Adequacy of Insurance

While most children had health insurance coverage at the time of the survey, insurance coverage may not always be adequate to meet their needs. Parents whose children were currently insured were asked three questions regarding the services and costs associated with their child’s health insurance. Parents’ responses to each of the three questions varied significantly. Parents of 18.0 percent of currently insured children reported that the out-of-pocket costs were never or sometimes reasonable. In contrast, 7.5 percent of children were reported to have health insurance that never or sometimes offers benefits or covers services that meet their needs and 5.1 percent were reported to have health insurance that never or sometimes allows them to see the health care providers they need.

Children were considered to have adequate health insurance coverage if their parent answered “usually” or “always” to each of the three questions. Overall, 23.5 percent of children lacked adequate insurance. Low-income children were less likely than children with higher household incomes to lack adequate coverage: 19.5 percent of children with household incomes below the Federal poverty level (FPL) were reported not to have coverage that meets all three criteria. The children most likely to lack adequate coverage were those with household incomes between 200 and 399 percent of the FPL, of whom 26.8 percent had coverage that did not usually or always meet all of the criteria.