to Medicaid again. Fortunately, she was able to get help from CSS’s navigator program. Because she worked multiple jobs over the years, she needed extra help submitting the right documentation for coverage. To her navigators at CSS, she said, “they [provided] me with the relief and confidence that I do not have to decipher the health care insurance world alone.”

Eventually, after getting the help she needed, Nicole celebrated her 26th birthday without losing access to her care. While she learned a lot from her courses, she learned even more firsthand. As Nicole said, “My greatest education in being a patient advocate [was] being a patient myself.”