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What are coverage options for young adults who have a mental illness?

QUESTION: We have a 25 year old son who is covered as a dependent under my husband's group plan. He has a complex mental illness diagnosis. What are his coverage options once he turns 26?

A: Under the Affordable Care Act, starting in January of next year, no insurer will be able to turn your son down for coverage because of his mental health condition. Depending on his income, he may qualify for subsidized coverage in the state-based health insurance exchanges, where coverage of mental health and substance abuse services will be required as an essential health benefit. Or he may qualify for Medicaid under the health law's provisions that expand coverage to adults with incomes up to 138 percent of the federal poverty level, or about $16,000 a year. States can decide whether to adopt the Medicaid expansion, but even if your state doesn't expand coverage, he may qualify for Medicaid under the current rules because he may be considered disabled if his illness is severe.


Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.