Health Insurance for Children

Keeping our children safe and healthy is a high priority for many people. And due to the unpredictable nature of life with kids, accidents and emergencies happen and may require medical attention. Having health insurance for your children allows you the peace of mind to know if something were to happen, they have access to the care they need.

Do I need health insurance for my kids?

In addition to regular health check-ups, there are many reasons to get health insurance for your kids. Getting insurance for your children can help you pay for doctors’ visits, treatments, and other medical services.

There are several reasons to consider having health insurance for kids:

• General seasonal illnesses – As children’s immune systems develop, they may be more susceptible to getting sick (especially if they’re in school or daycare).
• Accidents, emergencies, and surgeries from unexpected life events or sports-related injuries.
• Pre-existing medical conditions that require ongoing treatment and medications.
• Routine preventive care and immunizations to help keep your children healthy.¹

What should I look for in health insurance plans for children?

It depends on how much you can afford to pay and how much coverage you need. Does your child have a pre-existing medical condition that requires ongoing treatment or medication? Do you also want to get vision, dental, or hearing coverage? Are your children involved in sports?

Different health plans offer different coverage. Be sure to read all plan documentation thoroughly before deciding on a health plan for your child.

What are the types of health insurance plans for children?

Options for kids’ health insurance include Medicaid, the Children's Health Insurance Program (CHIP), the Health Insurance Marketplace, or through a private insurer like Cigna Healthcare^SM*.

What are the ways to get health insurance for my child?

There are options for insuring your children. The first and easiest would be through your plan through your employer, and your child would be a dependent under your plan.

Some employers however do not offer the option to cover your child. In this case you could look into Medicaid and/or CHIP plans on the Health Insurance Marketplace, or through a private insurer such as Cigna Healthcare.

Medicaid and the Children’s Health Insurance Program (CHIP) Plans

CHIP plans are designed to offer an affordable health care option to lower-income families that do not qualify for Medicaid. However, you still need to meet certain financial and non-financial Medicaid requirements.

You can apply at any time of the year and your coverage may start immediately, though some states may take up to 90 days for your coverage to start. You can also have a deductible and/or copay, depending on your plan.

Covered Medicaid services vary by state, but most include:

• Routine doctor, dentist, and vision care
• Immunizations
• Emergency services
• Inpatient and outpatient hospital care
• Prescriptions
• Laboratory and x-rays

Health Insurance Plans Through an Insurance Company

Most private insurers, like Cigna Healthcare allow you the option to cover only your child. However, while these plans can have more comprehensive coverage, they may also cost more. You will also need to enroll during open enrollment or through a special enrollment period.

Before deciding on a plan, be sure to thoroughly read all plan documentation to be sure you get the level of coverage your child needs.

Health Insurance Plans Through the Marketplace

The Health Insurance Marketplace is an easy way to compare plans, and you may qualify for financial help from the government (also known as a subsidy).

Plans offered on the Marketplace cover these essential health benefits:

• Preventive health services such as well-visits, screenings, and immunizations
• Emergency services
• Ambulatory services
• Hospital stays (both inpatient and outpatient)
• Mental health and substance use disorder services (including counseling and psychotherapy)
• Prescription drugs
• Rehabilitative and habilitative services
• Laboratory services
• Preventive and wellness services and chronic disease management
• Pediatric services, including oral and vision care

Plans also may include dental and vision coverage and medical management programs (for chronic pain, diabetes, and weight management).

Can I get my child short-term health insurance?

Short-term health insurance is a good option if you need coverage quickly or if you need to bridge a gap in coverage due to unemployment. Plans are month to month, so if you need to discontinue your coverage for any reason you have the flexibility to cancel.

Short-term plans can be an affordable option, but coverage is limited, and if your child has a pre-existing health condition, they will not qualify.

How much does health insurance for children cost?

The least expensive options are Medicaid and the CHIP plans, but you will also need to meet certain financial qualifications. Plans offered on the Health Insurance Marketplace will also vary in cost.

Rates vary for plans through private insurers like Cigna Healthcare, so it’s important to do your research before buying a plan. You can also get coverage through a short-term plan, but these only cover emergencies and you may end up paying heavily out-of-pocket for other health-related expenses.

Can I get health insurance for my child only?

Yes. You can get child-only health insurance through Medicaid and CHIP plans, on the Health Insurance Marketplace, or through a private health insurer, such as Cigna Healthcare. Cost and coverage vary by plan, so be sure to factor this in when choosing a plan.

Do I need to get my child separate dental and vision insurance?

Possibly, and it really depends on where you get your plan. Some plans cover routine dental and vision care, while others do not. Most children do not have official eye exams until they are 3. Your child’s pediatrician may recommend official dental visits anywhere between when their first tooth erupts and age 3 or 4.

If your child needs dental or vision coverage, be sure to read all plan documentation carefully.

How long can my child stay on my health insurance?

The Affordable Care Act (ACA) requires insurers to allow children to stay on a parent or guardian’s plan until the end of the year that they turn 26. This applies to married children as well.

There are many reasons why your child may need health insurance. Think about your family’s needs and what kind of coverage you need. Make sure to review all your options before choosing a health plan.

*Offered by Cigna Health and Life Insurance Company or its affiliates

In Utah, plans are offered by Cigna Health and Life Insurance Company

Cigna Healthcare products and services are provided exclusively by or through operating subsidiaries of The Cigna Group^SM, including Cigna Health and Life Insurance Company, Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of South Carolina, Inc., and Cigna HealthCare of Texas, Inc. In Utah, all products and services are provided by Cigna Health and Life Insurance Company (Bloomfield, CT).

¹ Plans may vary. Includes eligible in-network preventive care services. Some preventive care services may not be covered, including most immunizations for travel. Reference plan documents for a list of covered and non-covered preventive care services.

This page is not intended for use in AZ.