Does Medicare cover children?

Medicare covers children who are disabled and 20 to 22 years and children diagnosed with permanent kidney failure (ESRD). Children who don't qualify for Medicare will need to be enrolled in other state-sponsored programs. Parents or legal guardians have to find coverage other than Medicare for children by comparing companies and shopping around to find affordable health insurance.

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UPDATED: Dec 14, 2021

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The Highlights

  • Medicare won’t cover your children unless they have a disability or has a history of kidney failure.
  • According to Medicare, your children are considered adults until they turn 22 years olds.
  • Medicare will cover disabled children between 20 and 22 years old.
  • Children without a disability may not qualify for Medicare.

Does Medicare cover children? The answer can be complicated. There are specific conditions in which Medicare covers your kids. Unlike health insurance, Medicare is only available for children with disabilities and children with kidney failure.

Our guide goes through the specifics on how Medicare for children works and what you can do to get your children insured.

Compare Medicare quotes for children through supplement and Advantage plans to standard health insurance companies using our free comparison above.

Can you get Medicare for a child?

It depends. Medicare is designed for children with disabilities between 20 and 22 years old or children with kidney failure. It’s not likely to get Medicare coverage for your child if they don’t have either of these things.

You may be able to buy Medicare for children as an Advantage plan if they do qualify.

Other Requirements to Get Medicare Coverage for Kids

If your child is between 20 and 22 years old and has a disability, they can qualify for Medicare insurance under these conditions:

  • Six Social Security work credits in the last three years
  • Receives Social Security retirement benefits
  • A child can qualify through the grandparents’ Medicare.
  • Regarding stepparents, the kid’s stepparent much has custody of the child for at least a year.

Sometimes age and disability aren’t enough to get Medicare coverage, so you’ll need to find another program to insure children.

How to enroll children into Medicare?

Any disabled child between 20 and 22 years old will automatically be enrolled in Medicare after two years (24 months) of receiving Social Security Disability Insurance (SSDI) compensation.

Children diagnosed with End-State Renal Disease (ESRD), or permanent kidney failure, will need to enroll for Medicare through the social security program.

What parts of Medicare coverage children?

All parts of Medicare cover children that qualify for Medicare, including Medicare Part A, Medicare Part B, and Medicare Part D. However, Medigap won’t be available to children.

Some states require Medigap coverage. Here’s a list of states that require Medigap and a list of states that doesn’t.

States that Require Medigap Plans be Available to Medicare Recipients Under 65
States that Require at Least One Medigap Plan (must be available to enrollees under 65)States that Don't Require at Least One Medigap Plan
IdahoNew Mexico
IllinoisNorth Dakota
KentuckyRhode Island
LouisianaSouth Carolina
MichiganWest Virginia
New Hampshire
New Jersey
New York
North Carolina
South Dakota
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Search for your state in the dialog box in the top right of the table. Also, it may be a good idea to check your state statutes on Medicare coverage.

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How much does Medicare cost for children?

Medicare rates for children are no different than for adults. Medicare Part A comes with a $1,400 to $1500 deductible, but the Standard Part B plan can be as low as $149 per month. However, Medicare Part B comes with a $203 deductible for the year.

Also, Medicare Part B has a coinsurance policy where you pay 20 percent of services, while Medicare pays the other 80 percent.

How to get health insurance for children who aren’t disabled?

Children who are 18 and younger may not qualify for Medicare, but they can be enrolled in Children’s Health Insurance Programs (CHIPS or S-CHIP). S-CHIPs are state health insurance programs for low-income families. Anyone over 19 years old can enroll in Medicaid.

Medicare Coverage for Children: The Bottom Line

Medicare is very clear that they won’t insure children between 20 and 22. Anyone under 65 with ESRD can receive Medicare coverage with the same deductible and limits as other Medicare recipients.

Since affordable Medicare for children may not be an option, you can start looking for health insurance from the best insurance companies.

Compare Medicare supplement and health insurance companies by entering your ZIP code in the free comparison tool below to find coverage for your children.

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