Health Insurance for Kids in 2016 and 2017
In 2014 major changes enacted by the Affordable Care Act (Obamacare) made child-only health insurance plans – private health insurance plans that only cover a child (no adult on the policy) –available to children in any state.
Health insurance for your child
Here are the basic pieces of information you need to know:
- Outside of open enrollment periods: For 2017 Obamacare’s open enrollment period is scheduled to run from November 1, 2016 until January 31, 2017. Outside of open enrollment it may not be possible to get Obamacare-compliant coverage for yourself or your child unless you can show that you have experienced a qualifying major life event.
- Qualifying life events: You may be able to enroll in an Obamacare health insurance plan after January 31, 2017 if you experience what is known as a qualifying life event. These include the birth or adoption of a child, marriage or divorce, the loss of employer-based coverage, or moving to a new coverage area. Qualifying life events may trigger a sixty-day open enrollment window for you or your child.
- Investigate short-term coverage: If you’re applying for health insurance outside of the enrollment period, eHealth suggests that consumers consider short-term health insurance plans. Be aware, however, that these plans will not provide you with robust coverage and it is possible to be declined based on your health or medical history.
- Having a baby is a qualifying life event under Obamacare: If you have a baby and you’re uninsured, you have 60 days to buy insurance for yourself and your child. If you buy coverage after your child is born, coverage can typically start within 30 days.
- Getting pregnant is NOT a qualifying event: If you’re uninsured today, and you get pregnant, that does not make you eligible to enroll in a new health plan. You must apply for coverage during the nationwide Obamacare open enrollment period or within the sixty-day window following a qualifying life event.
- If you miss your 60 day window, you’ll likely have to wait until open enrollment: If you have a qualifying life event but miss your special enrollment window, you may need to wait until you experience another qualifying life event or until the next Obamacare open enrollment period before you can enroll in coverage.
- Grandchildren are not eligible for coverage on a grandparent’s policy: There may be exceptions to this rule (for example, if the grandparents have legal custody of the children), so it’s worth calling and talking to a licensed agent.
- If you missed your newborn’s 60 day enrollment window, you still have options: If you’ve missed your newborn’s window to buy new coverage, or if you’re uninsured and expecting a baby, you may be able to enroll in other “gap” insurance products that can provide some measure of financial protection until the next open enrollment period begins.
- You may qualify for a subsidy (like a discount) to help you pay for health insurance: The Affordable Care Act makes subsidies available to help lower and middle-income families pay for health insurance.
Here is a summary of the types of plans you can apply for:
This video explains how the enrollment periods work
To learn more about the status and availability of child-only health insurance plans in your area, contact a licensed health insurance agent like eHealthInsurance or your state’s department of insurance.