In some cases, you can get coverage from Medicare for children. This is mostly the case for those receiving Social Security Disability for at least 24 months. Unlike private health insurance plans, Medicare coverage doesn’t offer family plans. However, some very specific situations may allow Medicare coverage for your kids. This is what you need to know.
Medicare for Kids
Dependent children are eligible for Medicare in certain situations. This is especially the case when a child is severely ill.
Can a Child Qualify for Medicare
He/she has end-stage renal disease requiring dialysis and currently receiving SSA benefits may qualify for Medicare
If your child has ESRD that requires regular dialysis or needs a kidney transplant, Medicare eligibility is possible
A child that has a disability resulting in entitlement from Social Security Disability Insurance (SSDI) payments
Medicare for Child With Disability
Your child must have received SSDI benefits for 24 months to qualify for Medicare benefits. Children over the age of 20 must be disabled and receiving disability benefits for two years before applying for Medicare. They qualify for Medicare due to disability if disabled prior to turning 22 years old.
Certain relationship requirements must be met by the child in order to qualify for Medicare:
The child must be related to you by birth or legal adoption
Exceptions are made if the child is your stepchild for a year or longer, they may also qualify
You must have received Medicare credits through your employer in prior years
Benefits will remain available for adult children that qualify if they
Medicare Waiting Period for Children
Often there’s a two-year waiting period for Medicare coverage for kids with disabilities. If your child was born with a disability, you’ll have to wait until the child’s second birthday to receive Medicare. However, children with ESRD or Lou Gehrig’s disease have no waiting period for Medicare. Your child may be eligible for Medicaid or CHIP insurance if your child doesn’t have a disease or chronic/severe condition.
Medicaid is an option for children who reach 133% of the federal poverty level; that’s not always the case though, most states cover children at higher income levels as well.
The Children’s Health Insurance Program was created to provide benefits to eligible children; through both Medicaid and other CHIP programs.
CHIP will cover kids until the age of 19 if income is too high to qualify for the Medicaid program. In some cases, your child may be disabled but is still capable of working. For cases like this, your child will have a trial work period of 9 months.
If your child continues to work after the trial work period ends, Medicare will continue for over 7 years. After that, your child will be considered a Medicare enrollee instead of a Medicare beneficiary. This means your child will be required to start paying for continued Medicare coverage.
Medicare with Dependent Child
Health insurance is often received by workers through their employer, which includes coverage for their spouse and children as well. The Department of Health and Human Services allows children to stay on their parent’s health insurance until 26 years old.
If you’re 66 years old and retired with a 24-year-old child, your child might be covered under your employer’s plan. Medicare doesn’t usually cover children. If you’re enrolled in Medicare, your child might be eligible for COBRA or Health Insurance Marketplace coverage.
Medicare Advantage for Children
If your child qualifies for Medicare due to ESRD, you need to enroll them; enrollment isn’t automatic.
Your child may not be eligible to enroll in a Medicare Advantage plan. But, in certain cases, your child may be able to enroll in a Medicare Advantage Special Needs Plan (SNP).
Depending on where you live will determine if this program is available to your child with ESRD. Medicare Advantage SNPs have certain conditions that need to be met to qualify for eligibility.
Different SNPs have different eligibility criteria; one or more of these will need to be met:
Must have a specific chronic or disease/condition that leaves them disabled (such as ESRD)
Institutionalized in long-term care or another health facility
Eligible for Medicaid
If your kid qualifies for Medicare due to a disability, they can join a Medicare Advantage plan.
Any kid who is eligible for Medicare may join a Medicare prescription drug plan. These plans work paired with Original Medicare or as part of a Medicare Advantage plan.
SNPs include coverage for medical treatments and medications necessary to manage a certain condition, like ESRD. If your child qualifies, no additional prescription drug plan is necessary.
How to Apply for Medicare for My Child
There are many circumstances that will determine if your kid is eligible to qualify for Medicare coverage. Medicare for children can cover costs and help care for a child. If you believe your child might qualify, start the application process now. For more information, contact CHIP or your local Social Security Office. If you’re looking for information on Medicare Supplements, Medicare Advantage, or Part D, fill out our compare rates form to see what’s available in your area now.
About This Site
MedicareFAQ.com (hereinafter “the Site” or “this Site”) is an online resource for people seeking to learn more about their insurance options. Elite Insurance Partners LLC does not endorse any particular insurance plan, provider, or agent. Any information provided about any particular insurance plan, provider, or agent shall not be construed as an endorsement by Elite Insurance Partners LLC.
Copyright and Proprietary Rights Information
This website is owned and maintained by Elite Insurance Partners LLC. No content or images may be downloaded or reproduced without our prior and explicit consent.
While every effort is made to ensure the accuracy of the content of medicarefaq.com, we cannot be held accountable for typographical errors, errors of fact, or any other error or inconsistency found on this website. We hereby disclaim all liability from any damages resulting from the use of this website, or any services provided on any Elite Insurance Partners LLC website.
Links to Third Party Sites
This Site may contain links to sites that are controlled by third parties. These linked sites are not under the control of Elite Insurance Partners LLC, and Elite Insurance Partners LLC is not responsible for the contents of any linked site or any link contained in a linked site.
Information Collected by Elite Insurance Partners LLC
Elite Insurance Partners LLC uses this website to collect personally-identifiable information. When you use our service, you are authorizing the sharing of your inquiry and your personal information with Elite Insurance Partners LLC. The personal information we collect may include, but is not limited to:
These technologies help companies measure the effectiveness of ads, content, user experience and other marketing activities.
How Information Is Collected
We only collect your personally-identifiable information when you choose to share it with us. We will not collect any personally-identifiable information without your consent. The information you choose to share with us may be collected through this website, another website in the Elite Insurance Partners LLC network, or collected over the phone by one of Elite Insurance Partners LLC licensed insurance agents.
Cookies and other technologies, such as web beacons or tags, may be sent to visitors of this website. “Cookies” are text-only pieces of information that a website transfers to an individual’s hard drive or other web site-browsing equipment for record-keeping purposes. Cookies allow the website to remember important information that will make your use of the site more convenient. A cookie will typically contain the name of the domain from which the cookie has come, the “lifetime” of the cookie, and a randomly generated, unique number or other value. A “beacon,” “tag,” or “tracking pixel,” is a one pixel by one pixel image placed on a web asset or email. When your browser connects to a web page and the web page contains a web beacon image, your browser makes a request to the web server to download that image — and with this request, the server logs certain details like your IP address, the date and time, and more.
With cookies, web beacons and other technologies, the information collected and used is always anonymous and does not enable any third-party to identify you individually.
How Information Is Used & Opting-Out
By choosing to submit your personally-identifiable information to us, you are authorizing Elite Insurance Partners LLC to use this information for any purpose in our sole discretion. An Elite Insurance Partners LLC licensed agent may contact you by phone, email, mail, or other form of communication to fulfill your inquiry and provide you with other offers you may be interested in. You expressly consent to receive these communications whether you are on any Federal or state DNC (Do Not Call) and/or DNE (Do Not Email) list or registry.
Although it is our hope that you find this service valuable, if you would prefer not to participate, you can opt-out of this activity at any time by following the browser-specific instructions at the following link: https://www.usa.gov/optout-instructions
If you no longer wish to receive further communications from Elite Insurance Partners LLC, you may “opt-out” at any time and we will remove you from our mailing list within 10 days. You may opt-out of receiving emails by following the “Unsubscribe” link at the bottom of our emails, or by contacting us via the information below.
Elite Insurance Partners LLC 34125 Us Highway 19 North – Unit 200 Palm Harbor, FL 34684 email@example.com 1 (800) 845-2484
Changes to This Policy
This website is owned and operated by Elite Insurance Partners LLC.
Aetna Health and Life Insurance Company (An Aetna Company)
American Continental Insurance Company (An Aetna Company)
American Retirement Life Insurance Company (A Cigna Company)
Anthem Blue Cross Blue Shield
Blue Cross Blue Shield
Central States Indemnity (A Berkshire Hathaway Group Company)
Continental Life Insurance Company (An Aetna Company)
ForeThought Life Insurance
Gerber Life Insurance
Government Personnel Mutual
Individual Assurance Company
Loyal American Life Insurance Company (A Cigna Company)
Mutual of Omaha
New Era Life Insurance
Omaha Insurance Company (A Mutual of Omaha Company)
Philadelphia American Life Insurance
SilverScript (A CVS Caremark Company)
Standard Life and Casualty
Stonebridge Life Insurance (A TransAmerica Company)