Families without affordable private insurance may still have several ways to obtain medical, dental, behavioral-health, and preventive care for children. Options include Medicaid, the Children's Health Insurance Program, community health centers, school-based services, public-health programs, and charitable clinics.
Eligibility and services vary by state and location. Apply even when you are unsure whether your child qualifies.
Emergency notice: Free and low-cost clinics generally provide non-emergency care. Call 911 or go to an emergency department for a medical emergency.
Medicaid for Children
Medicaid provides free or low-cost coverage to eligible children. Income limits, program names, managed-care plans, and application procedures vary by state.
Children enrolled in Medicaid are entitled to the Early and Periodic Screening, Diagnostic, and Treatment benefit. EPSDT includes preventive visits and medically necessary diagnostic and treatment services for people under age 21.
Apply through the state Medicaid agency or the Health Insurance Marketplace. Medicaid applications are accepted year-round.
Children's Health Insurance Program
CHIP provides low-cost coverage to eligible children in families whose income is too high for Medicaid but who may not be able to afford private coverage. Every state operates CHIP in coordination with Medicaid.
Benefits and costs vary, but CHIP provides comprehensive child health coverage. Some states also use CHIP to cover pregnant women.
Community Health Centers
HRSA-funded health centers serve patients with or without insurance and adjust fees according to ability to pay. Services may include:
- Pediatric primary care
- Vaccinations
- Dental care
- Behavioral-health services
- Laboratory testing
- Prescription assistance
- Help applying for coverage
Not every site offers every service. Call ahead and ask whether the location accepts children of your child's age.
School-Based Health Services
Some schools operate health centers or partner with local healthcare organizations. Services can include:
- Basic medical visits
- Vaccinations
- Behavioral-health counseling
- Dental screenings
- Vision screenings
- Chronic-condition support
A parent or guardian may need to complete consent forms. Ask the school nurse or district office what is available.
Vaccines for Children
The federal Vaccines for Children program supplies recommended vaccines to eligible children through participating providers. Eligibility can include children who are Medicaid-eligible, uninsured, underinsured in certain settings, or American Indian or Alaska Native.
The vaccine itself is supplied without charge under the program, but a provider may charge an administration fee. A child cannot be denied a VFC vaccine solely because the family cannot pay that fee.
Contact the state or local health department to locate a participating provider.
Dental and Vision Care
States must provide dental benefits to children enrolled in Medicaid and CHIP. Provider availability and covered services vary.
Vision services may be available through Medicaid, CHIP, schools, community health centers, or charitable programs. Ask whether an eye screening, full examination, and eyeglasses are separate services.
Behavioral and Mental-Health Care
Affordable behavioral-health care may be available through:
- Medicaid or CHIP plans
- Community health centers
- School counselors and school-based clinics
- Community mental-health agencies
- Pediatric practices
- Telehealth programs covered by the child's plan
For an immediate mental-health crisis, use local emergency services or the appropriate national crisis resource.
Children With Special Healthcare Needs
State Title V maternal and child health programs, early-intervention programs, and disability services may help families locate specialists, therapies, care coordination, and support.
Ask the child's pediatrician, school, or state health department about programs serving children with special healthcare needs.
Marketplace Coverage
Families who do not qualify for Medicaid or CHIP may be eligible for savings on Marketplace coverage. Losing Medicaid or CHIP can create a Special Enrollment Period.
Compare the plan's pediatric network, prescriptions, mental-health benefits, dental options, deductible, and total expected costs.
What to Bring to an Appointment
A clinic may ask for:
- Parent or guardian identification
- Child's birth certificate or identity document
- Proof of address
- Income information
- Medicaid, CHIP, or insurance card
- Immunization record
- Medication and allergy list
- Prior medical records
Requirements vary. Ask before traveling.
Questions to Ask
- Is the clinic accepting new pediatric patients?
- What ages does it serve?
- Does it accept Medicaid or CHIP?
- Is a sliding-fee program available?
- Are vaccines available?
- Does it provide dental, vision, or behavioral-health services?
- What documents should I bring?
- Are referrals available for specialty care?
Sources
- HealthCare.gov: Medicaid and CHIP
- HealthCare.gov: Children's Health Insurance Program
- Medicaid.gov: EPSDT
- HRSA: Find a Health Center
- CDC: Vaccines for Children Program
Disclaimer
This article provides general directory information, not medical, insurance, or legal advice. Eligibility, benefits, and provider participation change. Confirm current details with the state program, health plan, or clinic.