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Parents’ Guide to Health Insurance for Children

For those looking for affordable insurance for you children, you have several possibilities. The insurance you end up selecting will depend on your financial situation, and the state you live in.

Options for Insuring Your Children for Health Care

Health coverage for kids can be found on both private and public health insurance exchanges, including policies that don’t contain adults. Here are some options you might want to consider:

Get Coverage for Your Kids on Your Plan
If you are covered by a health insurance plan through your employer, check with your plan or the person in charge of benefits at the company. You can also include them on your application for a new plan in the health care Marketplace. Your children can stay on your plan until they turn 26, unless your state’s rules differ.

Purchase Through the Affordable Care Act (ACA)
Child-only plans are available. You can only enroll for a health plan during the enrollment period. States can vary, but generally the enrollment period begins mid-November and ends by February. Check on the federal government site, www.healthcare.gov or your state’s Marketplace site.

Policies must also include essential services, including:
• Pediatric services (including dental and vision)
• Preventive and wellness services
• Management of chronic diseases
• Emergency services
• Hospitalization
• Outpatient services
• Prescription medications
• Mental health and addiction services
• Rehabilitative and habilitative services

Health insurance in the Marketplace, even for children-only policies, must include preventive care:
• Risk assessment for alcohol and drug use and behavioral issues
• Specified medications
• Immunizations
• Tuberculin and STI testing
• Health screenings for a variety of issues

Apply for ACA Subsidies

If you find that none of the health insurance plans available to your child are affordable, you can apply for subsidies to help with payments as long as:
• You meet financial eligibility requirements
• You are the parent or legal guardian
• You are within 100 percent and 250 percent of the federal poverty line
• You don’t have access to employer-provided insurance
• You have access to employer-provided insurance, but it doesn’t provide your needed minimum value (what is covered) or is not affordable

Apply for Children’s Health Insurance Program (CHIP)
You can apply for CHIP anytime of the year to see if you qualify. Each state has its own requirements for enrollment. If you apply for Medicaid through your state, also possible anytime of the year, you will be told whether or not your children qualify for CHIP.
Each state determines what benefits are offered by CHIP. However, every state must include comprehensive health insurance coverage, which features benefits for:
• Routine check-ups
• Doctor office visits
• Immunizations
• Dental and vision care
• Prescriptions
• Inpatient and outpatient hospital care
• Emergency services
• Lab and x-ray services

According to heathcare.gov, routine doctor’s office and dental care visits are free. Depending on your state, you might have to pay copayments and/or a monthly premium. You can expect to pay no more than 5 percent of your family income.

Have Questions?
If you want to find out more about health insurance for children, give us a call at (855) 899-4814. Or start here and get insurance quotes to compare.

Insurance Reference Guides

Where you live may affect your coverage options. Our reference guide will assist you in findoing plans available in your state.

Insurance Terms Glossary

From "absolute liability" to "written premiums," we've done the work for you to define commonly used insurance terms.

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