Health Insurance Options for Children

Updated:Apr 11,2014

New Rights for Children
Starting Sept. 23, 2010, health insurance companies are prohibited from denying coverage to children under age 19 or excluding coverage for a pre-existing medical condition. You can search for private health insurance coverage for children at Healthcare.gov. This website lets you shop for and compare the health insurance plans available in your state. Click the Find Insurance Options Now tab to start your search.

Children’s Health Insurance Program
Your child or teen may be eligible for free or low-cost health insurance through your state’s Children’s Health Insurance Program (CHIP) or Medicaid, depending on your income. Go to Insurekidsnow.gov or call (877) Kids-Now (877-543-7669) to find out if your child is eligible.

Options for Young Adults 
Stay on a parent’s plan: If you’re under 26 and aren’t offered health coverage through a job, you can stay on or rejoin your parent’s health insurance plan, even if you’re married, don’t live with your parents or are no longer a dependent of your parents. Contact your parent’s insurance company to take advantage of this option.

Health Insurance Marketplaces Now Open: New Health Insurance Marketplaces are open in every state. They provide one-stop shopping for health insurance for individuals and families who need coverage. Financial assistance is available to help make the premiums affordable. Insurance companies are not allowed to deny coverage to individuals with pre-existing medical conditions or charge higher premiums because of health status. To find the Health Insurance Marketplace for your state, visit www.healthcare.gov or call toll-free at 1-800-318-2596.

Eligibility: Individuals who need coverage who are legally residing in the U.S. and who are not incarcerated are eligible to purchase coverage through their state’s Marketplace. Small employers with fewer than 50 full-time employers can also purchase coverage through the Marketplace. Insurance companies will not be allowed to deny coverage to individuals with pre-existing medical conditions nor will they be allowed to charge higher premiums to people because of their health status.

Financial Assistance Available: Most uninsured individuals qualify for financial assistance called a Health Insurance Premium Tax Credit to help make their insurance premiums affordable. The amount of financial assistance depends on your income and family size. Individuals with low incomes may qualify for free or very low premiums. To find out how much financial assistance you may qualify for, check out the Kaiser Family Foundation’s subsidy calculator.

Types of Coverage: All of the health plans sold through the Marketplace are offered by private insurance companies and are required to meet minimum requirements. All of the plans are required to cover a comprehensive set of benefits that includes hospital care, doctors’ visits, emergency care, prescription drugs, lab services, preventive care, and rehabilitative services. Before choosing a plan, individuals will be able to see whether their healthcare practitioner participates in the plan’s network (if choosing a network plan). Individuals will be able to choose the plan that best meets their needs and budget. Individuals with low-incomes may instead qualify for free or low-cost coverage through Medicaid or the Children’s Health Insurance Program.

How to Enroll: Individuals who need coverage can fill out a single application to find out what financial assistance they are eligible for and to apply for coverage. To find your state’s Marketplace and to apply online go to www.healthcare.gov. Individuals can also call toll-free 1-800-318-2596 to apply. Those needing assistance with filling out the application can get help from trained, certified counselors; to find in-person assistance near you, contact your state’s Marketplace or visit www.healthcare.gov.

The next open enrollment period will begin on November 15th, 2014 and end on February 15th, 2015. However, in certain circumstances, you may be able to buy coverage outside of the regular open enrollment period, such as if you:

  • Have or adopt a baby, or
  • Get married, or
  • Move to a new state, or
  • Lose your other health insurance coverage.
Additionally, those who qualify can apply for the Children’s Health Insurance Program (CHIP) or Medicaid at any point during the year. There is no open enrollment period for these programs. Also, if you own or operate a small business, you can begin offering coverage to your employees at any time.

Individual coverage: If you need coverage effective immediately and would like to search for and compare plans available now, go to finder.healthcare.gov to start your search. The Foundation for Health Coverage Education’s website, also includes state-by-state information on different coverage options or sources of financial assistance that may be available to you.

Community health centers:
Some hospitals, health centers and clinics provide medical care, prescription drugs, dental care and other services regardless of your ability to pay. Anyone may use a community health center, whether you have health insurance or not. How much you pay will depend on your income. Find a community health center near you.

Learn more: 
Also in this section:

Consumer Health Care

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