Child-Only Health Plans

The Affordable Care Act made a lot of changes to the healthcare industry, some of which apply directly to child-only health plans. These policies—designed to provide health benefits strictly to insured kids—are now available to children in every state.

But with so many family plans available, why would you need a child-only health plan? There are various reasons, which may include divorce and custody situations, the cost of child-only plans vs. employer-sponsored family plans and children with special needs that may not be otherwise covered by certain family plans.

So, if you find yourself in a similar situation, what can you expect a child-only health plan to cover?

All policies must cover the essential health benefits, including annual physicals, preventative services, immunizations and treatment for chronic conditions.

Children cannot be denied coverage because of preexisting conditions or falling ill during the course of the policy.

Many plans also offer vision and dental benefits for kids under 19.

While gathering information about child-only health plans, you’ll have to consider these two options.

HMO: To control costs, health coverage is limited to a network of medical providers as described by your insurance provider.

PPO: This plan allows you to visit any medical providers, although in-network services will often have a higher rate of coverage (therefore costing you less).

Regardless of the plan you select, you seldom have to worry about paying the premiums because low-income households may be eligible for subsidies (in the form of tax credits) under certain conditions. Want to learn more about your options and how much they cost? Your independent insurance agent can help you find the best combination of policy and price.