Health Insurance for Kids: Options, Costs and Deadlines

The right health insurance for kids depends on your income and the coverage you already have. In general, most families use one of four paths: Medicaid or CHIP, a parent's job plan, a Marketplace family plan, or a child-only plan. All four also cover checkups and vaccines, usually at $0 in network. Plus, kids can stay on a parent's plan until age 26.

Your four options for health insurance for kids

Every child in America has at least one path to real coverage. The trick is starting with the right one, because the order matters. First, check public programs. Then compare what your job offers against a plan you buy yourself.

Still not sure which box you fit? A licensed agent can sort it out in one call to 888-730-6031.

Medicaid and CHIP: low-cost health coverage for children

CHIP stands for the Children's Health Insurance Program. It covers kids whose families earn too much for Medicaid but not enough to buy private coverage easily. Also, each state runs its own version. For example, Florida's program is Florida KidCare, and you can learn more on our page about Florida plans and programs.

Here is the best part: you can apply for Medicaid or CHIP any time of year. Plus, under CHIP, routine well-child and dental visits cost nothing. Some states charge a small monthly premium, but your total yearly costs can't go over 5% of family income.

Who qualifies

However, income limits vary a lot by state. As of January 2026, KFF lists CHIP limits from under 200% of the federal poverty level in some states up to 405% in New York. Meanwhile, the national figure sits at 255%.

So what does that mean in dollars? The 2026 federal poverty level for a family of four is $33,000. In a state with a 255% limit, that family could earn about $84,150 a year and still qualify. In other words, CHIP is not just for families with very low income.

Once approved, kids under 19 get 12 months of continuous coverage. That federal rule took effect January 1, 2024, so a mid-year raise won't knock your child off right away.

Before you apply, check your state's rules at InsureKidsNow.gov or call 1-877-543-7669. Then come back to us if your child doesn't qualify.

Adding kids to a parent's plan

For most families, the simplest health insurance for kids is a spot on a parent's plan. In that case, everyone shares one card, one network and one family out-of-pocket limit. Plus, kids can stay on that plan until 26.

In fact, that age-26 rule is generous. Your child can stay on even if they marry, have a baby, move out or skip a job offer. On a Marketplace plan, coverage usually lasts through December 31 of the year they turn 26.

When you're ready to see real numbers, compare individual and family plans side by side.

Child-only plans for grandparents and guardians

Sometimes a child needs a plan of their own. Maybe a grandparent on Medicare is raising them, since Medicare doesn't cover dependents. Or a parent's plan may not fit the child's doctors, so you need another option.

That's where a child-only plan helps. Federal rules say insurers that sell a plan at a metal level must also offer a child-only version for kids under 21. Also, these plans carry the same essential benefits as any other Marketplace plan.

Documents to gather

• A birth certificate and the child's Social Security number
• Proof of guardianship or custody, if you aren't the parent
• Household income records for whoever claims the child on taxes
• Finally, a list of the child's doctors and prescriptions

Keep in mind that tax credits follow the tax household that claims the child. So before you apply, confirm who will claim them this year.

What health insurance for kids covers

Marketplace and Medicaid plans must cover a long list of preventive care for children. In network, these services generally cost $0, even before you meet a deductible. As a result, regular checkups shouldn't strain your budget.

• Well-baby and well-child visits, plus height, weight and BMI checks
• Vaccines from birth to age 18, such as measles, polio and HPV
• Vision screening for every child, plus hearing screening for newborns
• Autism screening at 18 and 24 months, and depression screening starting at 12
• Oral health risk checks and fluoride varnish once teeth come in

Beyond checkups, pediatric dental and vision care are also essential health benefits for children. However, adult dental and vision are not. When you see what vision coverage includes, you'll notice kids' benefits often go further than adult ones.

• Out-of-network checkups, since they can cost you full price
• Dental through a separate plan, since it may have waiting periods
• Services a plan's medical policy doesn't cover, so read the plan summary first

Need dental for the whole family, not just the kids? You can add a family dental plan that covers parents too.

What child health insurance costs

What health insurance costs for kids depends on the child's age, your ZIP code, the plan tier and your household income. For example, our breakdown of what family coverage really costs walks through real examples. Next, here are the numbers that matter most for the coming year.

Premium tax credits

First, Marketplace savings depend on income. The extra subsidy boost expired after 2025, and for 2027 coverage, households above 400% of the poverty level generally don't qualify. For a family of four, that line sits at about $132,000. Learn how premium tax credits work before you pick a plan.

The yearly cap on your costs

Your out-of-pocket maximum caps what you pay for covered care in a year. Once you hit it, the plan then pays 100% of covered in-network costs. Also, our guide to how the out-of-pocket maximum works shows how the family limit adds up.

When you can enroll in health insurance for kids

Timing trips up a lot of parents. The good news is that kids have more ways in than adults do.

First, Medicaid and CHIP accept applications all year. On top of that, a birth, adoption or foster placement opens a Special Enrollment Period. You then have 60 days to enroll, and coverage can start the day of the event. In addition, our guide to how the yearly enrollment window works covers the full calendar.

Losing other coverage, moving or gaining custody can also open a window. Read about the life events that let you change plans, then call us before the deadline passes.

How to pick the right plan for your family

Picking health coverage for children gets easier when you go step by step. We also use this order with every family we help.

1. Check Medicaid and CHIP first

   It takes just one application. Plus, if your kids qualify, it is often the lowest-cost route.

2. List your kids' doctors

   First, write down the pediatrician, specialists and children's hospital you use. Then search each carrier's doctor directory.

3. Compare total yearly cost

   Add 12 months of premiums to likely copays, then review how metal tiers compare for a family that sees the doctor often.

4. Decide on dental and vision

   See whether the medical plan includes pediatric dental. If not, then price a separate dental plan.

5. Enroll before the deadline

   After that, pay the first premium on time so coverage starts when you expect.

New to your area? We also have tips on picking a primary care doctor for each family member.

Check the pediatrician before you check the price.The rule our licensed agents repeat most with parents

Health insurance for kids: FAQs

Sources

• HealthCare.gov: The Children's Health Insurance Program (CHIP)
• Medicaid.gov: Continuous eligibility for Medicaid and CHIP coverage
• HealthCare.gov: Dates and deadlines for 2027 health plans
• KFF: Medicaid and CHIP income limits for children
• HealthCare.gov: Preventive care benefits for children
• CMS: 2027 premium adjustment and cost-sharing parameters

Vivna Insurance is a licensed, independent health insurance agency (NPN 19168641). We are not affiliated with HealthCare.gov or any government agency. Plan availability, networks and benefits vary by state and change over time.

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