Health insurance for kids

Today we're going to talk all about health insurance plans for kids. So whether your kids play sports or they're just active little monkeys like my girls are, you want to make sure that your health plan really covers you and covers your kids for the unexpected things that can come up, whether it's sickness or whether they get hurt. And so the first type of plan that you can have is an employer plan. And that's if the children, so let's say you work for an employer and that employer offers health insurance, you have the option to add your family. You can add your spouse or your spouse independence or just your dependence to that plan. So typically like the pros of these kinds of plans are that they're usually PPO type plans. So they're preferred provider organization type of plans, and they're sponsored by an employer. So they're typically more expensive and better plans that you probably wouldn't be able to get on your own for the same or similar costs. And so the benefits of that is that you have access to the doctors and hospitals. So most likely the hospitals that you're going to need to be a network or the pediatric urgent cares or your pediatrician will probably all take those type of plans. And another benefit to having these plans is that a lot of times the employer will subsidize. So they'll pay for a portion of the parent's plan, the employee, and sometimes even they'll pay for a portion of the kid's plan as well. It depending on the employer. And so some of the things that are drawbacks of these type of plans are number one, you're stuck, you know, you're dependent on the employer. And so what if the employer lays you off? Or what if the employer changes insurance for the following year and goes to like a cheaper HMO type of plan? And then you've got to switch doctors and all that. You don't have the authority and the autonomy over your plan when it's tied to an employer. And then another con would be that it could be really expensive to add the children to your plan. And so all of those things are things to consider when it comes to employer plans. So number two are CHIP programs or state funded insurance programs for children. So the whole premise is, you know, everybody, every child should have access to affordable healthcare. And so these programs are in a lot of the states and I'll use Florida as an example since that's my home state. In Florida, we have a program called Florida Healthy Kids. And Florida Healthy Kids has two options. First of all, it has year round enrollment. So if a child is, you know, outside of the open enrollment period for the marketplace, they can still get on one of these plans. At least the children can. These are not plans that the parents can get on also. And these plans, the way it works in Florida is you have two options. You can either do a subsidized pay. And for that, you have to have low income, a low enough income that then the government will pay a portion of that. So you might get a plan for as low as $20 a kid or you pay the full pay amount. So if your income is above a certain threshold, you'll have to pay full price for the plan. So here it's a little over 200 bucks per kid. It could get expensive if you have more than one kid. But that is something that's available year round. And also one of the drawbacks is limited access to doctors and hospitals depending on what city that you're in. So what I see is the trend is like the busier cities, like a city like Miami or Lauderdale, you're not going to have trouble finding doctors who accept those plans. Whereas like if you live in a smaller town, it might be a little bit more difficult. The third type of plan for your children is the Affordable Care Act or the ACA marketplace. So a lot of people don't know this and it's a common question I get, but you kids can actually have their very own marketplace plan. So one of the things that I get is like from children age zero to 12 months, they're actually not eligible for the CHIP program, at least in Florida. They're not eligible for the healthy kids. It only starts at age one. So what do the people do in that gap period, right? In that zero to 12 months, you can actually get your child during open enrollment, their very own ACA plan. And those plans typically, it's like I always talk about ACA plans and marketplace plans. Most of the plans have higher deductibles. They're more limited networks. They've gotten pretty expensive. You can find PPO options, not in every single state, but you can on the marketplace. You just really have to make sure that the doctors that you want accept those plans. The good side about it is that you can enroll during open enrollment or your child can, or you can enroll if you have a qualifying life event. So if a child is just born, that is a qualifying life event, or also losing their health coverage, let's say through an employer, that's also a qualifying life event, or then you can hop, you know, put your child and enroll them into a marketplace plan. Again, you know, sometimes higher deductibles, less access, but the good news is that you can have that on their own. Another place where I see this being a big benefit is in like a family. Let's say you have multiple children. Let's say you have three kids and one of your child, one of your children has some special needs where they're on some certain medication that, you know, is pretty expensive medication. The other two kids are perfectly healthy. Well, you don't want to have to have the same insurance plan, or you don't necessarily have to have the same insurance plan for all three kids. And so for the child that needs a little bit more care, they need that medication, they can have their very own marketplace plan. The fourth type of insurance plan that you can get for kids is underwritten private coverage. And so these types of plans tend to be, also have access to a PPO network, which we've talked about, great access to doctors and hospitals. One of the drawbacks of these plans, though, is that a lot of them do not enroll children by themselves. So the children have to be on with at least one parent. You can have one parent and four children, that's fine. But one parent has to be on with any of the children. And so a lot of times, like a family will come to me and they just want coverage for their kids, because maybe they get covered, the employee, through their employer job or employer plan. And that employer plan offers an enrollment for the kids, but it's way too expensive. So a lot of times on this private underwritten coverage, because there's so many benefits to it, and especially the cost of it tends to be one of the lowest, as long as you medically qualify, we're able to put the whole family onto the private underwritten coverage at a fraction of the cost of what it would be to put them on the state program, the CHIP program, or on the affordable care marketplace on their own. And again, access to the doctors and hospitals is huge with that. And a lot of times those underwritten plans, they have a lot of great accident injury coverage built in where it'll supplement your plan so that you don't have to meet a really high deductible before they kick in for the common stuff, like the broken bones and things like that. So if you have more questions on what types of plans are the best to enroll your kids in, don't hesitate to reach out to me at alexandracontos.com. 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