How to Find Health Insurance for Children

Research suggests that children in the United States who do not have insurance are more likely to have unmet medical needs compared to children who have health insurance.

According to the Children’s Hospital Association, around 95% of all children in the United States have some form of insurance coverage — private, state-sponsored, or federal options.

The number of children who have insurance has risen over the decades as state and federal governments have prioritized providing affordable coverage for children. But over 4 million children still have no health insurance coverage.

If you are one of the more than 4 million families with no health insurance coverage for your children, or if you are facing the loss of your child’s current health insurance, this article is for you.

Read on for information about how to find health insurance for children, how to enroll them, and other important information you need to know.

Health insurance is designed to help cover the costs of healthcare — from routine checkups to long-term care.

Access to coverage is especially important for children since uninsured children in the United States are more likely to have unmet medical needs. These urgent healthcare needs include services like routine physicals and vaccinations, to treatment for illnesses that can worsen without treatment, like ear infections and respiratory tract infections.

One important way to improve the health of children is to help them access health insurance.

There are several ways to find health insurance for a child. Some options are designed specifically for low income families. Depending on the parents’ income, these options may be affordable or free.

Here are two main options for healthcare for children: public plans and private plans. The most common options for each type include:

These insurance options are provided by the United States government:

Medicaid is a program sponsored by the federal and state governments. It provides low cost insurance coverage for families with limited income. Children can be enrolled at any time — there is no open enrollment period limitation — and, in some circumstances, may be automatically enrolled if a parent is enrolled.

Eligibility for Medicaid is based on the family’s income and the child’s age. In 2025, a family’s income must be between 133% to 375% of the federal poverty level (FPL), based on the child’s age and the state in which they live. These income standards change slightly each year.

The current FPL is $15,650 for an individual and $21,150 for a household of two people. The amount goes up as the family size increases. The FPL amount also typically changes annually.

Medicaid covers newborns, preventive care, prescription drugs, specialist care, hospitalizations, and more.

You can find more information about how to enroll your child in Medicaid in your state at the HealthCare.gov website.

CHIP offers low cost health coverage to children and some pregnant people who do not qualify for Medicaid. CHIP eligibility rules and costs vary from state to state, but they range from 170% to 400% of FPL, and you’ll never pay more than 5% of your total family income per year.

Like Medicare, children may enroll in CHIP at any time of the year through their state’s Medicaid office or by phone.

• routine checkups (well-child visits are free, but some services have a small fee)
• immunizations
• doctors’ and dental visits
• vision care
• hospital services
• behavioral health (mental health) support
• emergency care

You can find more information about how to enroll your child in CHIP in your state at the HealthCare.gov website.

Medicare is government-sponsored insurance primarily for individuals ages 65 years and older; however, some people younger than age 65 years — including children — may also qualify.

Children who qualify for Medicare may enroll any time after they receive a qualifying diagnosis or if they qualify and have a loss of their private insurance coverage.

For Medicare, a “child” is defined as an unmarried person younger than 22 years old or a person between ages 22 and 26 years who meets other requirements.

One parent has earned credits toward Medicare by working and paying Social Security OR one parent is receiving or is eligible for Social Security or Railroad Retirement Board benefits, and:

• They have end stage renal disease (ESRD), and all the following conditions apply:
  • Their kidneys no longer work.
  • They need regular dialysis or have had a kidney transplant.
  • They are a dependent child of a person who meets either of the requirements listed above.

• They are between ages 20 and 22 years and currently receive Social Security disability benefits.

In addition to meeting the conditions for ESRD and at the qualifying age to be eligible for Medicare, a child must be related to a person who currently qualifies for or is receiving Social Security or Railroad Retirement benefits as one of these:

• a biological child
• a legally adopted child
• a stepchild (for over 1 year)
• a grandchild or step-grandchild (in some cases)

For families who do not qualify for Medicaid or CHIP, private insurance options are available, such as:

These insurance policies are subsidized by employers, and a child is typically covered through plans that cover the entire family or the employee and a child or children. Typically, the employer pays a portion of the cost, and the employee (parent) will pay the remaining premium.

Private plans typically cover the same services as public plans — routine care, hospital services, emergency care, and others. Exact services and costs will vary by insurance company.

Depending on the type of plan, there may be out-of-pocket costs for medical appointments and services, and routine pediatric care may be covered completely.

Child-only plans can be purchased through the federal Affordable Care Act (ACA) Health Insurance Marketplace or directly from insurers. Many large insurers — Aetna, Anthem Blue Cross, Cigna, UnitedHealthcare, Blue Shield of California, and Kaiser Permanente — offer plans that meet the health needs of children.

These plans may be purchased by parents or guardians on behalf of a minor if they’re not covered under a family or group policy.

Marketplace plans must include essential health benefits like preventive care, emergency coverage, hospitalization, prescription drugs, and pediatric dental and vision services. Tax credits and cost-sharing reductions are available based on household income, making coverage more affordable for moderate income families.

Families may purchase child-only plans directly from various insurance providers. Short-term health insurance is available for urgent coverage needs, such as playing sports or traveling. However, these plans usually do not cover preexisting conditions, and they may not cover routine pediatric care.

These plans may not be a good option for children who need ongoing healthcare. They are typically only a short-term solution and are usually not recommended for ongoing child health coverage.

Finding health insurance for children involves understanding eligibility rules, knowing which programs are available, and comparing plan benefits and costs.

Your choices will depend on your family’s income, where you live, and your child’s individual health needs. You have options from free public-funded insurance coverage to private insurance through your employer or through the healthcare exchanges.

Most states offer free assisters to help individuals navigate the ACA Health Insurance Marketplace, and most companies have human resources staff who can help if you are choosing employer-sponsored health insurance.

High quality health insurance is available for most children in the United States, but knowing your options is key.