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Health Insurance for Children

Health Insurance for Children

Health insurance for children is one of the most beneficial investments you could make to protect your child. Keeping your children healthy at home is important to your child’s development. Active children tend to be healthy children, so be sure to keep your children active and avoid letting them watch too much television or play too many video games.

More children are covered by health insurance than ever before because parents are finding affordable options made available to all income levels. Often though, children who go without coverage are members of families that make too much money to qualify for Medicaid yet not enough to afford private health insurance.

Health Insurance Cost for Children

Medicaid is a federally-funded, state-run program that provides medical assistance for individuals and families with limited incomes. It will pay all the health care costs that you cannot afford. There are a few different ways to qualify, and they can be different depending on where you live, but this is the best option for lower income families to obtain children’s health insurance.

If your income is too high and you do not qualify for Medicaid, there are other options available to you. You might choose or already have in place an individual plan for your family healthcare. Health insurance for children is often a choice between a health maintenance organization (HMO’s) or a preferred provider organization (PPO’s). Because children make frequent trips to the doctor, let’s take a look at which plan works best for your needs and level of income.

HMO

HMO’s offer a low monthly premium, but are not very flexible. An HMO entitles you to doctor’s visits, preventive care, and medical treatment. You pay a co-payment for each doctor visit, often as little as $5 for each appointment. You cannot choose a doctor outside of the HMO network. An HMO covers a percentage of prescription drugs, your co-payment will vary depending on the cost of the medication. You will have a primary care provider who will take care of routine medical needs and prescriptions. Your primary care doctor will refer to a specialist if necessary, who also needs to be in the network. Emergency room care is paid for without a referral.

PPO

PPO’s are more flexible and have a slightly higher premium but they can be more flexible. You are allowed to go outside your network without a referral an see any physician you choose. Seeing an in-network doctor allows you to pay, out-of-pocket, only a small co-payment. If you go on your own you'll need to pay in full for all treatments and then submit a bill to the insurer for reimbursement. A PPO may reimburse as much as 80 percent of out-of-network expenses.

So, if you have a family you might want to go with the HMO, and get the lower monthly premium. In the long run you might save money on co-payments. You can always shop around for the right doctor in your network to meet your needs. Whichever children’s health insurance you choose, just be sure to have a plan in place to keep your children active and healthy.


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