Alyssa Lane
There are several options for insuring your children, including through your employer's plan, Medicaid, the Children's Health Insurance Program (CHIP), the Health Insurance Marketplace, or through a private insurer. Each state has different rules about who qualifies for CHIP, and the benefits differ in each state, but all states provide comprehensive coverage. Children's health insurance is essential to their health and wellbeing and can provide financial protection for when they get sick, injured, or need medical attention.
| Characteristics | Values |
|---|---|
| Insurance Type | Children's Health Insurance Program (CHIP), Medicaid, Private Insurance, Employer-Sponsored Insurance, Short-Term Insurance |
| Coverage | Preventative Care, Injuries, Illnesses, Pre-existing Conditions, Routine Check-ups, Immunizations, Dental, Vision, Counselling, Ambulance, Emergency Room Services, Prescription Drugs |
| Cost | Varies based on Plan Type, State, Child's Age, Income, and Coverage Needs |
| Enrollment | Any time of year, immediate coverage in some cases |
| Availability | Varies by State, dependent on eligibility criteria |
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What You'll Learn
Children's Health Insurance Program (CHIP)
The Children's Health Insurance Program (CHIP) provides free or low-cost health coverage for children and teens in families who earn too much to qualify for Medicaid but still need assistance in paying for health insurance. CHIP is available in all states, and each state has its own rules about who qualifies for coverage. Some states also cover pregnant women under CHIP.
CHIP provides comprehensive health coverage, including routine "well child" doctor and
You can apply for CHIP at any time of year by filling out an application through the Health Insurance Marketplace. If it appears that anyone in your household qualifies for Medicaid or CHIP, your information will be sent to your state agency, who will contact you about enrollment. If your children qualify for CHIP, you won't need to buy a separate insurance plan for them.
In some cases, parents may qualify for a health plan with financial assistance through programs like Covered California, while their children are eligible for CHIP. In such cases, parents cannot decline CHIP enrollment for their children and add them to their own plan.
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Medicaid
Children's Medicaid is a specific program within Medicaid that provides free or low-cost health coverage for children in low-income families. To be eligible for Children's Medicaid, a child must be 18 years old or younger, although in some cases, children with disabilities who are 19 or 20 years old can get Medicaid. Children's Medicaid covers medical and dental care, and if a child is enrolled in the program, they will not need to be covered by their parents' insurance plan.
CHIP is another health insurance program that covers children in families who earn too much money to qualify for Medicaid but cannot afford private health insurance. CHIP is managed by individual states according to federal requirements and is funded jointly by states and the federal government. CHIP qualifications are different in every state, but they generally depend on family income. CHIP provides comprehensive coverage, including routine "well child" doctor and dental visits, and may also cover other services depending on the state.
Both Medicaid and CHIP applications can be submitted online, by phone, by mail, or in person. To apply, individuals can use the HealthCare.gov online application or apply directly through their state's Medicaid or CHIP agency. To find out more about specific state programs and eligibility requirements, individuals can contact their state Medicaid agency or call the Insure Kids Now hotline at 1-877-543-7669.
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Private insurance
Alternatively, you can purchase private insurance directly from an insurance company or a health maintenance organization (HMO). These plans often offer a range of coverage options and can be tailored to meet the specific needs of your children. The costs and benefits of private insurance plans can vary, so it is important to carefully review the details of each plan before making a decision.
Another option for private insurance is to explore child-only coverage plans. Some health insurance carriers, such as the Preferred Provider Health Insurance Plan (PPO) Select Basic, offer affordable, age-banded rates specifically for child-only coverage. These plans are designed to provide coverage for children who may not be included in their parents' or guardians' insurance plans. The premiums for child-only coverage are typically based on the age of the child and are independent of other coverage purchases.
It is worth noting that private insurance costs can be reduced through various means. For example, if you have a Marketplace health plan, you may be eligible for a premium tax credit to lower your monthly premiums. Additionally, when applying for Medicaid or the Children's Health Insurance Program (CHIP), you may discover that you qualify for an individual insurance plan with savings based on your income. These programs often have no limited enrollment period, allowing you to enroll at any time of the year.
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Short-term insurance
Short-term health insurance is a good option for people who are generally healthy and do not require regular health services or prescription medications. It is also a good option for those who need immediate coverage or are in between coverage. Short-term insurance can be an affordable solution for those looking for limited health coverage during transitional periods in their lives. These plans are typically much more affordable than major medical plans, with monthly costs as low as $55 compared to at least $225 for major medical coverage. However, they do not offer the same benefits as ACA major medical plans, such as coverage for pre-existing conditions, mental health, substance abuse, maternity care, and more.
Short-term plans can be a good option for those who need coverage quickly or who need to bridge a gap in coverage due to unemployment or while waiting for an employer-sponsored plan. They are also suitable for those who are experiencing life changes, such as graduating from college. However, it is important to note that short-term plans may have waiting periods, and they do not guarantee the same essential health benefits and protections as Affordable Care Act plans.
Short-term health insurance applications typically involve answering health-related questions and specifying the duration and coverage options that suit your needs. After submitting the application, you will receive plan details, terms, and conditions from the insurance provider. It is important to carefully review all the information and compare different plans before making a decision.
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Employer-sponsored insurance
If your employer offers health insurance coverage for your family, they may fully cover the cost of your premium but not that of your dependents. In this case, you will have to pay the full cost of your children's premiums. However, there are other options to explore. Firstly, your children might qualify for premium subsidies in the exchange, under the "family glitch" fix by the IRS. Secondly, they may be eligible for Medicaid or CHIP, depending on your income and location. Each state offers CHIP coverage and works closely with its state Medicaid program. CHIP provides low-cost health coverage to children in families that earn too much to qualify for Medicaid.
If your employer has 20 or more employees, your children may be eligible to purchase temporary extended health coverage for up to 36 months under the Consolidated Omnibus Budget Reconciliation Act (COBRA). To do this, you must notify your employer in writing within 60 days of your child turning 26. If your employer has fewer than 20 employees, your state may have similar rights under its own laws.
The Affordable Care Act requires plans and issuers that offer dependent child coverage to make this available until a child turns 26. This applies to all employer plans and individual market plans. If your child is covered under your employer's plan and turns 26 during the taxable year, the value of the health care coverage for the rest of that year is excluded from your income for tax purposes. Once your child ages out of your coverage, they may have other options. If their employer offers a health plan, they may be eligible for coverage under that plan.
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Frequently asked questions
CHIP stands for the Children's Health Insurance Program. It provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid.
CHIP covers routine "well child" doctor and dental visits, emergency room services, treatments, surgeries, and other medical services.
Each state has its own rules about who qualifies for CHIP. You can apply through the Health Insurance Marketplace or call 1-800-318-2596 to find out if your child qualifies.
You may be able to get an insurance plan through the Marketplace or a private insurer with savings based on your income. You can also look into child-only health plans, which specifically cover children and may provide more affordable options.
Pre-existing conditions may not be an issue for some children's insurance plans, but it's important to carefully read all plan documentation to understand what is covered. Short-term health insurance may be useful in these cases, but it's important to consider the potential for substantial out-of-pocket expenses.
