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How long can my child remain on my health insurance plan?

The length of time that your child can remain on your health insurance plan depends on the type of insurance plan you have and the state you reside in. In many situations your child can remain on your policy until the age of 26.

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Due to the passing of the new health care bill, as long as the child does not have the option to obtain an employer based health insurance plan, it is required for the health insurance companies to allow children to stay on the parent’s policy until the age of 26.

This is likely to encourage those children that are still full-time students to be able to afford to finish their education.

However, most insurance companies will then require further documentation to be presented, such as a statement or transcript from the college or university they attend. Further, the insurance companies prefer that they are still claimed as a dependent by you. This has changed very recently.

Previously, it was up to the states to decide and pass regulation as to when a child could be covered under a parent’s health insurance policy. Further, the states do have the option to make that a later age, but 26 is now the minimum age that a child may stay on the parent’s policy.

Health Care Reform Bill of 2010

Other items that were passed under the Health Care Reform Bill of 2010 that affect children were a few changes that include the following:

  • Children may not be denied coverage due to pre-existing conditions
  • CHIP (Children’s Health Insurance Program) still must be maintained to offer low-income families coverage for their children, and
  • A wellness program requires qualified health insurance plans must provide immunizations as well as other preventative care for children.

Before we get ahead of ourselves though, let’s walk through the basics of what type of health insurance policies there are available to insure our children.

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Types of Health Insurance Available for Children: Traditional Plans

The first type of insurance is referred to as the traditional type of insurance. This is the basic medical insurance, which is often called catastrophe insurance. It does not offer preventative insurance; it simply covers certain amounts at the time of an accident or illness and will only cover up to the pre-determined amount.

There is also a more comprehensive type of traditional insurance called major medical insurance, which will cover more procedures, higher limits, and some continuing illnesses.

Types of Health Insurance Available for Children: Managed Health Care Plans

The second type of insurance is the most commonly known insurance and they are the managed health care plans. This type includes HMOs (Health Maintenance Organizations), PPOs (Preferred Provider Organizations), POSs (Point of Service), and EPOs (Exclusive Provider Organization).

The first and a very common type utilized is the Health Maintenance Organization which requires a primary care physician to be assigned. This primary care physician will be utilized for most visits and if a specialty care physician is needed, a referral will be required.

Preferred Provider Organization health insurance will provide in-network physicians at very inexpensive coinsurance rates. The differing factor between a PPO and HMO is that there are more options to go to different physicians as well as to see specialty physicians without obtaining a referral.

A Point of Service plan combines the offerings of these two plans by giving the insured the option to choose at the “point of service” whether they want to use their PCP (primary care physician) or to go to an in-network physician of their choosing.

Exclusive Provider Organizations are similar to PPO (Preferred Provider Organizations) in the fact they offer a network of providers. The difference with this type of insurance is that it only offers that certain network of providers and does not allow the option to go outside that network.

When sourcing your health care options and reviewing insurance rates be certain to get a number of quotes from reputable providers. One you have the insurance quotes in hand look into provider reputation with your state department of insurance or independent auditors like A.M.Best and J.D. Powers. All three entities listed above rate insurance companies on different factors and offer unbiased accounts of their reliability.

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