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Health Insurance for Kids – 3 Types of Child-Only Plans

Health Insurance for Kids – 3 Types of Child-Only Plans

Posted Jun 08, 2018 by Jenifer Dorsey

Can You Buy Child-Only Health Insurance? 

In short, yes! There are several affordable health insurance options for kids, including: 

  1. Short-term health insurance plans: affordable, temporary coverage
  2. Major medical plans: ACA-compliant coverage sold through government and private exchanges
  3. Children’s Health Insurance Program (CHIP): state-based program providing low-cost coverage 

 

We all want the best for our kids. It can probably be said that, as parents, most of us want them to enjoy a relatively worry-free existence. But when the family is uninsured, it can be tempting to take greater measures to keep everyone healthy and safe to avoid paying for unexpected medical care. Maybe this means trying to lessen the risk of injury by skipping the family ski weekend or not letting your child head off to summer camp with their best friend. 

Ideally, parents and children should have minimum essential coverage as required under the Affordable Care Act (ACA). We know, however, that sometimes circumstances require us to make tough choices. Maybe your entire family is uninsured but you want to make sure that at least your kids have coverage.

If you’re looking for an affordable health insurance plan for your child (an individual plan as opposed to one offered through an employer’s benefits program), then you do have a few choices. 

Learn what you need to know about 3 common child-only health insurance options.

1. Short-term health insurance for a child

Maybe you just need temporary benefits for a dependent until your employer’s plan kicks in, or maybe you’re looking for dependent-only coverage until the next Obamacare open enrollment period. 

Short-term health insurance provides benefits for 30 to 90 days, under current laws, and child-only policies are available for kids age 2 and older. A key advantage of temporary coverage for kids is cost – short-term premium rates usually cost less than unsubsidized Obamacare plan premiums. 

Ready to get right to a quote? Start here.

Short-Term vs Obamacare Child-Only Cost Comparison[1]

  Monthly Premium Annual Deductible

Secure STM[2] (lowest-cost option through Health eDeals)

$77.50

$5,000

Bronze Plan[3] (lowest-cost Obamacare Plan, unsubsidized)

$242.59         

$6,800

 

Keep in mind that short-term plan rates are lower because short-term plans offer coverage to help pay for unexpected and potentially high-cost illnesses and injuries

They are not considered minimum essential coverage that fulfills the ACA’s individual mandate, and they do not include comprehensive benefits, such as vaccinations, autism screening, behavioral assessment, developmental screening, hearing and vision screening or other preventive care for kids.[4]

A general rule of thumb: The more robust the short-term plan benefits, the higher the premium you are likely to pay.

Different temporary health plans offer different types of coverage; for example, Connect Plus (available through this website) provides limited benefits for certain pre-existing conditions while other plans do not include such benefits – a pre-existing condition is any medical condition that exists before you begin coverage through a new health insurance policy.[5]

There are also plans that may include a few basic preventive services or the option to add benefits for doctor’s office visits. 

A temporary plan could be the right option if your child:

●      Is 2 years old or older 

●      Will be temporarily uninsured (30 to 90 days)

●      Isn’t eligible for a special enrollment period outside of Obamacare open enrollment

●      Qualifies for an exemption  from the ACA’s individual mandate

●      Doesn’t qualify for an ACA subsidy and needs affordable health insurance

●      Needs coverage quickly (as soon as the next day)

●      Has a high likelihood of needing care outside a major medical plan network 

How much is child-only short-term health insurance? Find out now!

You may want to consider major medical if your child:

●      Is eligible for a special enrollment period outside of Obamacare open enrollment

●      Qualifies for an ACA subsidy (premium tax credit or cost-sharing reduction)

●      Needs long-term coverage

●      Requires ongoing care or prescription drug coverage for pre-existing conditions 

Explore major medical as an option.

2. Major medical health insurance for kids

When your child needs a long-term (i.e., beyond 90 days), ACA-compliant health insurance solution, then major medical insurance is often the clear winner. 

These plans may cost you more, but they qualify as minimum essential coverage, and they also include no-cost preventive care services and healthcare services in the 10 essential health benefits categories as outlined by the ACA (for example, Obamacare plans must include some pediatric oral and vision care at no additional cost). 

Additionally, major medical plans are guaranteed issue, which means your child will not be denied coverage based on health history and pre-existing conditions must be covered.

Learn more about short-term plans and how they differ from Obamacare.

Child-Only Short-Term + Obamacare Premium Comparison[6]

  Unsubsidized Premium Subsidized Premium

Secure STM[7] (lowest-cost option through Health eDeals)

$77.50

Not applicable

Bronze Plan[8] (lowest-cost Obamacare Plan, unsubsidized)

$242.59

$160.59[9]

 

Premium subsidies vary by household size and income. Estimate your subsidy with our Health Insurance Cost and Subsidy Calculator.

An Obamacare plan could be the right option if your child:

●      Qualifies for an ACA subsidy (premium tax credit or cost-sharing reduction)

●      Needs long-term coverage

●      Requires ongoing care or prescription drug coverage for pre-existing conditions 

●      Is eligible for a special enrollment period 

Did you know? Having a baby or adopting a child are qualifying events for a special enrollment period, but you only have 60 days from the time of the adoption or birth to obtain a health plan.  Learn more about special enrollment periods.

3. Children’s Health Insurance Program (CHIP)

The Children’s Health Insurance Program is available to kids in families who earn too much to qualify for Medicaid but not enough to buy an individual (or family) health insurance plan through HealthCare.gov, a state-based exchange or the private market.

Each state determines its own CHIP eligibility requirements, and the program name may also vary by state (select your state to find out what it’s called where you live). Learn more about CHIP and how to qualify here, or visit Medicaid.gov for your state’s CHIP profile.

You may want to look into the Children’s Health Insurance Program if your child: 

●      Needs a low-cost coverage option

●      Is eligible for CHIP based on your state’s program criteria

●      Requires coverage outside of an open or special enrollment period

What health insurance should you choose?

Above, we explained how different child-only health insurance plans apply to different circumstances. The table below offers a high-level comparison of the different coverage types. 

If you need help determining what type of child-only health insurance will be best (and most affordable) for you, use Agent Finder to search for a local producer (i.e., agent or broker) who can help.

Compare Child-Only Short-Term, Major Medical and CHIP

  Short-Term Major Medical CHIP

Next-Day Coverage Available

Typically

Provider Choice

*

Limited by network

Limited by network

Year-Round Enrollment

Benefits for Pre-Existing Conditions or Preventive Care

*

Get a Quote + Apply Now

Special/open enrollment only

Policies >90 days

Guaranteed Issue

Income-Based Rates Available

Minimum Essential Coverage

*Dependent upon plan selected. 

Is short-term health insurance right for your child? Read about the pros and cons.

Summary + Next Steps

There are 3 key options when it comes to child-only health insurance: short-term plans, major medical coverage, and CHIP. Which option is best for you largely depends on circumstances such as affordability, healthcare needs, and Obamacare exemption status.

Shop around, compare plans and get help with your decision!

Find out what temporary coverage costs.

Read up on major medical insurance under the ACA.

Contact us to request more information about child-only coverage, including short-term and major medical plans.

 

Originall posted July 7, 2016.


Legal Disclaimers

[1]Sample rates for 10-year-old living in Maricopa County, Arizona, 805002

[2]Quote obtained through HealtheDeals.com

[3]Quote obtained through INXSCloud

[4]Preventive care benefits for children . (2018). HealthCare.gov. Retrieved 8 June 2018, from https://www.healthcare.gov/preventive-care-children/

[5]HealthCare.gov. “Pre-Existing Condition.” https://www.healthcare.gov/glossary/pre-existing-condition/

[6]Sample rates for 10-year-old living in Maricopa County, Arizona, 805002

[7]Quote obtained through HealtheDeals.com

[8]Quote obtained through INXSCloud

[9]Sample rate for child-only coverage in a 3-person household with a household income of 203% of the federal poverty level ($41,560 per year)