Medicare for Kids

As we already know, Medicare started as a program for adults aged 65 and older. But through the course of time, it has allowed others to receive federal health insurance even if they are not 65.

Children, defined by under the age of 22 who is unmarried, can receive Medicare and other government-related healthcare if they meet certain conditions. One of which is if your child will be has a disability or special needs. 

Children’s Eligibility

To qualify, children must be disabled and checked through the Social Security Administration. They need to have been receiving social security for their benefits for two years before applying for Medicare. Medicare will pay for the doctor’s visit and medical services that are provided for those disabilities and conditions that are allowed to be covered.

Notes to consider:

Parents are still responsible for paying Medicare programs, though there are some child healthcare programs that are free through Medicare. An example of which you may be eligible for CHIP or Children’s Health Program. Even if you have other types of insurance, you can still receive Medicare

Requirements for Parents

In order for the child to be eligible, parents also have to meet requirements set by the federal health program.

• Benefits are given to children when they are disabled or have a type of disease like ESRD.
• Medicare treatment is given to legally adopted or birth-related children. Stepchildren can only receive Medicare if you have been a parent for at least one year.
• A parent also must have received Medicare credits in the past years through work.
• If a parent is eligible for social security disability or the railroad retirement board benefits, then the child also qualifies for Medicare Part C.

Time Limits on Getting Medicare for Kids

Medicare benefits have time restrictions for those who have end-stage renal disease. Coverage ends about 12 months following the last dialysis treatment. It can also end after three years past from the date that your child received a kidney transplant. If you have a child who is disabled, then he or she can keep benefits as long as they continue to be disabled. The law allows anyone over the age of 22 to qualify for Medicare through disability if it began before age 18 and even if you don’t have any working credits.

What is CHIP?

CHIP  -  Children’s Health Insurance Program; created in 1997 and has been one of the best programs for children’s healthcare in the US until now. It provides health coverage for children in families that make too much to qualify for Medicaid but also can’t afford private health insurance.

CHIP is administered on a state level just like Medicaid, but it is partially funded by the federal government. There is a federal matching rate for CHIP programs in each state that equals to about 15 percentage points, actually higher than Medicaid. However, you have to work with each state as they all have their own CHIP program with CMS and general guidance services.

How to Get a CHIP?

In general, only low income families are eligible for CHIP.

Monthly income must be below a certain amount for kids to qualify. For example, for a family of one, then the monthly income must be below $1,344 or a yearly income of $16,116. You also qualify for the chip if your income is $2,004 or less, but there are certain restrictions for this program

Children only qualify for CHIP if; 

• they are 18 or younger
• You are a US citizen and live in one of the 50 states. Legal permanent residents may also get childcare for children. 
• Income must be low and provable

You can enroll in Medicare or CHIP for your children at any time of the year.

What Does CHIP Cover?

Each state has its own way of handling CHIP, so these benefits maybe different for your specific area. In general, the following are included in CHIP:

• Routine Check-Ups
• Immunizations
• Prescriptions
• Doctor visits
• Vision care
• Dental care
• Lab tests and x-ray services
• Emergency care costs

Do I Need Medicare if my child is eligible for CHIP?

Medicare can be used to supplement health coverage for your child if they are under the age of 22 and qualify for Medicare because of an illness or disability that makes them eligible to receive care. While Medicare eligibility isn’t based on income, you receive certain cost allowances if you don’t have the best income.

What Medicare Plan is Right for My Child?

If you are eligible for Medicare, then the best plan is sold through a private health insurance company in the form of Medicare Advantage plans. There are many advantages to using Medicare Part instead of CHIP or other private health insurance policies. One example is that you can see doctors at any Medicare-approved facility, and you can also get coverage for your child’s doctor’s visits and so much more, which brings the costs down a lot.

If you don’t qualify for other children’s healthcare programs, Medicare may be the right answer. One thing to remember is that you have to receive social security benefits for a disabled person for 2 years before you can get on a Medicare plan even if for your child.