Protect Your Child’s Health
Florida families have multiple health care coverage options for their kids when parents do not have an affordable offer of coverage from another source such as employment or military benefits. This blog will briefly discuss each option and explain how to navigate the choices to protect your child’s health.
- Medicaid Children’s Health Insurance Program – This combined Federal-State program provides comprehensive health coverage for children under the age of 19 with a household income of up to 133% of the federal poverty level ($33,383 per year for a family of 4). Medicaid/CHIP offers full coverage for the child’s medical, behavioral health, prescription, dental, and therapy needs. There are no monthly premiums for Medicaid/CHIP and no deductibles.
- Florida KidCare is operated by the Florida Healthy Kids Coalition and offers three coverage options for children under the age of 19. The options are: (1) $15 per month per child for a family with income up to 158% of the federal poverty level ($39,659 for a family of 4), (2) $20 per month per child for a family with income up to 200% of the federal poverty level ($48,200 for a family of 4). KidCare’s reduced-cost plans have no deductibles and minimal co-pays. (3) KidCare also offers a Full Pay option with monthly premiums starting at $215/month for families whose income exceeds 200% of the federal poverty limit.
- The Health Insurance Marketplace offers plans to children in households that do not qualify for Medicaid or Florida KidCare’s reduced cost options. Families with incomes between 200.01% and 400% of the federal poverty level ($61,500 for a family of 4) typically receive financial assistance to help pay for their child’s plan. Marketplace plans are private health insurance coverage offered through commercial insurance companies. The plan choices vary by county but in all cases, plans are required to offer 10 Essential Health Benefits plus an option for dental coverage to plan participants.
Choosing the Right Plan for Your Child
The State of Florida’s No Wrong Door Policy has been established to assist parents in working through the various options to choose the best solution for their child’s health coverage needs. As Marketplace Navigators, we encourage parents to start with us!
Our services are free and we offer unbiased education and assistance helping parents walk through the process to select the best coverage for their child. Submitting a Marketplace application will immediately alert the parent whether their child may qualify for Medicaid. However, because the final Medicaid determination is made by the State of Florida, the Health Insurance Marketplace will electronically send the application to Florida Medicaid and a representative will contact the family if the child qualifies for a free plan. If the child does not qualify for free Medicaid, the family is notified and their application is forwarded to Florida Kid Care for processing. Florida KidCare will advise the parent if the child qualifies for reduced cost KidCare coverage or full pay coverage. Navigators can help parents send in important documents that may be requested as part of the application. If the child only qualifies for full pay coverage, the parent can return to the Navigator to research Marketplace plans that may be less costly and provide the needed benefits for the child.
Choosing the right plan for your child can be confusing! As Navigators, we help parents eliminate confusion, understand the best option for their children including researching treatment facilities, medication needs, and other special services that are unique to your child.
Call us today, we are licensed by the State of Florida and focus on serving residents in Orange, Lake, Seminole, and Osceola counties. Call us at 1-877-564-5031 or email: [email protected] for an appointment. And remember, our services are FREE!
What is Florida Healthy Kids, and how can they help?
Florida Healthy Kids provides low–cost health insurance for uninsured children in the State of Florida. The program offers coverage for doctor visits, hospitalization, lab tests, x–rays, prescriptions, vision care, and more. The program is designed to help families with children who have limited or no coverage from their parents‘ employers, Medicaid, or other sources. Families may qualify for the program based on income and family size, and may also qualify for additional assistance such as reduced premiums and additional coverage.