December 13, 2023
2 minute read

Do you need health insurance for your newborn, and how do you get it?

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 benefits 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 care. Their coverage will also come with copays or coinsurance, deductibles, etc.

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 vision insurance.

When can I apply for health insurance for my newborn?

Having a baby is a Qualifying Life Event (QLE), 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 Period (SEP). 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 claims.

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 agents 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 (800) 827-9990.

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© 2024 HealthMarkets Insurance Agency. All rights reserved.

* Medicare Advantage, Medicare Supplemental Insurance, and Part D options can be explored.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.

To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.

Attention: This website is operated by HealthMarkets Insurance Agency, Inc. and is not the Health Insurance Marketplace® website. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency nationwide except in MA. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in an insurance plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.

HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces.

This information is not a complete description of benefits. Call the Plan’s customer service phone number for more information.

50509-HM-1223

© 2024 HealthMarkets Insurance Agency. All rights reserved.

* Medicare Advantage, Medicare Supplemental Insurance, and Part D options can be explored.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.

To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.

Attention: This website is operated by HealthMarkets Insurance Agency, Inc. and is not the Health Insurance Marketplace® website. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency nationwide except in MA. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in an insurance plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.

HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces.

This information is not a complete description of benefits. Call the Plan’s customer service phone number for more information.

50509-HM-1223

© 2024 HealthMarkets Insurance Agency. All rights reserved.

* Medicare Advantage, Medicare Supplemental Insurance, and Part D options can be explored.

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program to get information on all of your options.

To send a complaint to Medicare, call 1-800-MEDICARE (TTY users should call 1- 877-486-2048), 24 hours a day/7 days a week). If your complaint involves a broker or agent, be sure to include the name of the person when filing your grievance.

Attention: This website is operated by HealthMarkets Insurance Agency, Inc. and is not the Health Insurance Marketplace® website. HealthMarkets Insurance Agency, Inc. is licensed as an insurance agency nationwide except in MA. Not all agents are licensed to sell all products. Service and product availability varies by state. Sales agents may be compensated based on a consumer’s enrollment in an insurance plan. No obligation to enroll. Agent cannot provide tax or legal advice. Contact your tax or legal professional to discuss details regarding your individual business circumstances. Our quoting tool is provided for your information only. All quotes are estimates and are not final until consumer is enrolled. Medicare has neither reviewed nor endorsed this information.

HealthMarkets Insurance Agency offers the opportunity to enroll in either QHPs or off-Marketplace coverage. Please visit HealthCare.gov for information on the benefits of enrolling in a QHP. Off-Marketplace coverage is not eligible for the cost savings offered for coverage through the Marketplaces.

This information is not a complete description of benefits. Call the Plan’s customer service phone number for more information.

50509-HM-1223