Having kids is an exciting (and exhausting) time. There are so many things to look forward to and stay on top of, re-examining your health insurance might not seem like the most important. But the first time your child(ren) gets sick, you want to know that you have a doctor you can trust and that you won’t have to worry about a huge bill on top of caring for your little one. To ensure you have the right health insurance for your children, consider these three key points.
1. What does the health insurance plan cover and how much are you responsible for out-of-pocket?
If you currently have a health insurance plan, examine your benefits statement to see the level of care it covers for your child. Are well visits and immunizations included pre-deductible? What are the copays for sick visits? What if your child needs to see a specialist, how does that work?
If you already have kids and one or multiple have conditions that need to be managed, you’ll want to make sure your health insurance plan covers the care and prescriptions they need without requiring a large out-of-pocket contribution from you. If you’re considering changing health insurance plans but want to keep the pediatrician you like, you’ll want to make sure they’re included in the provider networks of any plans you’re considering.
You should also consider your child’s/children’s hobbies. For instance, if your child is an avid skateboarder and has more than their share of broken arms, you might want to choose a plan that covers care for these injuries.
If you're expecting your first child and don’t know where to start, Healthline has an article that walks you through child well visits and immunizations for the first four years. In addition, you can check out this page on Medlineplus.gov, a site maintained by the National Institute of Health, that outlines common infant and newborn ailments. Once you have a handle on what to expect in those first years, review your current health insurance plan to make sure it offers adequate coverage. Then interview pediatricians within its network to make sure you can find a good fit. If you can’t find a doctor you like within the network, ask friends and family for recommendations and research the insurance plans that include those healthcare providers.
Another thing to note: children can stay on their parents’ health insurance until the age of 26, which is great news if you have kids going to college or for those who don’t have employer-sponsored health insurance.
2. What is my monthly budget for premiums and HSA contributions?
Along with the joy and unconditional love, kids come with some added expenses. You want to make sure you’re not insurance-poor, meaning you can actually afford the level of health coverage you have, but you also want to ensure you have adequate coverage should your child get sick. One way to offset the cost of copays, deductibles and other out-of-pocket expenses, is to contribute to a health savings account (HSA) if your employer offers one. The money is contributed pre-tax, which means you could end up saving up to 30% on those medical expenses, depending on your tax liabilities. The only requirement to contribute to an HSA is that you purchase a High Deductible Health Plan (HDHP).
3. Does my family qualify for help in paying for health insurance?
If you’re struggling to pay for health insurance, you might qualify for assistance through Medicaid, CHIP, and premium tax credits and cost-sharing reductions available through the Healthcare.gov marketplace. To find out if your family is eligible for any of these federal or state-run programs, visit Healthcare.gov.
Starting a family is an exciting time filled with expectations and its share of worries. You can alleviate some of those anxieties by choosing the right health insurance plan for your family.
Disclaimer: the content presented in this article are for informational purposes only, and is not, and must not be considered tax, investment, legal, accounting or financial planning advice, nor a recommendation as to a specific course of action. Investors should consult all available information, including fund prospectuses, and consult with appropriate tax, investment, accounting, legal, and accounting professionals, as appropriate, before making any investment or utilizing any financial planning strategy.