The Affordable Care Act (ACA), also known as ObamaCare, gives parents a variety of options to get appropriate health insurance for their children. Parents currently have the option to cover their through their employer’s insurance plan up to age 26 if their employer offers dependent care, take advantage of a marketplace plan, or use Medicaid or Children’s Health Insurance Program (CHIP) coverage.
It is important to note that children are part of the individual mandate for health insurance coverage, and are subject to a penalty if not covered by 2014. The penalty for uncovered children under the age of 18 is $47.50 (one half the amount of the adult penalty), and there is a family maximum. The adult penalty $95 per person or 1% of the household income (whichever is higher).
Key Benefits for Children’s Health
The ACA introduced a series of essential health benefits that must be included in new plans by 2014. These benefits include pediatric vision and dental care, which eliminates the need for parents to have separate vision or dental policies for their children.
Preventive care is also among these health insurance benefits, and is particularly important for children. Thanks to ObamaCare, these preventive benefits are offered with no cost sharing – that means that the family doesn’t have to pay a copayment or deductible for the care. With benefits ranging from developmental, vision and hearing screening to vaccinations, these preventive health services will start children on a healthy path early in life. Preventive services continue through childhood and into adult life. For more information about children’s preventive health care, visit the Healthcare.gov Preventive Benefits site.
Obtaining Health Insurance for Children
Many parents are able to cover their children through workplace insurance. Due to the ACA, these parents can now cover their children until their 26th birthday. This is true even if the children are married, not living in the parent’s household, attending school, not financially dependent on their parents, or eligible to enroll in their own employer’s plan.
If the child is not able to be covered on a parent’s workplace insurance, coverage can also be purchased through the marketplace. The entire family doesn’t need to purchase coverage through the marketplace; they offer policies that cover children only, as well. All marketplace policies will offer the essential health benefits, including the preventive benefits described above.
A family who uses the marketplace to get health insurance may qualify for help with the cost of health coverage. Individuals and families with income between 100% – 400% of the federal poverty level will be eligible for tax credits to reduce insurance premiums. In addition, those earning 100% – 250% of the federal poverty level will be eligible for assistance with insurance cost-sharing, like deductibles and copayments. In 2013, a family of four with income between $23,550 and $94,200 would qualify for some sort of assistance. For more information about whether your family might qualify, Healthcare.gov provides a Quick Check Chart showing assistance based on income and family size.
Children can qualify for health insurance through Medicaid or CHIP even if their parents are working. CHIP provides low-cost health insurance to children in families that earn too much to qualify for Medicaid. In some states, CHIP also offers coverage for parents and pregnant women. To determine eligibility, parents can either fill out a marketplace application or visit InsureKidsNow.gov.
As described on Healthcare.gov “Medicaid provides health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities. Medicaid programs must follow federal guidelines, but they vary somewhat from state to state.”
Medicaid and CHIP benefits vary by state, but each offers comprehensive coverage including check-ups, doctor visits, emergency care, immunization, prescriptions, and dental and vision care. To find out more information about what services are provided in a particular state, visit the state index at Insure Kids Now.
Medicaid and CHIP eligibility is expanding in many states, even working parents without health insurance can seek coverage for themselves and their children. If a parent fills out a marketplace application, they will automatically be notified if they qualify for Medicaid or CHIP.
Whether a parent has the option to cover their children under workplace coverage or decides to seek separate coverage, taking care of a child’s health is essential to giving them a bright future.