Kaiser Permanente California Child Health Insurance

There’s some good news for parents in California who are looking for private medical insurance coverage for their kids under age 19. Kaiser Permanente is accepting California child health insurance applications on a year-round basis! Rates continue to be based on the child’s age and where he or she lives, but now, three additional factors will be considered in determining the final premium: prior health coverage, pre-existing conditions, and qualifying events.

Pediatrician & Young Boy

     

  • Prior Insurance to Avoid 20% Surcharge: In accordance with state law, California child health insurance applications submitted to Kaiser Permanente will be subject to an automatic 20% surcharge unless the child had prior health coverage. The surcharge will be waived for kids with prior insurance within the last 90 days of the application date. The previous policy does not have to be in active status when you apply; the child just needs to have had health insurance within the 90 day window.
  • Pre-Existing Conditions: A rate adjustment could apply to the premium when the child has a pre-existing medical condition. The rate-up will be affected by the medical history of the child and if there is a qualifying event.
  • Qualifying Event: Children with a medical issue plus a qualifying event could receive a lower pre-existing surcharge than those with a pre-existing condition but no qualifying event. Following are examples of a qualifying event: Birth of a baby; adoption; loss of coverage, either due to loss of the job that provided the group insurance, divorce, legal separation, becoming ineligible for the plan, loss of Medicaid or other public program, or death of the policy holder; court order; becoming a resident of California. In California, kids who apply for health coverage during their birth month are also considered as having a “qualifying event”. For more information on qualifying events, click California Child Health Insurance Rates and Qualifying Events.

Changing Your Child's Health Insurance Plan

If your son or daughter is already insured on Kaiser Permanente California child health insurance plan and you are interested in switching to a different plan, you can do so at any time. If your goal is to reduce your monthly premium, you might consider switching to a plan with a deductible. If your child is already on a deductible plan, think about increasing the deductible. Kaiser Permanente’s $40/$2000 and $40/$3000 HMO Deductible Plans tend to be popular options for children who mainly need office visits and prescriptions, which are not subject to the deductible under these two plans. If, however, your child tends to need frequent or costly treatments, then in the long run, it may be more cost-effective to upgrade to a plan with a lower deductible or copayment. The $25 Copayment Plan offers the most comprehensive benefits. For a more affordable option, consider the $50 Copayment Plan.

California Health Insurance for Kids Through the Government

If the premium for California child health insurance is no longer a manageable option, consider the Child Health Insurance Program (“CHIP”). CHIP was designed to offer medical benefits to kids whose families exceed the Medi-Cal income threshold, but who are unable to afford private health coverage. For details, click InsureKidsNow.gov.

 
 
 
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