Children’s Health Insurance: What to Choose and What to Avoid

December 4, 2013

Choosing the right health insurance plan for your child can be a daunting task. The Affordable Care Act (ACA) mandates that all Americans – adults and children – be covered by a qualified plan by Jan. 1, 2014. So here’s what you need to know about coverage for your kids:

Find the Right Family Plan

Most people will choose a family plan from Covered California, the state’s online marketplace for health insurance. A family plan covers adults and children equally, generally with the same copays and deductibles. A platinum or gold plan carries the highest monthly premiums but provides the most insurance; silver and bronze plans have a less expensive monthly cost, but healthcare will cost more.

Under the new law, children can stay on their parents’ health insurance plan until they reach the age of 26.

What Is Right for My Child?

Most children tend to have fewer chronic health problems than adults and might not need as much coverage. A healthy child won’t have monthly prescription costs or as many routine screenings as an adult. However, children do need immunizations, yearly physicals and may be more accident-prone than their parents.

A good health plan for your child will need to include wellness checkups, emergency medical treatment, a low prescription copay for medication and coverage for procedures, such as x-rays.

What Should I Avoid?

Unless your child has chronic health conditions, frequent surgeries or high-dollar drug costs, you should avoid purchasing too much insurance. Your monthly premium needs to be paid regardless of whether your child uses healthcare services; purchasing a plan that covers more than you need is, in a way, like flushing money down the drain.

Of course, choosing the wrong coverage is dangerous, too. A plan that has drastically high copays for routine office visits can lead to more out-of-pocket costs than you’d counted on. Kids are notorious for ear infections, mystery stomach bugs and bumps and bruises that may necessitate a visit to the pediatrician.

Finding the Balance

For parents looking to insure the whole family, it’s necessary to find the right balance between the needs of the adults and the needs of the children. Relatively healthy families might score significant savings by choosing a silver or bronze tier, while adults with health complications will probably need to choose a gold or platinum plan regardless of their hale and hearty children’s perfect attendance records.

Still confused about the right level of coverage? Contact us and we’ll help make sure your whole family is protected from all of life’s skinned knees and sore throats.

Post author Loren Pleet