Four ways to stay insured after college graduation

As college graduation arrives, many college seniors are busy planning their next moves – to a new home, a new job, perhaps a new city. And while those transitions all involve careful consideration, college graduation very often brings another critical transition: New health insurance coverage.

Since the passage of the Affordable Care Act (aka Obamacare), choosing new coverage – or holding on to existing coverage – has been much easier for college grads. Young adults are much more likely to be insured than they were before the ACA was enacted, and are the age group that has seen the largest reduction in uninsured rates.¹

But young adults are still known as the "young invincibles" – less concerned about catastrophic health costs and, as a result, not always convinced that purchasing health insurance is a good value.

Coverage for recent graduates? Priceless.

While young adults may consider health insurance premiums an unnecessary expense, many don't realize that "going bare" can be costly – no matter how healthy the person is. Since 2019, there hasn't been a tax penalty for going without health insurance, but even when the penalty was in place (from 2014 through 2018), it paled in comparison to the real penalty: Attempting to pay for a serious medical event without health coverage.

At Vox, health reporter Sarah Kliff spent well over a year collecting emergency room bills from across the country, and the reports are an eye-opening look at just how much it costs when people end up needing emergency treatment – which can happen to anyone, regardless of how healthy they are. A five- or six-figure medical bill would be crippling for most young people, especially on top of the student loan debt many graduates are struggling to pay off after college.

The good news for grads is that there are coverage options available. Here's a quick primer on the most logical and obvious coverage options that will help ensure recent graduates can avoid a coverage gap. (We're listing these numerically, and not "best to worst" or vice versa. It's up to each graduate to weigh factors that include employment, availability of a parent's plan, etc.)

1. Remain on your parent's insurance

Before the ACA was enacted, it was common for health insurance plans to drop dependents as soon as they graduated from college. But the ACA changed that, requiring almost all health plans (with the exception of retiree-only plans and plans that aren't regulated by the ACA, such as short-term health insurance) that offer dependent coverage to allow young adults to remain on a parent's plan until they turn 26. So for young adults with coverage under a parent's plan, graduating from college no longer requires a mad scramble to find new health insurance.

Under the ACA rules, there are no strings attached. The young adult doesn't have to be a student, doesn't have to be on the parent's tax return, and can even be married and living on the other side of the country – although in that situation, it might be wise for them to purchase their own health insurance, since the provider network of the parent's plan might not cover them if they live far away.

There are several points to consider before deciding whether remaining on a parent's plan is the best course of action, and we cover them in more detail here.

2. Buy an ACA-compliant individual plan

For new grads who want a plan that covers the essential health benefits and pre-existing conditions, a plan purchased through the health insurance Marketplace/exchange is likely to be an ideal solution.

ACA-compliant plans for individuals are available in every state, (some states run their own exchange, but the majority use HealthCare.gov). And premium subsidies and cost-sharing reductions are available through the exchange to make coverage and care more affordable.

(Caveats: People with income below the federal poverty level — FPL — generally aren't eligible for subsidies, which results in a coverage gap in the states that have refused to expand Medicaid. Nine states have a coverage gap as of 2025. And if a young adult is still claimed on a parent's tax return, the parent's income would also be taken into consideration for subsidy-eligibility determination.)

ACA-compliant plans (sold on or off-exchange) are only available during the annual open enrollment period (November 1 to January 15, in most states), and during special enrollment periods, most of which are triggered by specific qualifying events. Some examples of qualifying events include:

• A new grad who moves to a new area (assuming they were already insured before the move) would be eligible to purchase an ACA-compliant plan based on the move.
• A new grad who loses access to their coverage under the school's student health plan would be eligible to purchase an ACA-compliant plan based on the loss of coverage (assuming the student health plan provided minimum essential coverage, which most do).

Some special enrollment periods don't require a specific qualifying event, such as the year-round enrollment opportunity for American Indians and Alaska Natives, as well as the year-round enrollment opportunity (in most states) for subsidy-eligible applicants whose household income doesn't exceed 150% of FPL.

But ACA-compliant plans cannot be purchased outside of open enrollment if the applicant does not qualify for a special enrollment period.

3. Check Medicaid eligibility

In 40 states, Medicaid has been expanded to cover all adults with income up to 138% of FPL. In 2025, that's $21,597 for a single individual (the limit is higher in Alaska and Hawaii). In the District of Columbia, Medicaid is available to adults with household income up to 215% of FPL.²

Medicaid enrollment is available year-round, and Medicaid does cover pre-existing conditions. In most cases, there are no premiums. For a new grad living in a state where Medicaid has been expanded, this could be a perfect solution during the weeks or months that it might take to find a job after graduation.

In New York, Oregon, and Minnesota, there's also an option for very low-cost coverage for people who earn too much for Medicaid, but are still fairly low-income. Those three states have Basic Health Programs (BHPs), available to individuals earning up to 200% of the poverty level (250% in New York). In New York, the BHP is called The Essential Plan, in Oregon it's called Oregon Health Plan Bridge, and in Minnesota it's called MinnesotaCare.

4. Get coverage through a new employer

Getting health coverage through an employer is probably the path that most college grads envision, and it's an excellent option if it becomes available. Employer-sponsored health insurance generally offers substantial benefits, and employers typically pay a large portion of the premiums.³

Under the ACA, employers can require a waiting period of up to 90 days before a newly hired employee is eligible for health benefits (assuming the employer offers coverage and the employee will meet the eligibility requirements, such as working full-time).⁴

To bridge this gap, some people turn to short-term health insurance, which can be purchased anytime and can have a total duration of up to four months. But if the new grad has experienced a qualifying life event that triggers a special enrollment period, they can enroll in a Marketplace plan to bridge the gap, and cancel it when the new employer-sponsored health plan takes effect.

Thanks to the ACA, it's easier than ever for young adults to have health insurance coverage, even if the benefits they assumed they'd receive from employers take longer than expected to materialize.

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.