Review your child's health insurance plan in Madison, WI to make sure they are getting enough coverage.

Does Your Child Health Insurance Plan Provide Enough Coverage?

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 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.

 

What benefits are included in ACA-compliant health plans for children?

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 –

  • Newborn screenings for certain genetic disorders and screenings for infants at risk for specific illnesses
  • Autism screening at 18 and 24 months
  • Behavioral assessments and medical history in five age categories
  • Blood pressure and obesity screening in five age categories
  • Developmental screening for children under age three
  • A range of immunizations
  • Vision screening

In addition, many plans offer pediatric dental coverage.


See the full list of preventive care benefits that must be covered for your child.

 

Do all child health insurance plans offer the same benefits?

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 Unity’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.