Insurance

During early adolescence, teens should begin learning the basics about healthcare insurance, costs, and coverage. As developmentally appropriate, parents should include them in conversations about insurance and involve them in some decision-making as they take on more responsibility for their care. This starts with an awareness of the financial implications of having insurance to a more in-depth understanding of costs that would affect the young adult’s or family’s budget. Depending on their age, type of insurance, and coverage limitations, they may be responsible for monthly premiums, meeting an annual deductible amount, and co-pays for medications, office visits, and other services.

The YA should have a general understanding about the types of insurance that are available.

Private insurance: They may have private insurance through their parent’s employer, but only up to age 26 unless they have a verified disability.
Medicaid: This is a type of government-funded health insurance, often called Medical Assistance, that provides health care coverage for low-income adults and people with disabilities. The Social Worker can check with the AYA’s local Department of Health and Human Development (HHD) program to confirm their eligibility for Medicaid.
Employee Benefits: If the young adult is employed, insurance may be available through their employer. Some employers offer several plans, but the premiums, deductibles, and copays will vary.
The Marketplace: The Health Insurance Marketplace (www.healthcare.gov) is a health insurance plan that is used by individuals who do not have health insurance through employment, Medicare, Medicaid, or another source. The Marketplace plans covers ten essential health benefits, free preventative health services in-network, and coverage for pre-existing conditions.

Social Security

Most people think that Social Security is income for people who have retired, but benefits extend to other population groups. The social worker will work with the AYA and family to see if they qualify for SSI benefits based on disability. Fact Sheet: Social Security Is Important to Young People

If the AYA receives SSI benefits, they must be aware of changes that will occur when they reach 18 years of age: What You Need To Know About Your Supplemental Security Income (SSI) When You Turn 18 New decisions are made about your disability at 18 that may affect benefits. This process is called age-18 redetermination.
SSI website for youth: Youth | SSA

Additional resources:

Insurance

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