Health Insurance 101 is a lesson typically learned on the go. Often you're not even aware how important insurance coverage is, or that your current coverage is inadequate, until you're looking at medical bills and wondering how they got so big so quickly. Obtaining the best coverage possible for your child ahead of time can help you to avoid headaches later on. When considering health coverage, look at co-pays, deductibles, and out-of-pocket costs. Check policies to see if well-child check-ups, immunizations, office visits, and inpatient and outpatient services are covered. Consider your child's dental and vision needs. Even if you're in the middle of medical crisis now, don't lose hope. Your child may still have health coverage options you're not aware of.
Employer-Provided Health Insurance
One of the most common sources of health care coverage for children is insurance provided through a parent's employer. Rules and reimbursement for employer-provided insurance vary from company to company. For example, some companies limit the time period in which you can sign your child up for the insurance coverage, while others do not. Similarly, one employer-provided policy may offer preventative care, low co-pays and low deductibles. Another company may offer a less expensive policy that doesn't cover preventative care and has higher co-pays and deductibles. Dental and vision coverage may or may not be provided. Read the fine print on employer-provided coverage to determine how to make the best of this benefit and if you could need a secondary policy to assist with uncovered costs.
Private Coverage
Private insurance coverage is an option for parents who are unemployed, employed part-time or self-employed. Explore options thoroughly. Because these policies lack the benefit of an employer's financial contribution and group discount, they can be expensive with high out-of-pocket costs and coverage restrictions. Dental and vision coverage may be missing, as well. Again, read the fine print and understand exactly what your child is eligible for and what he is not.
CHIP
The Children's Health Insurance Program is a state and federally funded program that helps to provide low-cost health insurance coverage for children. If your family earns too much money to qualify for Medicaid but can't afford the high cost of health insurance, CHIP maybe the answer. While individual states determine how the CHIP program will be designed--eligibility guidelines, benefit packages, etc.--the insurance they offer must cover well-child visits, immunizations, dental and inpatient and outpatient medical services. To find out about CHIP in your state, go to InsureKidsNow.gov.
Medicaid
Like CHIP, Medicaid is funded by the federal and state government. It can also vary slightly, depending on which state you live in. Different factors play a part in whether your child may be eligible for Medicaid. For instance, a family income at or around the federal poverty level can qualify a child for Medicaid. Certain disabilities, chronic conditions and pregnancy may also qualify a child for Medicaid. Medicaid provides a wide range of services, including preventative care, inpatient and outpatient services, and dental and vision care. In some cases, Medicaid may also help to pay for services your child received in the weeks prior to being approved for Medicaid. Medicaid may also be utilized as a secondary insurance to help to cover out-of-pocket expenses that your primary insurance doesn't cover.
Additional Resources
Prescription assistance, waivers and premium payment assistance are just a few examples of additional health care coverage resources that maybe available for your child. Explore your options on the Financial Assistance Information page provided by the National Institutes of Health, listen in the Resources section. Also, ask your county health department or consult with a social worker at your local hospital. They are often familiar with state and condition-specific resources and can help you find the health care benefits your child needs.
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