Congratulations on your new baby! Whether you’re adding to your household through birth or adoption, your newest family member will need health insurance just like you. But does your newborn even need coverage, or can it wait?
This article will explain the benefitsbenefitsThe health care items or services covered under a health insurance plan.
Read more » of getting health insurance for newborns, when you should apply, and how to get your baby covered.
Why do you need health insurance for newborns?
While prenatal care may have been covered under your current plan, your baby will need their own coverage after they are born. You have some time to coordinate benefits,
read more on that below, but it’s a good idea not to delay.
Just like health insurance for adults, health insurance for newborns can cover things like hospital care and stays, physician visits (like the pediatrician), vaccines and boosters, and other treatments and preventive carepreventive careRoutine health care to prevent illnesses, disease, or other health problems.
Read more ». Their coverage will also come with copays or coinsurancecoinsurancePercentage of costs of a covered health care service you pay after your deductible.
Read more », deductiblesdeductiblesThe amount you pay for covered health care services before your insurance pays.
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Does my health insurance automatically add my baby to my plan?
No, your health insurance will not automatically add anyone (even your newborn baby) to your plan. Whether you have a group plan through your employer, a private plan, or an Affordable Care Act plan, you must actively add your baby. This is also true for any supplemental insurance you have, like dental or visionvisionA health benefit that at least partially covers vision care, like eye exams and glasses.
Read more » insurance.
When can I apply for health insurance for my newborn?
Having a baby is a Qualifying Life Event (QLEQLEA change in your situation that can make you eligible for a Special Enrollment Period.
Read more »), so you can apply for health insurance for your baby as soon as they are born. This period of time is considered a Special Enrollment PeriodSpecial Enrollment PeriodA time outside the Open Enrollment Period when you can sign up for health insurance if you qualify.
Read more » (SEPSEPA time outside the Open Enrollment Period when you can sign up for health insurance if you qualify.
Read more »). You have up to 60 days to apply for your newborn’s coverage for an Affordable Care Act plan and 30 days for employer plans.
‘Coordinating benefits’ for your family
If both parents are employed or have their own individual plans, you will need to ‘coordinate benefits’ when adding your child. This means you will need to choose if you add the baby to one or both for the adults’ plans, select which will be the primary plan if your baby will be on both plans, and notify your insurance plan (or plans) of your decisions. Ensuring you have coordinated your family’s benefits can help when it comes time to your baby’s first insurance claimsclaimsA payment request submitted to a health insurer for medical services and items.
Read more ».
Don’t forget to coordinate benefits for your supplemental insurance plans when adding baby, too.
How to add a newborn to insurance if you already have coverage
Adding a newborn to insurance, health or supplemental, is as easy as contacting your benefits provider (for group plans) or health insurance company (for private and Affordable Care Act plans). Let them know you’ve had a baby, which qualifies as a QLE. You will need to answer a number of questions (like when the baby was born), make your plan selections and provide supporting documents.
How to get health insurance for a newborn if you are uninsured
Once your baby is born, you can apply for health insurance during your Special Enrollment Period through your employer benefits, by shopping online, or you can contact a licensed health insurance agent.
Licensed health insurance agentsagentsA trained insurance professional who can help you enroll in a health insurance plan.
Read more » can help you compare plans, find coverage that matches your needs and budget, and help you through the application process. Their help comes at no cost to you, and it will not affect the cost of your plan. If you’re unsure about what kind of coverage to get for your family, reach out today by calling (866) 405-0604.
