Child Health Insurance Coverage Basics

Child Health Insurance Coverage Basics

December 18, 2020

Child Health Insurance Coverage Basics

From the time your child is born, they are vulnerable to injury and illness. Like adults, children need a health insurance plan that meets their needs at every growth stage. With open enrollment right around the corner, now is the time to add your child to your current plan. According to the Health Insurance Marketplace, they can stay on your plan until the age of 26. 

Finding the right insurance provider and plan for your child can be difficult today. So, if you need help adding your child to your plan or looking at different options, speak with a health insurance broker. An agent can help you compare individual & family health insurance plans and guide you through the underwriting process for your child. To learn more about how to enroll your child, contact Insurance Enterprise today. 

Why Your Child Needs Health Insurance

Children today are more active than ever. School activities, trips with the family, and neighborhood friends keep your child engaged throughout the year. The more active your child becomes, the more vulnerable they are to injuries at home or school. They are also susceptible to catching illnesses, as their immune system are still developing. Some of the main reasons your child needs health insurance include

  • Your child is playing sports.
  • School injuries or contagious illnesses are likely.
  • Insurance provides protection during trips.
  • Your child may have a pre-existing illness.
  • Social activity is at its highest during childhood.

If you don’t want to put your child on Medicaid, but you missed open enrollment, you can still get health insurance for your child. Some providers offer enrollment all year. Check with your health insurance agent to determine which plans are still available and how to get health insurance coverage for your child. 

Health Insurance Options for Your Child

If you need to buy health insurance for your child, here is a brief rundown of your options:

Major Medical Health Insurance

Also known as the Affordable Care Act (ACA/Obamacare) insurance. You may get good coverage, but it can also be very expensive and not always available year-round. To make 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.

Short-Term Health Insurance

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

Fixed-Payment, or Fixed-Indemnity Plans

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

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, you or your child is on the policy.

Children’s Health Insurance Program (CHIP or Medicaid)

Every state has CHIP as an option, but every state has its own rules on who qualifies. You typically need to be low-income to qualify.

Does Your Child Qualify as a Dependent?

Before you add your child to your policy, you need to establish that they qualify as a legal dependent. To determine if your child is eligible, they must meet the following criteria:

  • They are a biological relative, stepchild, adopted child, or foster child.
  • Your child must be under the age of 26.
  • Your child must live with you for at least six months out of the year.
  • If your child has a job, they must not earn more than half of what it costs to support them.
  • No one else can claim your child as a dependent.
  • Your child cannot file taxes jointly with someone else.

Welcome to the MultiPlan PHCS Network

What are the benefits of PHCS coverage? You get to choose any doctor within the PPO network. This gives you an additional opportunity to save your healthcare dollars. MultiPlan’s PHCS Limited Benefit Network gives you discounted access to qualified doctors, healthcare facilities, labs, imaging centers, and hospitals at no additional charge.

Multiplan is one of the oldest and largest healthcare networks in the U.S. Currently, MultiPlan contracts with over 770,000 respected practitioners, 5,000 hospitals, and 70,000 ancillary care facilities, making it easier than ever for you to find a participating healthcare provider in your area. You save an average of 20-30% off inpatient and outpatient hospital charges when you use the MultiPlan Network.

A Health Insurance Solution That Makes Sense

  • We leverage what you pay for medical services. You end up paying much less than what insurance companies pay out.
  • We negotiate procedures and services from healthcare providers and treatment facilities within Multi-Plan on your behalf. So, if you are self-paying, you save up to 80 percent when you use a provider that is in the network.
  • PHCS Multi-Plan is the largest healthcare PPO network in the country.
  • You choose any doctor in the network.
  • Our plans pay out benefits based on all benefits schedules regardless if the benefit exceeds your discounted price. You simply pay the remaining balance.
  • Use Healthcare Bluebook, a simple online tool, to help you find the best care and price for your procedure in your local area.

We Offer Affordable Health Insurance in These States:

Contact Insurance Enterprise for Premier Health Insurance

If you have questions about group or individual health insurance and need health insurance quotes, contact Insurance Enterprise at 888-350-6605. Speak to a licensed agent and find out more about how you can get an affordable health insurance plan.