“When health care reform was passed in 2010, many applauded the provision that children could no longer be denied health insurance coverage due to pre-existing conditions, but there’s decidedly less clapping now.
“As an unintended consequence of health reform, a lot of insurers stopped offering individual coverage for children. That put parents in a bind, and children in danger. How would you feel if you were told that you children could no longer be declined for health insurance, but then you found that no plans were actually available?” asks Carrie McLean, a consumer health insurance expert with eHealthInsurance.com.
The situation is severe. There are an estimated 6 million children in the U.S. without health insurance. “While more insurers and states are stepping up the plate this year, in over 20 states today, there is no child-only health insurance on the market. Even when child-only plans are available, their availability may be limited to a single insurer or to specific once-a-year enrollment periods,” says McLean.
They may also be expensive. “Two years later, the unintended consequence of this new regulation is that many parents now wait to purchase a policy for their child until after they are already sick and have expensive medical bills looming. This drives the cost of child-only health insurance up so high that premiums in many states are unaffordable,” explains Joel Ohman, founder of InsuranceProviders.com.
When children don’t receive proper health care from the start, the fallout can last a lifetime. The big question is, what can parents do?
Check to see if health insurers are still offering child-only policies in your state. You can find out from your State Insurance Department. Ask too, if the state is holding a child-only open enrollment period. Many states have two enrollment periods a year.
Another alternative, says Erinn Springer, media specialist with GoHealthInsurance.com an online portal for finding health insurance coverage, is try to add a child to an individual or group health policy as a dependent. “Children will not be turned down coverage when added to an adult’s individual plan or when added as a dependent to a group plan,” says Springer.
Review your state’s eligibility requirements for the Children’s Health Insurance Program (CHIP), also known as Medicaid. Many states have expanded CHIP coverage in the past few years.
Do investigate your state’s Pre-Existing Condition Insurance (PCIP) Program to see if you child is eligible. This plan provides coverage for individuals with pre-existing conditions with funds from health care reform. “While it’s a great and affordable option, children cannot have health insurance coverage for six months prior to enrolling in the plan,” says Springer. You can learn more about PCIP here.
You can also call health insurance companies directly to ask about their child-only coverage, because in some states, health insurance companies may not sell child-only plans through agents.
Know too, that just because you miss the enrollment period, there may be some wiggle room and you may be able to apply. However, you could face potentially higher premiums as a result, says Phil Lebherz, executive director of the Foundation for Health Coverage Education. If you qualify, you may be able to find coverage for your child through government programs depending on your income by going to www.CoverageForAll.org
or calling the U.S. Uninsured Help Line, 800-234-1317.
“If you lost your family coverage due to a lay-off and can’t afford COBRA, remember that in many states, this is a qualifying event and may allow you to enroll your kids in a child-only plan,” says McLean.
Unfortunately, says Springer, right now there isn’t a one-size-fits-all solution for finding child-only coverage; it is heavily dependent on the state. You can find a chart outlining state by state availability and open enrollment period for child-only coverage here .
Lastly, says McLean, “No one wants to see children go without health insurance and access to medical care, but despite health reform’s best intentions, children are falling through the cracks right now. Not all of them need to. Parents should take some time to understand the options in their state and do what they can to avoid letting their children go uninsured.””