Pediatric Services
Your children's health is your priority. Our pediatric coverage ensures they receive all the care they need from infancy through adolescence, including checkups, vaccines, and specialty care.
Your children's health is your priority. Our pediatric coverage ensures they receive all the care they need from infancy through adolescence, including checkups, vaccines, and specialty care.
Children have unique healthcare needs that change rapidly as they grow. From newborn screenings to adolescent wellness exams, pediatric care focuses on preventing illness, monitoring development, and catching potential problems early when they're most treatable. Regular pediatric care establishes healthy habits and builds a foundation for lifelong wellness.
The Affordable Care Act recognizes pediatric services as one of the ten essential health benefits, including pediatric dental and vision coverage that isn't required for adults. This means children have access to comprehensive healthcare services covering not just medical care but also dental cleanings, eye exams, and glasses, all essential for their development and success in school.
Our health insurance plans provide complete pediatric coverage from birth through age 26 (when children can remain on their parents' plan). We cover well-child visits at no cost to you, immunizations, developmental screenings, and specialty care when needed. Your children deserve the best start in life, and our coverage helps make that possible.
Regular checkups from birth through age 18 covered at 100% with no copay. Includes physical exams, growth and development monitoring, hearing and vision screenings, and age-appropriate health guidance for parents.
All CDC-recommended vaccines covered at no cost, including DTaP, MMR, polio, hepatitis, varicella, flu shots, and school-required immunizations. Keeps your children protected against preventable diseases.
Assessments for developmental milestones, autism spectrum disorder, speech and language development, and learning disabilities. Early identification enables early intervention for the best outcomes.
Essential dental coverage for children including preventive care (exams, cleanings, X-rays, fluoride, sealants), basic services (fillings, extractions), and orthodontic coverage for medically necessary braces.
Annual eye exams covered for children to detect vision problems that can affect learning. Coverage for glasses or contact lenses ensures your child can see clearly in the classroom and beyond.
Mental health services for children including therapy for anxiety, depression, and behavioral issues, ADHD evaluation and treatment, and counseling. Children's mental health is covered equally with physical health.
Well-child visits follow the American Academy of Pediatrics schedule: multiple visits in the first year, annual visits ages 1-3, then yearly checkups through age 18. These visits catch problems early, ensure proper growth, and keep immunizations current. All covered at 100%.
When your child is ill, coverage for pediatrician visits, urgent care, and emergency care ensures they get treatment quickly. Common childhood illnesses like ear infections, strep throat, flu, and respiratory infections are treated with appropriate medications and follow-up care.
Access to pediatric specialists when needed, including pediatric cardiologists, neurologists, endocrinologists, allergists, and more. Children with chronic conditions or complex medical needs receive coordinated care from specialists who understand pediatric medicine.
Therapy services to help children develop skills, including speech therapy for language delays, occupational therapy for fine motor skills, physical therapy for gross motor development, and applied behavior analysis (ABA) for autism. Covered as essential health benefits.
The American Academy of Pediatrics recommends the following schedule for well-child visits, all covered at 100% as preventive care:
Visits at 3-5 days (newborn), 1 month, 2 months, 4 months, 6 months, 9 months, and 12 months. These frequent visits monitor rapid growth and development, administer immunizations, and address feeding, sleep, and developmental concerns.
Visits at 15 months, 18 months, and 24 months. Focus on developmental milestones, language development, autism screening, and transitioning to toddler nutrition. Important immunizations continue during this period.
Annual visits ages 3-5 assess school readiness, vision, hearing, and social development. School-required immunizations are completed. Ages 6-11, annual visits focus on healthy habits, academic performance, and physical activity.
Annual visits ages 12-18 address puberty, mental health, substance use prevention, sexual health, and preparation for adult healthcare. Meningitis, HPV, and Tdap vaccines are recommended during adolescence.
Yes, well-child visits are covered at 100% with no copay when you see an in-network pediatrician. This includes the exam, routine immunizations, and standard screenings. If additional services are provided during the visit (like treating an illness), those may have separate charges.
Under the ACA, children can remain on their parents' health insurance plan until age 26, regardless of student status, marital status, or financial independence. This provides young adults time to establish careers and find their own coverage.
Yes, pediatric dental and vision are essential health benefits that must be included in ACA-compliant plans for children. Adults don't have the same requirement, which is why children's coverage is more comprehensive in these areas.
Habilitative services (therapy to help children develop new skills) are covered as essential health benefits. This includes speech therapy, occupational therapy, physical therapy, and behavioral therapy for conditions like autism. Coverage continues as long as treatment is medically necessary and progress is being made.
You can choose any in-network pediatrician for the lowest out-of-pocket costs. PPO plans also allow you to see out-of-network pediatricians at higher cost. Consider factors like location, office hours, hospital affiliations, and whether the practice accepts same-day sick appointments.
Your children deserve comprehensive healthcare that supports their growth and development from infancy through young adulthood. Speak with a licensed agent today to find a plan with robust pediatric coverage that keeps your whole family healthy.