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The ACA and Health Insurance for Kids
Kids Coverage Included as an Essential Health BenefitUnder the ACA, all health insurance plans are required to offer 10 essential health benefits when you seek care from a provider within your plan's network. These essential benefits include pediatric services. This includes dental care, as well as a number of preventive services, including (but not limited to):
- Vision screening
- Alcohol, tobacco, and drug use assessments
- Obesity screening and counseling
- STI prevention counseling and screening
- Hemoglobin screening
Having or Adopting a New Child is a Qualifying Life Event
If you have a baby on the way or are planning to adopt, the newest addition to your family may qualify you for a Special Enrollment Period. This period is usually open for a 60-day window and allows families to enroll in a new family plan and find coverage necessary for the whole family.
How Long Can I Provide Health Insurance for My Child?
You can provide health insurance for your dependent child until they turn age 26, at which point they will lose their health coverage.
According to the Centers for Medicare & Medicaid Services (CMS), "The Affordable Care Act requires plans and issuers that offer dependent coverage to make the coverage available until the adult child reaches the age of 26. Both married and unmarried children qualify for this coverage. This rule applies to all plans in the individual market and to new employer plans."1
What Does CHIP Do?
CHIP (the Children's Health Insurance Program) provides comprehensive health coverage for kids who cannot get insurance anywhere else. This coverage can include (but isn’t limited to): routine check-ups, immunizations, doctor visits, and emergency services. Benefits vary depending on your state’s regulations.
Can My Child Get CHIP If I Have Insurance?No, your child cannot get CHIP if you have an ACA plan. If you have this type of health insurance plan, and you learn that you’re eligible for CHIP, you are required to end your plan. You can choose to keep your ACA plan; however, you will no longer qualify for subsidies that may lower to cost of your health insurance plan. You may also have to pay back subsidies that were received while your child was eligible for CHIP.
Find Kids' Health Insurance at HealthMarkets
No matter how your life changes, you can count on HealthMarkets to help you find the health insurance plan that fits the whole family. When you're in need of health insurance for your kids, it's important to understand how the ACA works in favor of your growing family.
1.CMS. Retrieved from https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Market-Reforms/Coverage-for-Young-Adults Accessed on January 22, 2021