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Child Only Health Insurance in Texas

Children's health insurance is necessary to help pay for doctor visits, immunizations and other medical expenses. Many parents insure their dependent children through employer-sponsored health insurance plans. Unfortunately, some parents do not have access to group health coverage or employer plans. The Texas Department of Insurance has many resources available for parents who need to purchase health insurance for their children. Child-only health insurance in Texas is available through a variety of sources including private insurers and state-sponsored programs.

  1. Private Insurance

    • Texas child-only health insurance is available through private individual insurance carriers. Individual insurance carriers can provide insurance to your child without you included in the policy. Texas private insurance carriers are required to provide health insurance to children under the age of 19 even if a pre-existing condition exists, according to the provisions of the Affordable Care Act. Private insurance plans include fee for service, also known as indemnity plans, or managed care plans. In most cases, you can select a doctor or hospital within a specified network. The insurance company pays a percentage of health services such as hospital fees, surgery, prescription drugs and routine checkups.

    Children's Medicaid

    • Texas Children's Medicaid is a child-only health insurance program that pays for acute health services including physician care, inpatient and outpatient services, X-rays and laboratory work. Children's Medicaid serves low-income children whose family cannot afford to pay health care costs. Parents who receive public assistance or Supplemental Security Income (SSI) are automatically eligible to receive Medicaid. Other low-income families must apply for Medicaid and meet certain qualifications. For example, to qualify for Medicaid, family income cannot exceed 185 percent of the federal poverty level.

    Children's Health Insurance Program

    • Texas offers a Children's Health Insurance Program (CHIP) for families who earn too much to qualify for Children's Medicaid. The program covers children who are Texas residents, under 19 years of age and uninsured for at least 90 days. The cost of services is based on the family's income and assets as well as the number of people in the household. According to the Texas Health and Human Services Commission, as of February 2011, co-payments for doctor's visits range from $3 to $10 and annual enrollment fees for the plan do not exceed $100 annually. The Children's Health Insurance Program offers similar benefits to Texas Children's Medicaid including dentist visits, vaccines, hospital care, X-rays and more.

    Health Insurance Pool

    • Texas offers a health insurance risk pool for those with a history of medical problems. Children may be enrolled in the risk pool insurance program if a pre-existing health condition exists. The primary difference between the Texas health insurance pool and insurance offered through private Texas insurers is the source of funding. Risk pools are state and federally sponsored whereas individual insurance carriers are privately funded organizations. Although private insurers are required to extend insurance to children with pre-existing conditions, the children must also be able to meet other underwriting criteria established by the insurer. The health insurance pool is an option for children who cannot meet all underwriting qualifications of private insurers.

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