As per the Affordable Care Act, health insurance providers are required to allow children under the age of 26 years to remain on their parent’s health insurance plan. Due to which very few insurers offer child-only plan options. Perhaps, people can find some other options to find health insurance for their children.
Some Other Health Insurance Options for Kids:
ACA-Compliant Private Family Health Plan
Individuals who don’t qualify for an employer-sponsored health plan, or who are self-employed can look for an individual and family health plan on the ACA marketplace. ACA-compliant family plans are cheap and affordable compared to buying an individual plan for every family member. ACA plans available on the marketplace are required to provide ten essential health benefits to provide coverage to individuals and their families. Covering essential health benefits like lab tests, vaccinations, and hospitalization, ACA-compliant health plans are the best option to have coverage for self as well as children. The ACA plans also cover dental and vision care for children under the age of 19 years.
Short Term Child-Only Insurance
If individuals are having a short gap in coverage, and are unable to buy a plan due to a cash shortage, then they can buy a short-term plan for their children. Among all the health plan options available, short-term plans are the most affordable, though these plans have limited benefits. The short-term plans do not need to provide the minimum essential benefits as per the ACA, and can even deny coverage for any pre-existing conditions. The short-term plan should only be considered by an individual if he/she is unable to include his/her child to a long-term ACA compliant health plan. Though, one should remember that short-term plans are not available in every state.
Children’s Health Insurance Program (CHIP)
It is a low-cost health insurance program designed for families who don’t qualify for Medicaid based on their income. Each state has set its standard for families to qualify for this low-cost health plan. This plan will be available to individuals depending upon the place they live, their income, and their family size. In some of the states, CHIP also covers pregnant women.
The process to Sign Up for Kids’ Health Insurance
Individuals should know about their options to obtain health insurance for their children. Before looking for private plan options, individuals should make sure they don’t qualify for CHIP because it is an extremely affordable option for obtaining health insurance for children. In many states, individuals might need not pay any amount to obtain this coverage for their children. Individuals can sign for this plan throughout the year, however, they need to qualify for this plan based on their state’s eligibility criteria. Every state has different eligibility standards and residents of that state are required to meet those requirements. Individuals can know if they qualify for CHIP or not by applying for a plan through the ACA marketplace, which will automatically direct them to enrollment information in their state if they qualify for CHIP based on their income.
Individuals who don’t qualify for CHIP but have other health insurance plans, then they can add their children to their plan. People can request their insurance carriers to include their children in their health plan, and they can direct people some instructions to ensure that their children are covered. However, on switching from an individual to a family plan, people’s monthly premium will increase.
On having a baby, a person qualifies for a special enrollment period through the ACA marketplace. A person can either buy their first health insurance plan or can switch their plan by creating an account on Healthcare.gov. Here a few simple questions will be asked about the family and income, and then the person will be directed to the marketplace. The marketplace will show all the plans currently available in the state, and will also show if the person qualifies for any subsidy. Through the marketplace, individuals can sign up for their coverage as well as for their children’s coverage.
Individuals who do not qualify for a special enrollment period may buy a short-term plan until the open enrollment starts. Short-term plans are limited insurance options that help people pay for only major medical expenses. However, people should compare the plans, and carefully read through the plan’s terms and conditions before enrolling in a short-term plan.
Requirements for Insuring Kids
Children should meet the following requirements to qualify as a dependent on their parent’s health insurance plan.
Relationship – Child needs to qualify as a dependent on their parent’s plan. The child must be biologically related to his/her parent, officially adopted foster child, or a stepchild to qualify as a dependent.
Residency – The child should have lived with the parent for at least 6 months to qualify as a dependent.
Age – Children should be under the age of 26 years to remain on their parent’s ACA-compliant private insurance plan or their parent’s employer-sponsored health care plan.
Tax filing – Children who filed a joint tax return with their parent last year cannot remain dependent on their parent’s plan.
Income contributions – While remaining dependent on their parent’s plan children may work and pay for their expenses. However, children cannot financially support themselves while remaining on their parent’s plans. This means that children’s total income should be less than 50% of their care expenses.
Single claim – A child can be claimed as a dependent by a single household only and if someone else has claimed a child as a dependent, then that child cannot be added to other household health plan as a dependent. This is irrespective of the child’s biological relationship.
To qualify for CHIP, children should meet all the above-mentioned criteria and their household must also meet the income criteria. Every state has different eligibility criteria and people can know about their state’s essential qualification by creating a profile at Healthcare.gov.