Before shopping for a medical plan for your child, you need to know more about Children’s health insurance policies and when is the best time to purchase.
As of Sept. 23, 2010, insurance companies that sell “child-only” health plans — as well as individually purchased family plans that cover dependents — cannot deny coverage to anyone under the age of 19 because of a health condition. They also can’t exclude care associated with a pre-existing medical condition.
The Los Angeles Times reports that over the past year many insurers dropped out of the “child-only insurance” market when the Patient Protection and Affordable Care Act took effect, making it impossible in some states to purchase an insurance plan for a child not covered under a family policy. According to a survey released last year by the Senate Health, Education, Labor and Pensions Committee, 39 states had at least one insurer leave the child-only market after the health reform law took effect, and 17 states reported having no carriers selling these plans. The U.S. Department of Health and Human Services has helped by allowing states to take action to fight people’s tendency to delay buying insurance until they need it.
Insurers are temporarily allowed to charge higher premiums for children with a medical condition, though that will end in 2014 — assuming the health reform law is not overturned. The federal government also allows insurers, if permissible by state law, to set up open enrollment periods to deter people from waiting to buy coverage until they’re sick. Although handled differently across the country, in some states people can avoid a financial penalty by buying a plan during open enrollment; for other states, it’s the only time during which a policy is guaranteed.
In California, insurers that refuse to sell child-only plans are barred from selling individual plans of any type for five years. And kids with a pre-existing medical condition who sign up during open enrollment (which takes place during a child’s birthday month) can’t be charged more than twice the rate for a healthier child. That means a kid with diabetes will pay no more than double the rate of a child with no health issues.