How to Acquire Medicare Health Coverage for Your Child

Medicare Health Coverage is typically available to senior citizens or disabled adults.  Medicaid is health coverage (insurance) available to children.   Medicaid is free to those who qualify.  It is typically for low income families, but children in other situations, such as foster care, may also be eligible.

Medicare Health Coverage is typically available to senior citizens or disabled adults.  Medicaid is health coverage (insurance) available to children.   Medicaid is free to those who qualify.  It is typically for low-income families, but children in other situations, such as foster care, may also be eligible.

Children are not generally eligible for Medicare Health Coverage.  Medicare is for adults who are either sixty-five or older or disabled.  Medicaid Health Coverage is health insurance available to low-income children, as well as to low-income pregnant women.  While Medicare and Medicaid sound similar, they are different programs.

In order for your child to qualify for Medicaid, your child must meet one or more of the following eligibility criteria:

• Be part of a family household with limited income, generally under 185 percent of the federal poverty level, but may vary from state to state.


• Be an infant born to a mother who was eligible for Medicaid, based on income, while pregnant.  The infant can remain on Medicaid for the first year regardless of the family’s eligibility as long as the mother is still the custodial parent.


• Be part of the foster care system or eligible for adoption assistance.


• Qualify for SSI benefits, based on special needs/disabilities.

Medicaid covers visits to doctors, dentists, mental health providers and hospitals that accept the plan.  It covers prescriptions, lab work and procedures eligible under the plan.  Some visits, medication or procedures may require documentation that they are medically necessary and advance approval.  There is a cost to the child's parents for any eligible services or prescriptions.

To apply for Medicaid for your child, you should visit your state's official resident website to find out eligibility criteria and the application process for your state.  Social or human service agencies should also have this information, including health departments.  You will need to fill out an application and submit documentation in order for your child's eligibility to be determined.  Required documentation may include birth certificates, photo ID's, pay stubs, proof of residency and/or adoption decrees.