How to get your child health, vision and dental coverage. Here’s what to know.

1. Can I put my child on my employer’s health insurance?
2. When should I consider buying my children’s health insurance?
3. What are my options when it comes to ACA health insurance plans?
4. What should I do if I can’t afford to pay for health insurance?
5. What can I do if I don’t qualify for Medicaid but can’t afford health insurance for my child?
6. Can I put my kids on my short-term health insurance plan?

You may be wondering: How do I get health insurance for my child? Sometimes, finding health insurance for children can be relatively easy. Oftentimes, if you get health insurance through your employer, you can enroll your child in your company’s health insurance.

Other times, it’s more complicated. Maybe you don’t think you have it in your budget to afford adequate coverage for them. Or the plan your company offers doesn’t provide all the health services your child needs. That’s one of the reasons why almost 5% of all kids don’t have health insurance.

The good news is that there are affordable options available. Here’s a guide that’ll answer your most pressing questions. This includes the big one: how to get health insurance for your child.

Looking for the family or individual health plan that’s right for you? Learn more now, or call a licensed insurance agent at 1-844-211-7730 to discuss your health insurance options. 

Can I put my child on my employer’s health insurance?

Yes. If your employer has at least 50 full-time employees, the Affordable Care Act (ACA) mandates that they offer health insurance for employees. They have to offer health insurance for their children too.

This is often the best option, says Todd Ackerman. He’s president of World Insurance Iowa Unit in Burlington, Iowa. “Many employer plans tend to be generous when it comes to covering the cost of premiums,” he explains. But expect to pay something out of pocket.

You’ll want to research the plan carefully, adds Ackerman. Here’s what he recommends you keep in mind:

• Are all your child’s doctors in the network? If they aren’t in the network of providers who work with your insurance, you’ll need to switch doctors. Or, if they’re not and you keep them, you’ll likely have to pay out-of-pocket costs. You can check the plan’s online directory. Or you may want to call the plan’s customer service number to ask. (You can also call a licensed insurance agent at 1-844-211-7730 to discuss your health insurance options.)
• Is the plan a Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO)? HMOs tend to have lower monthly bills (premiums), but less choice. You’ll select a primary care provider (PCP) who will coordinate all you and your child’s care. That means they’ll have to provide referrals for any specialist visits. And they’ll have to provide referrals for any medical procedures you or your child may need.

A PPO tends to have a higher monthly premium, but it offers more choices. You usually don’t need a referral to see a specialist. And you often have the flexibility to go out of network. But you’ll have to pay an out-of-network deductible (that’s the amount you pay out of pocket for covered health services before your insurance company pays the rest).

• Will your plan cover the medical care your child needs? This is particularly important if your child takes prescription drugs. It’s also important if your child needs physical, occupational or speech therapy. You’ll want to find out how much the plan will pay.

The first step is to take a closer look at the plans your employer offers. Then, explore what’s offered for individual or family plans. If you qualify, you may even be eligible for subsidies (premium tax credits that lower the cost of your health insurance) with an ACA health insurance plan.

Another way to find the family or individual health plans that can fit your needs? Explore available plans, or call a licensed insurance agent at 1-844-211-7730 to discuss your options. 

When should I consider buying my children’s health insurance?

Let’s say you have an employer that offers a health insurance plan. Your employer’s plan may only be available at a specific time during the year. And that will likely be different from employer to employer. So, you’ll want to talk with your employer’s human resources (HR) department (or the equivalent person) to ensure that you:

• Understand the enrollment dates
• Sign up on time
• Add your child (or children) to your plan

If you miss your employer’s enrollment deadline, a short-term health insurance plan could be a temporary option. You’ll want to be aware that the rules for short-term plans are changing. Depending on what state you live in, a short-term plan could cover you for only 3 months, plus a one-month extension, starting on September 1.

Unlike ACA plans, you’ll also need to go through a medical underwriting process to be eligible for short-term health insurance. That means your application and medical history may be reviewed to determine whether you have any preexisting conditions, as they are generally not covered by short-term health insurance plans. Those could include conditions like cancer or type 2 diabetes, and they may disqualify you from coverage.

Short-term insurance isn’t only available for people who miss their employer’s enrollment deadlines. It could also be a good option if you:

• Are between jobs
• Are self-employed
• Don’t get insurance through your employer

Lastly, you may purchase ACA insurance for your children. That’s the case even if you get health insurance through your employer. This also holds true if you qualify for Medicare or Medicaid. It’s also the case for CHIP, or the Children’s Health Insurance Program (more on that below).

However, you can only buy ACA insurance plans at certain times during the year. That’s during the Open Enrollment Period, or OEP, which normally takes place between November 1 and January 15 — though this varies in some states.

Even if you miss the OEP, you may still have a chance to buy insurance. This could happen if you have a qualified life event, such as getting married, divorced or having another child. This window in which you can buy ACA insurance outside of the normal enrollment period is called a Special Enrollment Period, or SEP.

What are my options when it comes to ACA health insurance plans?

You’ll want to look into all your ACA insurance options, and you may want to do this even if your employer offers child benefits, advises Ackerman. That way, you can figure out if there’s a better plan that costs less.

When it comes to ACA plans, you may also be eligible for subsidies. These lower the cost of your insurance and out-of-pocket expenses. The type of subsidies you get will depend on your child’s age. It also depends on what state you live in and your total household income.

When it comes to ACA plans, there are two types of subsidies you may qualify for:

• Cost-sharing reductions. This lowers what you’ll have to pay for deductibles, copayments and coinsurance. If you qualify, you must enroll in a type of ACA plan known as a silver plan. (ACA plans come in different metal plans, including bronze, silver, gold and sometimes platinum, all of which offer different kinds of coverage.)
• Premium tax credits. When you buy an ACA plan, you estimate your income for the year. If you qualify for a tax credit based on your estimate, you can use it to lower your premium. It doesn’t have to be 100% accurate. If you overestimate your income, you’ll receive that as a credit toward future taxes. If you underestimate your income and receive too much of a discount, you’ll pay that back when you file your taxes.

ACA plans must cover these health benefits for children:

• Dental coverage
• Doctors’ visits
• Emergency services
• Inpatient and outpatient hospital care
• Laboratory services
• Mental health services
• Pregnancy and childbirth
• Prescription drug coverage
• Preventive care, such as immunizations
• Rehabilitative services and devices to help people with injuries or disabilities
• Vision coverage (usually an annual eye exam and glasses)

It’s important to note that for ACA plans, dental coverage is considered an essential benefit for children ages 18 and younger. That means it has to be part of your health plan. Or it has to be offered as a separate dental plan. (While it must be available to you, you don’t have to buy it.)

Your plan may offer even more services, depending on your state. When it comes to purchasing a specific ACA plan, Ackerman recommends that you ask questions. You may want to ask the same questions you do when exploring employer-based health plans.

Do you have questions about vision or dental insurance for you and your family? Get more details about supplemental insurance now or call a licensed insurance agent at 1-844-211-7730 to discuss your options. 

What should I do if I can’t afford to pay for health insurance?

You’ll want to find out whether you qualify for Medicaid, advises Ackerman. Medicaid provides health coverage for millions of Americans. This includes eligible low-income adults and children. It’s run by states. But it’s funded jointly by states and the federal government.

Medicaid eligibility for kids varies by state. To apply for Medicaid, you’ll need to go through your state’s Medicaid agency. Your agency should have information online. This may help you figure out if you fall within state income levels. It can also guide you through the application process.

Medicaid in all states must pay for the following for children:

• Dental care
• Doctors’ visits
• Emergency services
• Immunizations
• Inpatient and outpatient hospital services
• Laboratory tests and X-rays
• Mental health services
• Vision care, if needed
• Well-child and other routine checkups

Prescription drug coverage may be included, depending on your state. The same holds true for physical and occupational therapy.

What can I do if I don’t qualify for Medicaid but can’t afford health insurance for my child?

Some parents may find themselves in this position, especially if they suddenly realize their employer did not cover their children for one reason or another or if they suddenly find themselves pregnant. One option is to apply for their state’s Children’s Health Insurance Program, otherwise known as CHIP, says Michelle Katz, L.P.N., M.S.N. Katz is a consumer health advocate in the Washington, D.C. area.

Thankfully, your child may be eligible for health insurance through CHIP. It provides low-cost coverage to eligible children whose families earn too much to qualify for Medicaid. More than 7 million children and teens were enrolled as of April 2023. It’s always a good idea to check if you’re eligible. A family of 4 can make up to $80,000 a year and still qualify.

CHIP varies from state to state, but it generally covers the basic health insurance needs of children, says Katz. This may include:

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

Some states may provide even more services. Go to your state’s website for CHIP to find out what it includes. They may also have a website that tells you which providers accept CHIP and are available. For example, there’s a website where you can search for dentists in your area who accept CHIP.

Preventive care such as well-child doctor and dental visits are free under CHIP. But you may have to pay a copay for other services. This includes sick visits. Some states also charge a monthly premium.

As mentioned earlier, you can enroll children in CHIP at any time. There’s no Special Enrollment Period. This is unlike other forms of health insurance.

Need help filling out the application? Call 1-877-KIDS-NOW (1-877-543-7669). This is a free and confidential hotline. Once your child is enrolled, you’ll get an annual notice when it’s time to renew coverage.

Another great way to get health insurance for you or your family? Enter your ZIP code to search available plans or call a licensed insurance agent at 1-844-211-7730. 

Can I put my kids on my short-term health insurance plan?

As we mentioned earlier, short-term health plans might be a good temporary option for you if you miss the ACA enrollment deadline or are between jobs. But for kids, they may not be a good idea, notes Ackerman. The reasons include:

• Not all short-term health insurance plans cover preventive care. Short-term plans don’t have to cover annual physical exams, prescription drugs and vaccinations. This is unlike ACA plans. That means you’ll have to pay out of pocket for these things, which can get expensive.
• They often don’t cover preexisting conditions. Almost a quarter of kids under the age of 18 have some sort of preexisting condition. Short-term health insurance plans can deny you coverage if you have a preexisting condition. This is unlike ACA plans as well.

There are plenty of options to ensure your child gets the health care they need. What’s most important is exploring all the options. This way, you can determine what’s best for your child and your family.

Still have questions about what health insurance might be right for you or your family? Explore your options now or call a licensed insurance agent at 1-844-211-7730 to discuss your health insurance options.  

This article contains information that is compiled by UnitedHealthcare or its subsidiaries. UnitedHealthcare does not represent all the information provided are statements of fact. Please consult directly with your primary care physician if you need medical advice.

Sources:

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