Health Insurance for a Child Only: Finding Medical Insurance for Kids

Health insurance helps you cover medical expenses and avoid possible financial hardship due to high costs. The best plan for your family depends on your needs and circumstances.

There are various ways to get insurance for children. Plans can be available through a parent’s workplace, by adding the child to a parent’s individual or family plan or by finding health insurance for children only. There are also government-sponsored programs and marketplace tax credits to help those concerned about affordability.

Health plans for children cover those ages 0­–18 or 19. However, data used in this guide references children aged 0­–14.

• How to Get Health Insurance for Children Only
• How Much Does Child-Only Health Insurance Cost?
• What Does Medical Insurance for Kids Cover?
• Health Insurance for Children FAQs

Generally, there are four ways to get medical insurance for kids only. Depending on your circumstances and eligibility, you may have insurance for a child through the marketplace, a private health insurance provider, Medicaid or CHIP.

When choosing a plan, it’s best to shop around and compare the pros and cons of each option. In doing so, you make sure you’re getting the right coverage at a fair price.

Various factors affect the cost of medical insurance for kids. The family’s income and insurance plan provider can affect premium prices.

Getting health insurance for kids can help protect your family from huge health-related expenses. However, many children remain uninsured. Cost may be among the major reasons for this. According to the Kaiser Family Foundation, children who live below 100% of the federal poverty level comprise over 25% of uninsured kids.

Medicaid, subsidized marketplace coverage and CHIP make cheap health insurance for kids more accessible to families in need.

The table below shows the average insurance costs including the monthly average premium, yearly deductible, and maximum-out-of-pocket (MOOP) from the Health Insurance Marketplace for different market tiers.

These costs are averages. The lower deductible for a platinum plan is because some plans have a $0 deductible. Actual costs of premiums may vary depending on various individual factors.

The cost of health insurance for children-only plans can be cheaper than the cost of adding a child to a parent’s plan. However, higher metal tier plans tend to be more expensive.

On average, adding a child to a parent’s plan costs $276 per month per child. That’s more expensive than the average costs for catastrophic, bronze and expanded bronze plans but cheaper than silver, gold and platinum plans.

The location also affects health insurance prices. Options and costs may vary by state.

The table below shows the states with the lowest monthly insurance premiums for silver health plans for children. Note that this is just a snapshot of the marketplace coverage. These plans may be subsidized or replaced by government programs.

The medical services covered by health insurance depend on where you get the plan. For instance, health insurance plans under the Affordable Care Act (ACA) cover the 10 essential benefits. These are:

• Outpatient care
• Emergency room trips
• Hospital treatment for inpatient care
• Care before and after a baby is born
• Treatment, counseling and other services for mental health and substance use disorders
• Prescription drugs
• Services and devices for injury recovery, disability or chronic conditions
• Laboratory tests
• Preventive services for managing chronic illnesses
• Pediatric services, including vision and dental care for kids

While states may have different covered services under CHIP, all states should offer comprehensive coverage that includes:

• Routine checkups
• Immunizations
• Doctor visits
• Prescriptions
• Dental and vision care
• Inpatient and outpatient hospital care
• Laboratory and X-ray services
• Emergency services

States may also offer optional Medicaid benefits, but they should cover the following mandatory benefits:

• Inpatient and outpatient hospital services
• Early and periodic screening, diagnostic and treatment services
• Nursing facility services
• Home health services
• Certified pediatric, physician and family nurse practitioner services
• Rural health clinics and federally qualified health center services
• Laboratory and X-ray services
• Freestanding birth center services
• Transportation to get medical care

Short-term plans don’t offer comprehensive coverage. While emergency room visits and certain prescription drugs may be covered, pre-existing conditions may not be included.

Generally, the best health insurance for kids depends on family needs. But there’s cheap health insurance for kids available for low-income families. You may also find affordable policies in the marketplace based on your budget.

Looking for the best health insurance for a child can be challenging. Aside from the cost, there are various factors to consider. MoneyGeek answers some frequently asked questions to help you find the right plan for your child.