Handling Health Insurance When Having a Baby

If you’re a new parent, then you already know how incredible it is to take part in the birth of a child. Having a baby is a milestone event filled with “aww” inspiring moments that you’ll never forget. In order to be able to fully enjoy every new experience with your little one, it’s important not to get hung up on unnecessary worries. One of these potential concerns may pertain to your newborn’s health insurance coverage. We’re going to go over the most common health insurance questions that come up during the childbearing process so that you’ll have a good idea on how to proceed when the time comes.

Coverage Options

The options available to you depend on your current health insurance coverage situation. The following scenario-based choices are best discussed with your insurance broker as they are most qualified to help you with these important decisions.

newborn baby health coverage

I Have...

What Should I Do?

Single or Single + Spouse Coverage

If you have Single or Single + Spouse coverage, you will need to switch to a health insurance plan that includes children. This can be accomplished using an add/change/delete form and adding your child to your coverage plan as a dependent.

A Group Coverage Plan

When health insurance coverage is provided by your employer, you should speak with your Human Resources administrator or health insurance broker to see what options are available under your group contract. Keep in mind that your coverage options may be limited along with the company’s contribution which may also add an additional cost. If your group coverage is insufficient, child-only plans are available to you at your own expense.

A Family or Parent/Child Plan

If you already have a child and a family coverage or parent/child plan is currently in place, you simply need to update the insurance carrier with your new child’s information. This requires filling out an add/change/delete form which we’ve mentioned previously. The updating process may vary depending on your health insurance provider, so be sure to check their website or contact your broker to make sure you have all relevant information at hand.

No Health Insurance Coverage

In this scenario, we strongly recommend speaking with your broker and getting health insurance coverage as soon as possible. The medical-related costs associated with having a baby can pile up quickly. And these expenses can push you into debt that could have been avoided.

What About Prenatal Care?

Prenatal care is covered under the mother’s health insurance policy. This also applies to the actual delivery of the baby. Right up until the point that the umbilical cord is cut, health insurance providers classify the mother and child-to-be as a single person. Many people in the health insurance industry affectionately refer to this as the “belly button” rule. Wondering why that is? While the mother obviously has a belly button, a newborn’s belly button isn’t formed until after the umbilical cord is cut. So, one belly button equals one person to be insured. Once the baby is detached from the mother there are two belly buttons; both of which belong to people eligible for health insurance.

expectant mother health insurance

Take Advantage of the 60-Day Special Enrollment Period

The birth of a child is considered a “qualifying life event”. This provides you with a 60-day window to update or add to your health insurance plan. This special enrollment period applies to your entire household, so it may also be a good time to reevaluate your family’s coverage options. The coverage will be effective retroactively to your child’s date of birth, so there’s no need to rush the decision-making process. Please note that in order to successfully claim this qualifying life event you must notify your health insurance broker or provider of your child’s birth.

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