Child Only Health Insurance Coverage Options

As a parent, the right health insurance can provide peace of mind if your child becomes ill, experiences an injury, or requires urgent medical attention. Our agents at Health Plans of NC regularly help families find the right health insurance for their entire family, including recommendations for child-only health insurance.

What is child-only health insurance?

Although many families or individual health insurance plans include coverage for kids, there can be limitations. For example, extended coverage isn’t always available to all children on some employer-sponsored plans. So you may need to purchase child only health insurance to ensure quality coverage for your children. 

A child-only plan provides coverage specifically designed for kids and covers a range of injuries, illnesses, and preventative care. They work like other health insurance plans, with copayments, deductibles, and coinsurances. Depending on your family situation, you can purchase a child-only health insurance plan for a single child or multiple plans for all of your children within your immediate family. 

What are the health insurance options for children?

Several options are available if you want to arrange child-only health insurance for your child or children. 

Affordable Care Act (ACA) Insurance

ACA insurance typically offers the best level of coverage but, depending on the plan you choose, can be expensive. One of our experienced, locally-based NC insurance brokers can help determine if you qualify for any tax credits and discuss enrollment periods. You may be eligible to enroll outside open enrollment if you meet a specific qualifying event, like having a baby or loss of other coverage. 

Short-Term Health Insurance

The benefit of short-term health insurance is that you can apply at any time throughout the year and don’t have to worry about open enrollment periods. In addition, they make a good choice if you need fast approval of a plan, as most plans are approved within 48 hours. However, it’s important to be aware that pre-existing conditions aren’t typically covered and benefits can be limited. There are also some restrictions depending on where you live. Health Plans of NC can help advise what plans are available in North Carolina and talk you through any limitations. 

Children’s Health Insurance Program (CHIP)

CHIP, or Medicaid, is available in North Carolina for low-income families and provides affordable health insurance for your child. The aim is to ensure children from lower-income families receive the health coverage they need, including routine check-ups, dental care, and immunizations. 

To be eligible for CHIP in North Carolina, your child needs to be under 19 years of age. They must also be uninsured, a North Carolina resident, and a US citizen (or can meet immigration requirements). In addition, the total family income needs to fall below a specific amount depending on the size of your family. For example, for a family of four, your annual income before taxes needs to be less than $55,500 to qualify.

Fixed-Indemnity Plans

Fixed-indemnity plans, also known as fixed-priced plans, offer a daily limit for how much the provider will pay for medical treatment. For example, a $2000 daily cap for a hospital visit. They can be a suitable alternative if you can’t access short-term insurance coverage and typically offer coverage for pre-existing conditions.

Cost-Sharing Services

Cost-sharing services are an alternative to traditional insurance and are approved by ACA. They keep medical costs affordable because you share the costs among all plan participants. They cover most medical problems, though they don’t usually cover pre-existing conditions for the first few years. It’s essential to check that the cost-sharing service you’re considering covers child-only health insurance, as not all plans will. 

Why buy child-only health insurance?

Some of the most common reasons to buy child-only health insurance include the following:

Health insurance to attend school

Some schools can require children to have health insurance to attend. Many schools also ask for children to be fully immunized, and your health insurance policy may cover the costs. It’s usually more common for public schools to require coverage, although it’s up to the individual school and its policies. 

Your child is sick

In an ideal world, you would have health insurance organized before your child becomes unwell, but this isn’t always possible. If you need urgent coverage, contact a specialized health insurance agent who can quickly help you find the right child plan. Be aware that while you’re waiting, which can take a few days, any treatment costs will need to be paid for by you. If you’re eligible for CHIP or Medicaid coverage and haven’t arranged coverage, you can organize this to pay for any healthcare costs. 

You missed the open enrollment period

Because it’s easy to forget the open enrollment period, many people fail to add their child to their employer-based insurance within the 90-day special enrollment period. Organizing private health insurance, including short-term coverage, can be an excellent option to ensure your child has coverage. Some CHIP or Medicaid programs also let families enroll their kids throughout the year if they qualify.

To play sport

Many junior sports organizations require all children to have health insurance. Insurance can help organizations reduce their liability risk if there’s a sports-related injury during a game and can often be a condition to play in the league or for the sports team. Look for child health insurance plans that cover expenses that relate to injuries to make sure your insurance plan provides the right level of coverage.

Going on a school or group trip

Your child’s school or other community organization may require your child to obtain health insurance if they’re going on a trip. Coverage can ensure your child gets the health care they need if they are injured or fall ill during the trip. 

You don’t want to add your child to Medicaid

Some people don’t wish to add their child to Medicaid as they’ve had issues previously with the program or don’t believe it offers the benefits of an ACA plan. However, CHIP can be a great long-term option for many families. Talk to an experienced health insurance broker who can advise you on what suits you and your family. 

What’s included in child-only health insurance?

Inclusions for your kids depend on the individual policy. For example, ACA-approved plans and CHIP may include vision and dental coverage. However, short-term plans are less likely to do so. We recommend checking your policy details when researching to understand exactly what each plan covers. The cost of child-only health insurance can vary significantly depending on the type of plan, your child’s age, and the health care requirements. 

Need help finding the right insurance plan for your children?

At Health Plans of NC, we specialize in helping families in North Carolina to find the best health insurance plans for their needs and budget. So whether you’re looking for the best health insurance for kids or something that provides coverage for your whole family, get in touch with us today to find out how we can help you with kids health insurance.