Parents are often Health Care Central for their families. They’re the ones who usually make the appointments, fill the prescriptions and pay the bills. This is especially true when it comes to your little ones and their health care. It’s critical to set your child, and yourself, up for success by asking those important insurance questions.

Is your child’s new pediatrician covered? Will your plan cover a hearing test? Every family, especially younger families with kids, has different needs – both health-wise and financially. Here are three things every parent needs to know when trying to find the best health insurance plan for their kids.

What to look for in a health insurance plan for young kids

When looking for the health insurance plan that’ll best support your child, it’s important to remember that kids generally require more care. Whether for regular check-ups and immunizations, pesky daycare colds or surprise high fevers, children see the doctor more than healthy adults. That means you need the kind of health insurance plan that will support frequent health care provider visits at a cost your family can manage.

Preventive care coverage: Check-ups and immunizations

Preventive care can help set up your child for better long-term health. Regular check-ups, immunizations and screenings for development can help identify and prevent potential issues. Most health insurance plans cover preventive care services for kids at no extra cost, including all childhood vaccinations recommended by the Centers for Disease Control and Prevention (CDC).

Pediatric specialists and hospitals

Sometimes, the kind of care a child may need extends further than a primary care doctor. If your little one has a chronic condition or unique developmental needs, it’s important to make sure your plan covers coverage for pediatric specialists and hospitals. These providers specialize in specific areas of children’s health outside of general pediatrics. This can include pediatric cardiologists, child neurologists and much more.

Prescription coverage for common childhood illnesses

As a parent, you know better than anyone else how frequently kids get sick. Their immune systems are still developing, and they’re being exposed to new germs and illnesses every day. From chickenpox to colds and flu to pink eye, the right insurance plan should help cover your child’s treatment and prescription needs. Look for a plan that’s compliant with the Affordable Care Act (ACA), as they must cover prescription drugs and many health services for children.

Pediatric dental and vision coverage

Unlike adults, many dental and vision services for children under the age of 19 are often covered under comprehensive health insurance plans. The ACA deems pediatric oral and vision care as “essential health benefits” and often covers routine care. This includes regular eye exams, glasses, dental cleanings, fillings and more.

What health insurance options are available for families with children?

Fortunately, there are many health insurance options that can help meet your little one’s needs. Often, parents will go for a family plan that covers all members of a household, including young children as dependents. These can be provided through an employer or bought independently from the health insurance marketplace or a private insurance provider.

Individual or private health insurance

A private health insurance plan is one you can buy directly from a health insurance company. Private health insurance plans, like those offered by HealthPartners, provide a range of coverage options, so you can choose your health insurance based on you and your child’s needs.

Every plan is different, but when you stay in your network, most plans will cover the routine, recommended doctor visits, immunizations and tests your child will need for free. This means that if you have a family plan from a private health insurer, a lot of the services your child might need are typically covered. You can change or enroll in a private individual or family plan during the annual Open Enrollment Period (OEP) which happens each fall.

Employer-sponsored health insurance

When you receive health coverage through work, this is known as employer-sponsored health insurance. With this set up, your employer works alongside a private health insurance company to offer select health plan options. As an employee, you can choose your preferred plan based on your needs. Often, employer-sponsored health insurance is offered to you as an individual or you can cover your family, including children, as dependents with a family plan.

Marketplace health insurance

The health insurance marketplace is a federal or state exchange where you can buy health insurance coverage. Much like those offered by private insurance companies, plans purchased on a state or federal marketplace can include both individual, family and child-only options.

Marketplace plans are organized into four metal types (gold, silver, bronze and platinum), and they typically include coverage for emergency services and hospitalization, outpatient care, prescriptions, pregnancy and maternity care, mental health care and preventive health services.

For those on a budget, some marketplace plans are eligible for ACA premium tax credits and subsidies. If you qualify for an ACA subsidy, it can help offset the cost of coverage.

Medicaid

For those with limited income, the federal government offers programs that may help you better afford care for your little one. For instance, you can see if you qualify for Medicaid, a federal and state program that provides low-cost or free coverage to families who need assistance. Eligibility changes depending on which state you live in. In Minnesota, the Medicaid program is called Medical Assistance.

Not eligible for Medicaid? Residents of Minnesota can also consider MinnesotaCare, a state-run program that helps low-income families who don’t qualify for Medicaid get access to affordable coverage and care.

Children’s Health Insurance Program (CHIP)

Another program that may help is the Children’s Health Insurance Program, also known as CHIP. CHIP provides low-cost health coverage to children. Often, this is a great choice for families who earn too much to participate in Medicaid but who still need help with their kids’ health insurance coverage. Each state offers CHIP coverage which works alongside its state Medicaid program.

Can I get health insurance just for my child?

If you’re not looking for a family plan, some health insurance companies offer child-only health insurance plans. While each plan is different, coverage tends to be more comprehensive, although sometimes costly.

3 tips to finding the best health insurance plan for your kids

Once you know what your options are, it’s time to narrow down on your family’s needs. Here are some things to consider when looking for the right plan.

1. Explore plans with higher monthly premiums
As mentioned, kids are more likely to utilize care than the average adult. When choosing a plan, look past the monthly cost. Sometimes a family may choose a plan because the monthly costs are low, only to be disappointed when they pay more each time they use care.

For families with young kids, consider a plan with higher monthly costs. This means you’ll experience lower costs for care and pay a lower amount before your plan starts helping with costs (deductible). If you need a lot of care, this will save you money and keep your budget more consistent.

2. Take advantage of free services
Familiarize yourself with a list of free health care services for children. If you’re shopping for coverage, ask the health insurance companies you're considering what they cover for free and how much other common kids’ services (like a doctor visit when the baby is sick) will cost on different types of plans.

3. Prioritize your pediatrician
Your pediatrician is a key partner in keeping your child healthy and happy. It’s worth every minute to take the time to find a pediatrician who’s a good fit with your family and whose office location and hours fit your schedule. If you already have a pediatrician you like, call the insurance company and have them check to make sure they are covered.

Choosing a health plan for your family is an important decision. It’s never a bad idea to consult an adviser, plan representative or other trusted partner to help make the decision.

Have more questions about health insurance?

Our experts will help you find a health plan for you and your children that you’re confident in no matter your situation.