Feeling overwhelmed by the options?
You can count on KidCare to help you better understand what to consider when choosing the right health care coverage for your child.
About Florida KidCare
High-quality health and dental insurance made just for kids from birth through the 19th birthday.
Health Insurance 101
We’re here to help empower you to make informed decisions about your child’s coverage.
Navigating the world of health insurance can be overwhelming — especially when it comes to making the right choice based on your family’s needs and circumstances. Having high-quality health care coverage helps you prioritize your child’s health and well-being and lessens the worry about getting stuck with large medical bills.
Understanding key health insurance terms is the first step toward feeling confident about your child’s health care coverage options.
Key Health Insurance Terms
Premium
A set monthly fee you pay for insurance coverage
Tip: Choosing a plan with a slightly higher monthly premium but no deductible can help prevent unexpected expenses when you go to appointments.
Deductable
The yearly amount you must spend before your insurance will begin covering costs
Tip: Pay attention to the annual deductible. You MUST spend this amount before your insurance covers expenses. With Florida KidCare, there is a $0 deductible.
Copay
A flat fee you pay at the time of service each time you go to your doctor, fill a prescription or receive other medical care
Tip: With Florida KidCare, copays are never more than $10.
Coinsurance
A cost-sharing percentage you pay for health care after your deductible is met
Tip: There is no coinsurance with Florida KidCare.
In-Network Provider
A health care provider (doctor, hospital, or facility) contracted by your health plan to provide services.
Tip: Visiting an in-network provider typically has lower out-of-pocket costs.
Out-of-Network Provider
A health care provider (doctor, hospital or facility) not contracted by your health plan to provide services
Tip: Seeing an out-of-network provider usually costs more.
Out-of-Pocket Maximum
The highest amount you’ll have to pay for medical expenses in a year
Tip: With CHIP coverage through Florida KidCare, your out-of-pocket costs are limited to 5% of your family’s gross annual income each plan year.
Preventive Care
Services designed to prevent illness and keep your child healthy
Tip: No copay is required for preventive care services with Florida KidCare.
Emergency Care
Immediate treatment for serious injuries or illnesses
Tip: If you’re unsure whether or not to take your child to the ER, Florida KidCare health plans have 24/7 telehealth services to help answer your health questions any time.
Explainer Video Series: Watch and Learn
Learn more about some of the key factors to consider when selecting a health insurance plan.
What Sets Florida KidCare Apart
Florida KidCare offers affordable, high-quality health and dental coverage made just for kids, so they receive the services they need when they need them. In addition to standard health and dental care services, Florida KidCare families have access to extra benefits, called value-added benefits. These benefits vary depending on the health plan you choose. Examples include but are not limited to:
Asthma Support
An allowance for medically necessary hypoallergenic bedding, carpet cleaning, and peak flow meters and spacers
Extracurricular Memberships
Reimbursement for participation in Boys & Girls Clubs, Boy Scouts, Girl Scouts, YMCA, 4H and more
Healthy Lifestyle Benefits
Access to exercise tracker, nutritional counseling, weight management courses and more
Vaping/Tobacco Cessation
Coaching and incentives to quit vaping and using tobacco
Transportation Services
Transportation to certain medical and dental appointments
Water Safety Courses
Reimbursement for certain swimming and drowning prevention courses
Your Health Insurance Questions Answered
What’s the difference between a premium and a deductible?
A premium is the fixed monthly payment you make for health insurance, while a deductible is an out-of-pocket amount you must pay for medical services before your insurance starts covering costs.
How do I find in-network providers?
To find out if your child’s doctor is covered, you can check the provider directory for your insurance plan, either online or by calling the insurer’s customer service. If your child is enrolled in Florida KidCare, you can click here to view in-network doctors and specialists.
How do I know when to go to urgent care versus the emergency room?
Urgent care centers are ideal for issues that are not life threatening but require immediate attention, such as mild cuts, sprains, minor burns, mild asthma attacks, or a fever that won’t go away. They can also handle conditions like rashes, sore throats, or ear infections. On the other hand, an emergency room is for serious, potentially life-threatening conditions like severe chest pain, difficulty breathing, major head injuries, or signs of a stroke. If you’re ever unsure, calling your pediatrician or urgent care can help guide you.
Can my child’s health insurance help with specialized care, like mental health or speech therapy?
Many health insurance plans, including Florida KidCare, provide coverage for specialized care, such as speech therapy, mental health services and more. It’s important to check with your insurance provider to see which services are covered and whether you need a referral to access those services. Early intervention can be critical for your child’s development, so it’s worth checking to see what your plan offers.