At eHealth, we literally get hundreds (sometimes thousands) of phone calls every day. One of the questions we hear all the time is, “can I just get health insurance for my child?”

The short answer is always, yes. The longer and much harder answer is, what type of insurance does your child qualify for?

Key Takeaways

Child-only health plans are available and specifically cover children.

Child-only health plans are designed specifically to cover children’s healthcare needs, ensuring they receive the necessary medical attention without the complexities of adult coverage.

There are several options available to provide health insurance for your child.

When it comes to providing health insurance for your child, you have a range of options to choose from, including standalone child-only plans, family plans, and government-sponsored programs like CHIP (Children’s Health Insurance Program).

Multiple private insurance companies offer child-only health plans.

Many private insurance companies recognize the importance of child healthcare and offer dedicated child-only health plans, providing parents with flexibility and choice when selecting coverage for their children’s well-being.

What are child-only health plans?

Child-only health plans specifically cover children. Plans typically cover preventative care, injuries, illnesses, and other medical issues. They function much like any standard health insurance plan, with deductibles, copayments, and coinsurances, but only extend coverage to children.

A child-only health plan can insure a single child or multiple children who are within one immediate family.

Why would you need child only health insurance?

Many children receive health insurance coverage through their parent or guardian’s individual and family health insurance plans, but such extended coverage isn’t available to all kids. Child-only health insurance is available for kids who don’t have coverage through a parent.

Ensuring children have health insurance is essential to their health and wellbeing. According to the Kaiser Family Foundation, roughly 50% of children had insurance through employer-sponsored coverage, 37.5% were covered through Medicaid, and 5.6% of children were uninsured in 2019. Whether your child is uninsured or you’re looking for a new plan, shopping for health insurance for kids can help provide financial protection for when they get sick, injured, or need medical attention.

How do I get health insurance for my child?

Several different health insurance options are available. If you have to buy health insurance for your child on your own (no employer is offering it), here is a brief rundown of your options: You can find longer, more details descriptions below:

1. Children’s Health Insurance Program (CHIP or Medicaid)

CHIP is also known as the children’s health insurance program, or Medicaid. Every state has CHIP or Medicaid as an option, but every state has its own rules on who qualifies. You typically need to be low-income to qualify.

For low-income families, CHIP is usually the most affordable way to procure health insurance for a child. Coverages vary by state, but coverage typically isn’t cut back simply because these are low-income plans. The goal of these programs is to grant children from lower-income families quality health coverage.

              How to enroll:

1. Check Eligibility: Before enrolling, make sure your child meets the eligibility criteria for CHIP or Medicaid. Eligibility varies by state and is often based on income, family size, and other factors.
2. Gather Documents: Collect the necessary documents to prove your child’s eligibility, such as proof of income, Social Security numbers, and residency information.
3. Apply Online: Many states allow you to apply for CHIP or Medicaid online through their official websites. Use the state’s online application portal to provide the required information.
4. Apply by Phone: If online application isn’t an option, you can often apply by phone. Contact your state’s CHIP or Medicaid office to inquire about this method.
5. In-Person Application: Some states also offer in-person application assistance. Visit your local Department of Health and Human Services office or a designated enrollment center to apply in person.
6. Mail Application: In some cases, you may need to mail in your application. Follow the instructions provided by your state for submitting a paper application.
7. Wait for Approval: After submitting your application, you’ll need to wait for your child’s eligibility to be determined. This process can take some time, so be patient.
8. Receive Notification: Once your child’s eligibility is confirmed, you’ll receive a notice of approval. This will include information about the coverage and benefits your child qualifies for.
9. Choose a Health Plan: Depending on your state, you may need to choose a health plan within the CHIP or Medicaid program. Review available plans and select the one that best suits your child’s healthcare needs.
10. Complete Enrollment: Follow any instructions provided in the approval notice to complete the enrollment process. This may involve providing additional information or signing up for the chosen health plan.

2. Major Medical Health Insurance

Also known as Affordable Care Act (ACA/Obamacare) insurance. Major medical health insurance is always the best coverage, but it can also be very expensive and not always available year-round. To make the plans affordable, you may qualify for a QHP with a tax credit. To qualify to enroll, you either need a qualifying event or to apply during open enrollment.

All ACA health insurance plans for children provide the same coverages that adult ACA plans. These are the standard plans offered by most employers who provide health insurance as a benefit.

              How to enroll:       

1. Open Enrollment Period: Most major medical health insurance plans offer an annual Open Enrollment Period. This is the designated time when you can enroll in or make changes to your coverage. Check the specific dates for the Open Enrollment Period, which typically occurs once a year.
2. Research Plans: Before enrolling, research different major medical health insurance plans available in your area. Compare their benefits, network of doctors and hospitals, and costs to determine which plan best meets your needs.
3. Check Eligibility: Make sure you meet the eligibility criteria for the major medical health insurance plan. Eligibility requirements may vary based on factors such as age, income, and residency.
4. Apply Online: Many health insurance companies offer online enrollment platforms. Visit the insurer’s official website and follow the instructions to complete the online application.
5. Contact Insurance Agents: If you prefer personalized assistance, you can reach out to insurance agents or brokers who specialize in major medical health insurance. They can guide you through the enrollment process and help you find the right plan.
6. Utilize the Marketplace: If your country or region has a health insurance Marketplace (such as the Health Insurance Marketplace in the US), you can use it to enroll in a major medical health insurance plan. These Marketplaces provide a centralized platform to compare plans and enroll.
7. Gather Information: Collect the necessary information to complete the enrollment application. This may include personal information, household details, and income information.
8. Submit Application: Fill out the application accurately and submit it by the deadline. Make sure to review all the information before submitting to avoid errors.
9. Choose a Plan: Once your application is submitted, you may receive a list of available plans. Choose the major medical health insurance plan that aligns with your healthcare needs and budget.
10. Wait for Approval: After submitting your application, the insurer will review it and determine your eligibility. You’ll receive notification of approval or further instructions if needed.
11. Receive Plan Details: If your application is approved, you’ll receive a welcome packet from the insurance company. This packet will include details about your coverage, benefits, and how to access care.
12. Pay Premiums: To activate your coverage, you’ll need to pay your first premium according to the instructions provided by the insurer. Premiums are typically paid on a monthly basis.

3. Short-Term Health Insurance

Short-term health insurance is the most similar to major medical, but you can apply for your child at any time throughout the year. They’re affordable, and if you need fast approval, some will approve you in as little as 48 hours. The downside is that these plans usually don’t take people with pre-existing conditions, and their benefits are limited. They’re also not available in every state.

Pre-existing conditions might not be an issue for some children, but a large number of kids have significant preexisting conditions that would leave parents/guardians with substantial out-of-pocket expenses. This type of plan is most useful as emergency, short-term insurance when there aren’t large regular medical expenses.

              How to enroll:

1. Research and Compare: Begin by researching different short-term health insurance plans available in your area. Compare their benefits, coverage options, costs, and network of doctors and hospitals.
2. Check Eligibility: Ensure that you meet the eligibility criteria for short-term health insurance. This type of insurance is often suitable for individuals in between coverage, those waiting for employer-sponsored plans, or those experiencing life changes like graduating college.
3. Visit Insurance Provider Websites: Visit the official websites of reputable health insurance providers that offer short-term plans. Many insurers offer online application portals.
4. Start Application: Begin the online application by providing essential information such as your name, contact details, date of birth, and desired coverage start date.
5. Answer Health Questions: Short-term health insurance applications typically include health-related questions to assess your eligibility. Answer these questions truthfully and accurately.
6. Choose Coverage Duration: Specify the duration for which you need coverage. Short-term plans typically offer coverage for a few months, up to one year, depending on your needs.
7. Select Coverage Options: Customize your plan by choosing coverage options that suit your healthcare requirements. These options may include medical services, prescription drug coverage, and more.
8. Review and Confirm: Carefully review the information you’ve provided in the application. Make sure all details are accurate before proceeding.
9. Submit Application: Once you’re satisfied with the information, submit your application online.
10. Receive Plan Details: After submitting your application, you’ll receive plan details, terms, and conditions from the insurance provider. This will outline your coverage, benefits, exclusions, and limitations.
11. Pay Premium: If your application is approved, you’ll need to pay the first premium according to the instructions provided by the insurer. Premiums are typically paid on a monthly basis.
12. Access Coverage: Once your premium is paid and your coverage is active, you can start using the benefits of your short-term health insurance plan.

4. Fixed-Payment, or Fixed-Indemnity Plans

Fixed-payment plans, or fixed-indemnity plans, are your alternative when short-term plans are not an option. While also affordable, these plans often will take people with pre-existing conditions. But, they also have a daily limit on how much they’ll pay for any medical situation, like $5,000 for a hospital visit, etc.

Fixed-payment plans can be thought of as a per diem allowance for medical expenses. They’re useful as short-term insurance for children who don’t require regular care. Parents might also use this option if ongoing regular care costs less than a plan’s daily maximum.

              How to enroll:

1. Research and Compare Plans: Begin by researching various insurance providers that offer Fixed-Payment or Fixed-Indemnity Plans. Compare their benefits, coverage options, costs, and network of providers.
2. Check Eligibility: Ensure that you meet the eligibility criteria for these plans. They are often suitable for individuals looking for supplementary coverage to complement their existing insurance or for those seeking coverage for specific services.
3. Visit Provider Websites: Visit the official websites of insurance companies offering Fixed-Payment or Fixed-Indemnity Plans. Many insurers provide online application portals.
4. Start Application: Initiate the online application process by providing your personal information, such as name, contact details, date of birth, and desired coverage start date.
5. Choose Plan Options: Select the specific Fixed-Payment or Fixed-Indemnity Plan that aligns with your healthcare needs. These plans typically offer predetermined cash benefits for various medical services.
6. Review Plan Details: Carefully review the plan details, including the list of covered services and the corresponding fixed benefits for each service.
7. Submit Application: Submit your application online after ensuring that all information provided is accurate and complete.
8. Pay Premium: If your application is approved, you will receive information about the premium amount and payment instructions. Pay the premium as specified by the insurance provider.
9. Receive Policy Documents: Once your premium is processed, you’ll receive policy documents outlining the terms, conditions, covered services, and benefit amounts.
10. Access Benefits: When you require medical services covered by the plan, you can submit claims for reimbursement according to the fixed benefit amounts specified in the policy.
11. Renew or Adjust Coverage: Fixed-Payment or Fixed-Indemnity Plans are often customizable. You may have the option to renew the plan or adjust your coverage based on changing needs.

5. Cost-Sharing Services

There are a handful of faith-based medical cost-sharing services. These plans are typically affordable and cover most medical problems, but they won’t cover pre-existing conditions – at least not for the first few years that you or your child is on the policy.

Cost-sharing services aren’t traditional insurance, but they qualify as an ACA-approved alternative to traditional insurance. These types of plans can keep medical costs manageable because they’re spread out among many participants, but the costs might be greater than what a child’s care would be out-of-pocket. Not all cost-sharing services have child-only health insurance, so parents might shoulder a portion of the costs that older adults are incurring.

              How to enroll:

1. Research and Compare Plans: Begin by researching different Cost-Sharing Health Insurance Plans available. These plans may be offered by organizations or groups that share medical expenses.
2. Check Eligibility: Ensure that you meet the eligibility criteria for the specific Cost-Sharing Plan you’re interested in. Some plans may have certain requirements, such as adherence to a particular set of beliefs or values.
3. Join an Organization: Many Cost-Sharing Plans are offered through faith-based or community organizations. Start by contacting these organizations and expressing your interest in joining their health sharing program.
4. Review Plan Guidelines: Carefully review the guidelines, rules, and terms of the Cost-Sharing Plan. Understand how contributions are determined, what medical expenses are eligible for sharing, and any limitations.
5. Provide Information: Complete the enrollment application provided by the organization. This may include providing personal information, medical history, and agreeing to adhere to the organization’s principles and guidelines.
6. Submit Application: Submit your completed application to the organization. Some organizations may have an online application portal, while others may require you to mail or fax the application.
7. Pay Initial Share: Some Cost-Sharing Plans require you to pay an initial share amount before you can begin sharing in the medical expenses of others. This may be a one-time payment or the first month’s contribution.
8. Receive Membership Materials: Upon acceptance into the Cost-Sharing Plan, you’ll receive membership materials, which may include an ID card, membership handbook, and instructions on how to access shared funds.
9. Contribute Regularly: As a member of the Cost-Sharing Plan, you’ll need to contribute a fixed monthly amount to the organization. These contributions are then used to help cover the medical expenses of other members.
10. Submit Medical Expenses: If you incur eligible medical expenses, follow the organization’s guidelines for submitting the bills and documentation. Once approved, the community will share in these expenses.
11. Support Others: Part of the philosophy of Cost-Sharing Plans is the sense of community and mutual support. You’ll be contributing not only to your own medical needs but also to those of other members.
12. Stay Informed: Keep up to date with the organization’s communication regarding plan changes, updates, and any new guidelines.

The most common reasons to buy health insurance for kids

There are a few different situations that come up, and the types of coverage you can or should pursue will really depend on the situation you’re in. The most common reasons to buy health insurance for kids include:

1. My child needs health insurance to play a sport

Many youth sports leagues and organizations require all children to have health insurance. The requirement is to reduce the risk of liability in the event of a sports-related injury, as child health insurance plans often cover expenses related to injuries.

• Your Best Option: Major medical health insurance (ACA/Obamacare)
• Your Fastest, Most Affordable Option: Short-term health insurance. If you need it Monday, in some cases, you can apply as late as Friday (but don’t push your luck).
• When ACA & Short-Term are not an option: Look at fixed-indemnity plans, cost-sharing plans, and CHIP.

2. My child needs health insurance to go to school

Schools may require health insurance as a way to increase coverage rates among children. Many schools also require immunizations, which health insurance might be needed to pay for. Such requirements tend to be more common in public schools than in private schools, but any school might have these requirements.

• Your Best Option: Again, major medical health insurance (ACA/Obamacare) is typically your best option. 
• Your Fastest, Most Affordable Option: Again, short-term health insurance is typically the next best option.
• When ACA & Short-Term are not an option: Here, you may see if the school offers some form of association-based coverage to choose from. If that’s not an option, weigh fixed-indemnity products in your area against cost-sharing plans and CHIP.

3. My child needs health insurance before a trip

Organizations that take children on group trips might require that children have health insurance in the event a child becomes sick or injured while traveling with the group. School groups, bands and orchestras, youth groups, and other children’s organizations might sponsor a trip requiring insurance.

• Your Best Option: Like a broken record, major medical health insurance (ACA/Obamacare) will be the most comprehensive option if you qualify.
• Your Fastest, Most Affordable Option: Look into travel health insurance. In some instances, a travel health insurance plan may be enough to get your child through the trip. Just be aware that many travel insurance policies require you to have some other form of primary coverage that picks up the tab once your travel benefits run out.
• When ACA & Travel Insurance are not an option: Here, again, short-term insurance will be your next best option. Absent access to major medical or short-term, consider the fixed-indemnity and cost-sharing plans you have available in your area.

4. My child needs health insurance because they’re sick

Hopefully, health insurance is in place prior to a child becoming sick, as the initial treatment expenses might not be covered. Coverage can even take a few days to obtain, during which time treatment costs could have to be paid for out-of-pocket.

Low-income families might be able to get CHIP or Medicaid coverage that’s retroactive to when a child became ill. Families still shouldn’t wait for a kid to become ill before getting a CHIP plan, though.

• Your Best Option: If you can qualify, major medical health insurance (ACA/Obamacare) is what you’re going to want for your child long-term. If you have to, wait until the next open enrollment period and sign them up.
• Your Fastest, Most Affordable Option: There really isn’t a great second option. You can see if you qualify for CHIP, and you may. However, most of the other forms of coverage you can apply for won’t cover a pre-existing condition.

5. My child needs health insurance because I missed open enrollment

Very often, new parents are so tired from taking care of their little ones that they completely forget to add their child to their employer-based insurance during the 90-day special enrollment window (which actually happened to the author of this article).

Health insurance is available even if you missed open enrollment. Some CHIP and Medicaid programs allow qualifying families to enroll their children at any time of year. Short-term or fixed-payment health insurance for a child only is also generally available year-round.

• Your Best Option: Ask your H.R. department to call you, email you, and stop by your desk when your company’s next open enrollment period begins so you can get you’re your kid on your company plan.
• Your Second-Best Option: Get them on a major medical health insurance (ACA/Obamacare) plan. The challenge you’re likely to have is that Obamacare’s open enrollment period typically aligns with most employers’ open enrollment period.
• Your Next, Best Option: Try a short-term plan. If your child qualifies, the plans will cover new medical conditions that pop up. You’ll have a deductible and cost-sharing, but you’ll have coverage (hopefully until open enrollment begins).
• When short-term is not an option: Again, look at your fixed-indemnity options as well as cost-sharing plans and CHIP.

6. I don’t want to put my child on Medicaid

This is a question we hear all the time in our call center. While Medicaid plans can provide decent health insurance for a child only, it’s not always the best option for every family. Sometimes, people have a bad impression of Medicaid, or they may have had a bad experience with the program. Families can choose to purchase major medical health insurance rather than CHIP, but those that qualify for Medicaid often struggle to afford major medical plans’ premiums. You can look at some of the other options listed here, like short-term or cost-sharing services, but if you need a long-term solution, make sure you understand how CHIP works.

What private insurance companies offer child-only health plans?

Private insurance companies offer child-only health plans to provide essential coverage for children’s medical needs. These plans are designed to offer comprehensive healthcare services that cater specifically to children’s health and well-being. Here is a list of some private insurance companies that offer child-only health plans, along with brief information about each:

• Aetna: A reputable insurance provider, Aetna offers child-only health plans that include a range of benefits to meet children’s healthcare needs. Their plans often cover preventive care, doctor visits, and other essential medical services. Learn more about Aetna
• Anthem Blue Cross: Anthem Blue Cross offers child-only health plans with a focus on quality healthcare for children. Their plans may include coverage for vaccinations, wellness check-ups, and more, ensuring children receive necessary medical care. Learn more about Anthem Blue Cross
• Cigna: Cigna provides child-only health plans that emphasize comprehensive coverage, ensuring children have access to a network of healthcare providers and services. Their plans may cover various medical services and preventive care. Learn more about Cigna
• UnitedHealthcare: UnitedHealthcare offers child-only health plans designed to cater to children’s unique healthcare needs. These plans often include coverage for doctor visits, prescriptions, and other essential medical services. Learn more about UnitedHealthcare
• Blue Shield of California: Blue Shield of California provides child-only health plans that focus on delivering quality healthcare to children. Their plans may include coverage for pediatric services, preventive care, and more. Learn more about Blue Shield of California
• Kaiser Permanente: Kaiser Permanente offers child-only health plans that prioritize the health and well-being of children. Their plans often include access to a network of healthcare professionals and a wide range of medical services. Learn more about Kaiser Permanente

Find a child-only health plan

Finding a child-only health plan to cater to your child’s healthcare needs is a crucial step in ensuring their well-being. To find this unique offering, you can visit eHealth Insurance. When searching for child-only plans, you can easily navigate through the website’s user-friendly interface to specify the details of your search. You might want to set the primary member as the child in order to filter the results and find plans tailored to their medical requirements. By doing so, you’ll be able to explore a range of child-only health plans from reputable insurance companies. To get started, you can visit the eHealth Insurance homepage and begin your search for the best child-only health plan for your young one’s needs.

Health Insurance for Kids Frequently Asked Questions

How Much Does Affordable Health Insurance for Kids Cost?

Parents will find that the cost of health insurance for kids varies significantly. Plan type, state, and individual child details (e.g. age) all impact how much premiums are. Affordable health insurance for kids is usually available through one of the above-listed plan types, though.

Are Vision and Dental Included When Purchasing Health Insurance for Kids?

Whether a plan that offers health insurance for kids includes vision and dental coverage depends on the specifics of a policy. All Medicaid and CHIP policies include the coverages. Major medical plans and cost-sharing services might. Short-term and fixed-payment plans are less likely to.

How to get health insurance for my child?

Child health insurance is available through state and federal websites or through a broker such as eHealth. eHealth can help parents compare many of the policies that they’d find on state and federal marketplaces. You can apply for Medicaid or CHIP, find off-exchange health plans, and review qualified health plans on the platform.

Does my child qualify for CHIP?

Determining if your child qualifies for the Children’s Health Insurance Program (CHIP) involves considering several factors such as household income, family size, and state-specific eligibility requirements. Generally, CHIP provides affordable health coverage to children in families with incomes too high to qualify for Medicaid but unable to afford private insurance. Eligibility criteria vary by state, so it’s essential to check with your state’s CHIP program to determine if your child meets the qualifications. CHIP aims to ensure that all children have access to essential healthcare services, promoting their overall health and well-being.

Can I apply if I’m not the child’s parent?

In many cases, individuals other than the child’s parents can apply for CHIP on behalf of the child, such as legal guardians, relatives, or caregivers. The primary focus is on ensuring that eligible children receive the healthcare coverage they need, regardless of the applicant’s relationship to the child. However, requirements may vary by state, so it’s advisable to check with your state’s CHIP program to understand the specific application process and any documentation required. By extending eligibility to caregivers and guardians, CHIP aims to provide comprehensive healthcare coverage to children in need, fostering their growth and development.

Does paying health insurance reduce child support?

Paying health insurance premiums typically does not directly reduce child support. However, the cost of health insurance premiums might be factored into the overall calculation of child support, depending on the laws in your jurisdiction. It’s important to consult with legal experts or your local child support agency to understand how health insurance expenses could potentially impact child support arrangements.

How long can my child stay on my health insurance?

Children can usually stay on their parent’s health insurance plan until they turn 26 years old, regardless of whether they are living with their parents, are married, or are financially independent. This is applicable for plans offered by private insurance companies, as well as plans provided through employers. After the child turns 26, they may need to find their own health insurance coverage.

Can I get health insurance for my child only?

Yes, you can often get health insurance coverage for your child only. Many health insurance plans offer options specifically designed to cover children’s healthcare needs. Whether you’re looking for a comprehensive plan or a more basic one, you can explore child-only health insurance options that provide the coverage your child requires. Keep in mind that the availability of child-only plans may vary depending on the insurance company and your location. It’s advisable to research and compare different plans to find the best fit for your child’s health and well-being.

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