Health
Health Insurance for Child Only: Medical Insurance for Kids
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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.
Key Takeaways
There are different ways to get health insurance for kids only. Parents can find a plan through the marketplace, private insurance or government-funded programs that can accommodate low incomes.
The cost of health insurance for kids may vary depending on the type of plan and coverage. On average, the monthly cost of health insurance is $311 for a silver plan.
Medicaid and CHIP offer the most affordable health insurance for kids.
Table of Contents
How to Get Health Insurance for Children Only
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.
Common Health Insurance Options for Kids
Health Exchange (Marketplace)
Health insurance for kids is available through the Health Insurance Marketplace. A plan from the marketplace covers the following 10 essential benefits:
- 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
Health Exchange insurance offers choices between programs. However, your family must meet the eligibility requirements. You can only get insurance from the marketplace during certain enrollment periods.
Private Health Insurance for Child Only
It’s also possible to get a health insurance plan for kids through an insurance company. You can check insurance providers’ websites or contact an agent to learn more about their options.
Another option is to search through private companies. For instance, BlueCross BlueShield allows individuals and families to shop for insurance based on the state or zip code.
Private health insurance is available at any time, but these plans tend to be more expensive than other options. The more affordable option may be to purchase a short-term plan. However, a short-term plan may not cover pre-existing conditions or offer other essential health benefits.
Medicaid
For low-income families, Medicaid is a great option to get the necessary health coverage. This program follows federal requirements but states administer the plans. That means that aside from mandatory benefits, states may include optional benefits.
Not all individuals or families qualify for Medicaid. Generally, low-income families, individuals receiving Supplemental Security Income (SSI), qualified women and eligible children can get Medicaid benefits. States may choose to cover other groups.
Child Health Insurance Program (CHIP)
Families looking for affordable health insurance for kids who don’t meet the Medicaid income requirements may consider applying for CHIP. This program caters to families who earn above the Medicaid income threshold.
States have different rules for CHIP, so you may need to meet other eligibility requirements to qualify. All states offer comprehensive coverage, but some may offer additional services and benefits.
How Much Does Child-Only Health Insurance Cost?
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.
Average Kids’ Health Insurance Costs at Different Tiers
Metal Tier | Average Monthly Premium | Average Deductible | Average MOOP |
|---|---|---|---|
Catastrophic | $177 | $8,550 | $8,550 |
Bronze | $226 | $7,682 | $8,296 |
Expanded Bronze | $242 | $6,959 | $8,303 |
Silver | $311 | $4,553 | $7,805 |
Gold | $344 | $1,663 | $6,930 |
Platinum | $381 | $319 | $3,550 |
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.
States With the Cheapest Health Insurance
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.
States With the Lowest Kids’ Health Insurance Premiums (Silver HMO Plan)
What Does Medical Insurance for Kids Cover?
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.
Health Insurance for Children FAQs
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.
Read More About Health Insurance
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About Brenna Kelly, Licensed Health Insurance Agent
sources
- BlueCross BlueShield. "Individuals & Families." Accessed July 28, 2022.
- HealthCare.gov. "The Children’s Health Insurance Program (CHIP)." Accessed July 28, 2022.
- Kaiser Family Foundation. "How Could the Build Back Better Act Affect Uninsured Children?." Accessed July 28, 2022.
- Medicaid.gov. "Medicaid." Accessed July 28, 2022.