Tips for single parents whose children lack health insurance

Insure.com

Although these plans are sometimes difficult to find, you can buy individual health insurance specifically for your children, even as young as 6 months old. Experts say these plans are especially attractive options if you're divorced or if your children spend lengthy summer vacations with relatives halfway across the country, where your health plan might not have a network of doctors.

Before you rush into buying your children their own health plans, there are several factors to consider so you don't end up with a policy that omits needed coverage.

Children of divorce

A child health plan is perhaps most useful when you're divorced and living in a different state than your ex-spouse. The courts will often mandate either you or your ex-spouse provide health coverage for the children.

If you and your children are on a group health plan through your spouse's job and you get divorced, you and your children might be eligible for COBRA coverage, allowing you to keep the same exact health benefits for as long as 36 months. (See Know your COBRA rights). A better option might be for you to take COBRA and keep the children on your ex-spouse's plan. That's fine — as long as you and the children stay in the health plan's service area and you can afford the premiums.

If you move to another state, chances are you'll also be moving out of the service area covered by your HMO or PPO. In this case, you could add your children to another group health plan if you have access to one through your employer.

What happens, though, if your child spends the summer months and other vacations with your ex-spouse in another state? If your child is enrolled in an HMO and it doesn't have national networks, your child might not be covered.

An individual indemnity policy for the child might be the best solution. With a fee-for-service or indemnity policy, the child can see virtually any provider, no matter who the child is staying with at the time. (If your individual plan is an HMO, you can see only network doctors.)

A few HMOs will cover your children wherever they travel. For example, Blue Cross has an HMO plan called "Away From Home Care" that offers coverage nationwide. If your child is enrolled in that HMO, the child is covered even if you and your ex-spouse live in different states. (Note: The Away From Home Care plan is not sold in every state.)

The cost of having children

You might look into adding your child to your plan at work and realize you can't afford the increased cost. Don't be tempted to let the child go uninsured. A serious illness or accident could wipe you out financially.

"As a pediatrician, I know that health care coverage from day one is critical to a child's long-term health," said Dr. T. Berry Brazelton, pediatrician and nationally known parenting expert. "If we want our children to be successful, we have a chance to start by giving them the health care coverage they need and deserve."

If you can’t afford adding your child to your group health insurance at work, shop for an individual health plan for the child, especially if the child is over age 1. (Individual policies for babies are generally double because babies require so many doctor visits, checkups, and immunizations.) You might find a high-deductible individual health insurance plan for a healthy child that will save you money over COBRA premiums.

Before you go with such a plan, make sure you know what benefits the policy provides and compare them to the benefits the child would receive under a group health plan, if one is available to you. The cheapest plan will not always provide the child with the best value for your health insurance dollars.

"As important as counting their little fingers and toes, is accounting for your newborn's health insurance coverage," says Heidi Murkoff, author of the best-selling What To Expect pregnancy and parenting series.

In many states, individual health plans can reject your child due to medical conditions, such as asthma or a history of ear infections.  If the health plan accepts your child, despite health problems, the premiums will likely be expensive. Health plans can also accept your child but refuse to cover certain existing medical problems, which means you'd have to pay for such treatment.

Another major consideration when examining any health plan is the covered benefits. Individual plans often don't cover wellness or preventive care, so you'd have to buy that coverage for an additional monthly fee. Deductibles, co-payments, lifetime dollar limits, and out-of-pocket contributions also must be weighed.

If you meet income qualifications, your child also might be eligible for health insurance through the Children's Health Insurance Program or other state programs.

"It is shocking to think that nearly 5 million children are uninsured when they do not have to be," says Dr. Steven Schroeder, President and CEO of The Robert Wood Johnson Foundation. "Nationally, there are 8 million uninsured children. If we can enroll all children who are currently eligible for [state Children’s Health Insurance Programs] and Medicaid, we would cut the number of uninsured kids to less than half of what it is today."

Last updated February 10, 2003