Abstract BACKGROUND AND AIMS In the United States, health insurance is a prerequisite for healthcare affordability. Adolescents and young adults with inflammatory bowel disease (AYA-IBD) often require costly therapies, and health insurance knowledge and health insurance self-efficacy are essential for a successful transition from pediatric to adult centered care. Nevertheless, little is known about AYA-IBD knowledge of and familiarity with health insurance. METHODS English-proficient AYA-IBD 15 years and older receiving care at an academic pediatric practice were invited to participate. Participants performed surveys on health insurance knowledge and health insurance self-efficacy. Descriptive statistics were performed to report survey results. Analyses of responses by demographic categories were performed using ANOVA analyses. RESULTS Fifty AYA-IBD completed the surveys. Thirty AYA-IBD were 15-17y and twenty were 18-22y. The majority of respondents were male (27), white (38), non-Hispanic (34), and had Crohn's disease (33). The median (interquartile range) disease duration was 33 (13, 61) months. Most had been on biologic or small molecule IBD therapy (46). All had health insurance: 32 had private insurance, 5 military insurance, and 13 government insurance. The majority (58%) of AYA-IBD answered less than half of the health insurance knowledge questions correctly (Table 1). Reported self-efficacy in choosing and using health insurance was slight to moderate (Table 2). Answers did not vary by demographic groupings. CONCLUSIONS AYA-IBD demonstrated suboptimal health insurance knowledge and slight to moderate health insurance self-efficacy. Our findings identify an important opportunity to provide much-needed health insurance education to help prepare AYA-IBD to manage the costs of medical care. Table 1 AYA-IBD Health Insurance Knowledge Survey Responses Table 2 Health Insurance Literacy Measure (Self-efficacy) Questions and Response Distributions