If you’ve had the same health plan for years and you are expecting or recently welcomed a child, it may be a good time to review the health insurance coverage for your child. Did you know that if you buy an ACA-compliant plan directly from an insurance company or on healthcare.gov, you automatically get coverage for certain services for your child?
ACA-compliant plans in Wisconsin are required to provide a range of benefits, including specific preventive services for children – some at no out-of-pocket cost. However, if you buy a health plan that is not ACA compliant, your child may not have these benefits.
ACA-compliant health plans cover pregnancy and childbirth. This is true even if your pregnancy begins before your coverage takes effect. ACA-compliant health plans also provide for a range of benefits for children. These are called essential health benefits and include many preventive services at no out-of-pocket cost to you (even if you haven’t met your deductible).
Preventive services for children include:
In addition, many plans offer pediatric dental coverage.
No, not all child health plans offer the coverage required by the Affordable Care Act (ACA). This coverage is only guaranteed when you buy an ACA-compliant health plan.
Also, before you buy health insurance for your child, be sure to check the provider network. This is the network of doctors, clinics and hospitals that your health insurance covers. You may want to make sure your favorite doctors and clinics are in the network. Otherwise you could end up paying for out-of-network doctor visits.
Finally, if you have BadgerCare Plus (Medicaid in Wisconsin), the coverage may be different than what is offered in an ACA-compliant health plan. To learn more about child health coverage associated with BadgerCare Plus, visit HealthCheck.
All of Quartz’s adult and child health plans in Wisconsin are ACA-compliant health plans. Our customer service specialists are helpful, knowledgeable and happy to help you find a plan that fits your needs. For questions and help choosing a plan, call us at 608.644.3430.