What you need to know about adding your child to your health plan

Adding your child to your health insurance doesn’t have to be stressful — here’s what you may want to know to make the process go smoothly.

Congratulations on your new child! Whether you just had a baby, adopted or gained legal custody, this exciting change comes with a lot to manage — including health insurance.

The good news? These events are called Qualifying Life Events (QLEs). They let you add your child to a new or existing health insurance plan outside the annual Affordable Care Act (ACA) Open Enrollment Period. Here are 5 things that can help the process go smoothly.

1. Understand what a Qualifying Life Event is

A QLE is a change in your circumstances that allows you to sign up for health insurance outside the annual ACA Open Enrollment Period.¹ (Open enrollment is typically from early November until mid-January.) Common QLEs include getting married, losing coverage or moving.
For children, QLEs include:^{1, 2}

• Birth of a child: This is the most common QLE.
• Adoption: Legally becoming the parent of a child.
• Placement under a court order: Gaining legal custody of a child you are financially responsible for.

Your child can remain on your health plan until they turn 26. When they age out, that also counts as a QLE, meaning they may be eligible for a Special Enrollment Period to enroll in their own plan.¹

Find the plan that fits your growing family. Start comparing local coverage by calling a licensed insurance agent at (800) 827-9990.

2. Don’t miss the enrollment window

Even with a Special Enrollment Period, you have a limited time to add your child to your health plan. The exact timeframe depends on what type of health insurance you have. Typical windows for adding a child:

• Employer-sponsored plans: 30 days from the QLE.³
• Affordable Care Act (ACA) Marketplace plans: 60 days from the QLE.²

Whatever the window, enrolling within that timeframe is a way to make sure your child’s medical needs are covered from the day of their birth (or other QLE). It also helps avoid gaps in coverage.

If you miss it, you may need to wait until the next Open Enrollment Period to add your child. So acting quickly can help keep your child covered without interruptions. That’s especially important during the first three years of your child’s life because they’ll be going to the doctor often — for well visits and other reasons.

3. Have these key documents

You’ll need a few key documents to add your child to your health plan. Having them ready can make the process faster and less stressful.

Proof of the QLE:

• Birth: Your child’s birth certificate or proof of birth from the hospital if the official certificate isn’t available yet.
• Adoption or court placement: Adoption papers or court documents showing legal custody.

Personal information for your child:

• Full name
• Date of birth
• Social Security Number (SSN), if available

Some carriers may let you start the enrollment process with just proof of birth and provide the birth certificate and SSN later. Check with your plan to see what types of documents are accepted.

4. Choose a plan

When adding a child, you have a couple of options for healthcare coverage:

• Add your child to your existing plan: This is often the simplest choice. Your child will be covered under the same benefits you already have and you usually won’t need to make big changes.
• Shop for a new plan: A QLE lets you explore other plans for your whole family. This is a good option if your current plan doesn’t meet your needs — for example, if you want better insurance benefits for your growing family or wider network options.

Plans come in different types depending on your situation:

• Employer-sponsored plans: Provided through your job, often with shared costs for premiums and benefits.
• Individual or family plans: Purchased directly through the ACA Marketplace or an insurance company.
• Government programs: Programs like Medicaid and CHIP may offer coverage for children in eligible families.

Taking a few minutes to review your options can help you pick the plan that may fit your child’s needs and your family’s budget.

There’s a lot to keep in mind when you have a newborn, but don’t let health insurance be one of them. Discover healthcare coverage options available near you by calling a licensed insurance agent at (800) 827-9990.

5. How a licensed insurance agent can help

Adding your child to a health plan can feel overwhelming, but a licensed HealthMarkets insurance agent might make it easier. Here’s how:

• Expert guidance: An agent can explain complex plan details, from premiums and deductibles to specific coverage for your child’s medical care.
• Save time: They do the research and legwork for you, comparing plans from multiple insurance companies so you don’t have to.
• Personalized service: An agent can help you find a plan that may fit your family’s unique needs and budget, giving you a tailored experience.
• It’s free: Using a HealthMarkets agent comes at no cost to you.

Working with an agent can help you feel confident that your child has healthcare coverage — without all the stress.

Need help choosing a health insurance plan for your family? Call (800) 827-9990 to speak with a licensed insurance agent or explore plans online today.

For informational purposes only. This information is compiled by HealthMarkets Insurance Agency and does not diagnose problems or recommend specific treatment. Services and medical technologies referenced herein may not be covered under your plan. Please consult directly with your primary care physician if you need medical advice.