You’ll make several trips to the doctor’s office during the first month of your baby’s life. You can avoid wrangling with your health insurance provider (and unexpected medical bills) by understanding how newborn insurance coverage works in the first 30 days after birth. Consider what you need to do in order to get baby insurance, and learning when your newborn health insurance coverage will take effect.
Before Your Baby Is Born: Look at Your Current Coverage
Evaluate both parents’ coverage options.
While the proverbial bun is still in the oven, set aside some time to review your and/or your partner’s respective healthcare plans–especially if one or both of you get baby health insurance coverage through your employer.
Because some health insurance plans limit the number of dependents who can be covered under the same policy, you’ll want to check with your insurance provider to make sure your plan will allow you to add your baby to your plan once (s)he is born. Keep in mind that adding dependents to your plan may raise the cost of your monthly premium, so you may want to ask your insurer if adding dependents to your plan will affect the cost of your premium (and if so, by how much).
Get Coverage for Your Baby
In order to ensure health insurance for newborn children, most insurance providers require parents to add their newborn baby to their insurance policy within 30 days of their child’s birth or adoption (the sooner, the better). Depending on how you get your health insurance, you’ll need to take action in one of the following ways after welcoming your new baby into the world:
If you get insurance through your employer: Contact your HR department or the person who administers benefits at your workplace. Let this person know that you would like to add a dependent to your healthcare plan.
If you (or your partner) have coverage through a private plan: Call your insurance provider directly or visit our homepage and submit a form. A representative can walk you through the process of adding your baby to your plan. The representative will also let you know if adding a dependent to your plan will affect the cost of your monthly premium, and can inform you of any further steps you need to take to ensure your baby has coverage.
Informing your provider through your state’s Obamacare health insurance exchange: Under the Affordable Care Act, having a baby is considered a “qualifying life event,” entitling you to a special enrollment window during which you can make changes to your healthcare coverage. Parents have 60 days to enroll their newborn as a dependent on their plan. As long as a parent or legal guardian does this within 60 days of the baby’s birth or adoption date, coverage will apply retroactively.
To avoid a delay in baby insurance coverage, new parents should report a birth or an adoption to their state or federal Marketplace as soon as they can. Consumers can report this event online at HealthCare.gov or by calling the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325). Parents should not report these changes by mail.
Key Points: Baby Health Insurance & Health Insurance for Newly-Adopted Children
All state and federal Marketplace health insurance plans, as well as Medicaid and CHIP plans, cover the cost of prenatal care and childbirth/delivery. This is true–even if a woman was pregnant prior to enrolling in a plan and her coverage taking effect.
Adopting a child or having a baby counts as a qualifying life event, entitling parent(s) to a Special Enrollment Period. During this period, parents can make changes to their insurance plan, or enroll in a new one.
Parents have a 30-day grace period (or a 60-day grace period for Obamacare plans) to add their baby to their health insurance policy. As with most deadlines, the sooner parents do this, the better.
As long as parents are insured and add their newborn as a dependent to their healthcare policy within 30 days of their child’s birth or adoption, the newborn will be covered from the moment of his or her birth.
Health insurance plans are required by law to cover care for mothers and their newborns during and immediately following the labor/delivery process.
Source data according to HealthCare.com: Baby Insurance 101: Health Insurance for Neborn Children, 2018