Health insurance policies that cover only children are called “child-only policies.” Most policies that only cover children are part of larger health systems or plans in both the public and private sectors. This gives parents looking for child-only policies a lot of options.
Most adults and children in the United States get health insurance through their jobs. But many children, which in this case means anyone under 19 years old, don’t have any kind of health insurance. (The federal government usually says that a child is between 0 and 17 years old, but most state-run programs say that a child is between 0 and 19 years old.)
Children may live in a home where no one is covered or their parents or guardians can’t afford policies that cover them. In other situations, an employee health plan might only cover the employee or the employee and his or her spouse, but not the children.
Because of this, parents have to look for policies that only cover children. Even though there are many private and public options for insurance that only cover children, these options often depend on how much money the parents have. These are some of the choices:
Types of insurance for children only
When looking for health insurance for children only, there are many different plans to choose from. All of these will depend on what you need and how much money you have. Below we have outlined the specific differences based on cost, eligibility, coverage, and enrollment:
Medicaid
Medicaid covers low-income and indigent populations, providing comprehensive care to poor adults and children. Beneficiaries have to meet certain income and eligibility requirements, which vary from state to state.
Pros: Medicaid is a very good way to get insurance for children because it is all-inclusive and usually doesn’t charge copayments or deductibles. Unlike with ACA plans, eligible people can sign up for the program at any time of the year, not just during open enrollment. Only California, Maryland, Michigan, and Vermont charge premiums or enrollment fees for children in their Medicaid programs.
Cons: Medicaid is an insurance program for very low-income and indigent populations, and not everyone qualifies for the program. Some doctors might not want to see Medicaid patients because they don’t get paid much. In some states, it can take up to 45 days for Medicaid coverage to start after an application has been approved.
Children’s Health Insurance Program (CHIP)
CHIP is a program that covers all of a child’s healthcare needs. It is only for kids under 19 in most states. People who get CHIP aren’t poor enough to qualify for Medicaid, but they can’t afford private insurance either. As with Medicaid, different states have different rules about who can get Medicare. In some states, like Massachusetts, CHIP is part of the state Medicaid program. The Medicaid program handles the benefits of CHIP, which makes it work like a Medicaid program for children.
Pros: CHIP offers full coverage at a higher cost than Medicaid, but CHIP costs are still low, so coverage is still affordable. Like Medicaid, people who are eligible for CHIP can sign up at any time of the year, not just during an open enrollment period. In addition, routine well-child doctor and dental visits are free under CHIP.
Cons: The income limits for CHIP are higher than those for Medicaid, but they are still low. This means that many children are not eligible because their families make too much money. Also, coverage isn’t as good as with Medicaid, and in some states, it can take up to 90 days for coverage to start after an application has been approved. Twenty-one state programs have a deductible, copay, or both. More than half of the programs, or 26 of them, charge a premium or an annual fee to join.
Please note that some states, such as Massachusetts and California, have different names for CHIP and Medicaid, while others, such as Texas and Delaware, do not.
The Act on Affordable Care (ACA)
The ACA makes it possible for people and families to get health insurance through federally regulated and subsidized health insurance marketplaces. People must sign up for a plan during an open enrollment period or a special enrollment period to be eligible. The open enrollment period is usually in the fall. Beneficiaries can also qualify for a plan if they have a “qualifying life event,” such as having a child or adopting one, getting married or divorcing, losing coverage through their employer, or moving to a new coverage area.
Many people who want to sign up for ACA plans are eligible for subsidies to help pay for premiums, deductibles, and copays. People with pre-existing conditions can’t be turned down by ACA plans, and all projects have to cover the 10 essential health benefits.
Cons: To be eligible, beneficiaries must sign up for the plans during an open enrollment period, which usually starts in the fall. Exemptions are made for people with qualifying life events. Even with subsidies, the costs of ACA plans are higher than those of CHIP and Medicaid plans.
Private plans
Private plans are full-coverage health insurance policies that can be bought outside of the marketplaces set up by the Affordable Care Act.
Pros: Private plans can be bought right away from an insurance company without going through the marketplace set up by the Affordable Care Act. Beneficiaries don’t have to wait for open enrollment periods like they do with ACA plans. The same safety rules that apply to ACA plans also apply to private plans. Coverage can begin right away.
Private plans cost more than CHIP, Medicaid, and ACA marketplace plans. With an ACA plan, a parent can get help paying for coverage through subsidies. But with a private plan, they can’t.
Plans for the near future
Short-term health insurance is usually bought directly from an insurance company. It covers you for a year or less and fills in coverage gaps.
Pros: Short-term plans are a good way to fill in coverage gaps and protect against catastrophic events like a broken leg that could cost a lot. The premiums for these plans tend to be less than those for others because they only cover you for a short time, usually between three months and a year. Coverage can begin right away.
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