Child Only Health Insurance
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Child Only Health Insurance

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A Guide to Child Only Health Insurance

As soon as you had your children, you swore you’d protect them, no matter the cost. Health insurance for children is one of the best ways you can make good on your promise—and thankfully, the cost isn’t that high.

There are a few different ways to get health insurance for children, including getting child-only health insurance plans, including your child or children under your employer-provided health insurance, including your child on your private plan, and opting for ACA plans, short-term insurance, or CHIP (Children’s Health Insurance Plan)—an insurance plan for children provided by some states.

We’re going to share what you need to know about your options. So, if you’ve been wondering, “how do I get health insurance for my child”, ponder no further. We’re here to answer your questions and help you make the best decision for the health and happiness of your kid(s). 

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Why You Might Need Separate Child Only Health Insurance?

There are several reasons you may need separate, child only health insurance. Maybe your job’s health plan doesn’t cover dependents. Perhaps you aren’t covered at all, but your child has a condition that necessitates health insurance. 

Whatever the reason you are looking into children only health insurance, there is no shortage of options. 

What Are Your Options To Get Health Insurance for Children?

As we briefly mentioned, there are several ways to secure private health insurance for child only. We’re going to go into them in a little more detail here:

Your Employer’s Health Plan: This is how many children are insured: through their parent’s work-sponsored health insurance. However, some policies don’t extend to the dependents and may only cover the employee or just the employee and the spouse, leaving children without insurance.
Alternatively, even if the plan does extend to your children, including them could be prohibitively expensive, leaving you searching for other options. And there are other options!

ACA (Affordable Care Act): ACA plans allow people and families to obtain health insurance plans through federally regulated and subsidized health insurance marketplaces. You’re going to have to sign up during open enrollment in the fall or after an event that qualifies you for a special enrollment period, like a birth, marriage, adoption, or divorce.
While ACA plans are generally less expensive than private plans, they aren’t often as affordable as CHIP and Medicaid—even with subsidies. The good news is that, unlike private plans, ACA plans cannot deny coverage based on pre-existing conditions.

CHIP: CHIP is an ideal plan for people who don’t qualify for Medicaid (i.e. aren’t low income enough) and can’t afford private health insurance for child-only or ACA insurance. Well-child doctor and dental visits are completely free under CHIP and there is no enrollment period, so you can get this child-only health insurance anytime—though, in some states, the coverage can take 90 days to kick in after the application has been submitted.
To qualify, applicants must live in the state in which they apply, be 18 years of age or younger or be the primary caregiver with a child or children 18 years of age and younger as well as being a US citizen, or a non-citizen legally entered into the US, be uninsured and ineligible for Medicaid.

All or most of the following are typically included in CHIP programs:

Immunizations
Routine check-ups
Prescription drugs
Dental care
Vision and eye care
Maternity care
Mental health benefits
Up to 90 days hospitalization/year
Durable medical equipment
Substance abuse treatment
Partial hospitalization for mental health services
Rehabilitation therapies
Home health care
Hospice and palliative services
Medically necessary orthodontia
Autism spectrum disorder and related services

The major drawbacks of CHIP are that many children will still be denied coverage if their family’s income level is too high (the limits are higher than Medicaid, but still relatively low), and some states charge a deductible and/or copay. Some states also charge premiums and an annual enrollment fee.

This said for many CHIP plans are literal lifesavers. 

Private Health Insurance: Getting child health insurance through a private plan is one of the easiest and fastest ways to get coverage. There’s no enrollment period and these policies have incredibly comprehensive coverage. Private plans are also governed by the same protocols as ACA plans.
The main disadvantage of choosing private health insurance for child only as your child-only health insurance is that it is more expensive and there are no subsidies.

Medicaid: Medicaid is the government-run health insurance plan for low income individuals and families. This is by far the most affordable child health insurance you’ll find, but you may not qualify. In 2021, the income limit to qualify for Medicaid is around $1,073/month per individual and $1,452/month for a married couple. The exact amount will depend on your state.
Still, there are many benefits to Medicaid. There’s no enrollment period and only Vermont, Michigan, California, and Maryland charge premiums for children.
Just be aware that it can take up to 45 days for your application to be approved and some doctors may be reluctant to take Medicaid patients because of low reimbursement rates.

Short-Term Health Insurance: The final option for child health insurance is a short-term plan. Temporary health insurance allows you to get coverage for one to 12 months—though some providers will allow you to renew for up to three years.
This option for child-only health insurance is great for covering gaps between coverage or if you are between jobs and no longer have family coverage from your employer. It’s also very affordable, coming in at as little as $99/month.
The main drawback with the short term plan is these plans aren’t governed by the ACA, so providers can deny your child coverage based on pre-existing conditions. What’s more, the coverage isn’t that comprehensive. It will come in handy for a trip to the emergency room, but if your child regularly needs care or pharmaceuticals, there you will likely be paying entirely out-of-pocket.

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Which Child Only Health Insurance is Best?

That really depends on your income and your needs. Medicaid, followed by CHIP, ACA, and private insurance. Short term health insurance for child is inexpensive, but not comprehensive. Employer-sponsored health insurance rates could be lower than private insurance, but again, that depends on the kind of coverage your employer offers.

Consider what we have discussed here, and then get some quotes so you can see what you can expect to pay for various coverage options. 

We can help. Request fast and free health insurance quotes for child only. We’ve curated a list of top providers across all coverage options and will help you find the best and most affordable choice for you and your child. 

FAQs
Yes, if you are the legal custodian appointed by a court, you may apply for CHIP benefits. Affordable health insurance for child only is available to children not with their biological parent.
In some states and for some programs the cost is nothing, for others there may be a small annual fee or a copay for certain services. By federal regulation costs are limited to no more than 5% of income.
The two programs were designed to provide healthcare for children who were uninsured because they had no other options available or because they or their family could not afford coverage. The difference between the programs is a matter of the way the state chooses to fund the programs.
Eligibility for child only health insurance is based on the income of those with whom the children live. Persons may have a job and still qualify if they meet the income guidelines. Children are eligible up to their 19th birthday.