Newborn baby health insurance coverage is critical to the well being of your baby. Health care policies will cover your important first steps with benefits for pediatricians, immunizations, and other costs.

Bringing home a newborn baby changes parent’s lives. If this is your first child there are important steps to take right away. If your newborn was born preterm or with an existing medical condition there are other considerations. Learn how newborn baby health insurance coverage works.

  • Adding your newborn to existing plan
  • Coping with infants in the NICU
  • State exchange implications

Adding Newborn Baby to Health Insurance Plan

Newborn baby health insurance coverage comes automatically during the first 30 days after birth for parents with existing coverage. This rule applies with traditional health plan as well as many forms of supplemental health insurance for children.

This 30 day period goes by quickly when parents have a newborn baby in the home. Babies can turn the lives of parents upside down. There are several important steps to take inside these thirty days, despite the commotion. Remember that the birth of a newborn is a qualifying life event. This allows parents a brief window of time to make important financial choices.

Qualifying Life Event

The birth of a newborn baby is a qualifying life event which has implications for health insurance coverage, as well as flexible spending account choices. Healthcare providers limit the times during the year that plan participants can make policy changes to protect themselves from adverse selection. The IRS imposes similar rules for any tax favored payroll deduction.

Often the process of adding newborn baby health insurance coverage is as simple as contacting your existing provider and adding your infant to your existing plan. As long as you add your newborn within the 30 day period, the carrier must honor the request per qualifying life event rules.

Don’t delay. Treatments that fall after the 30 day grace period may not be covered, and you may run into pre-existing condition rules if your newborn becomes sick or shows signs of developmental delays.

Having a newborn baby may also mean an increase in un-reimbursed medical expenses, or a big jump in childcare expenses. Parents who plan on utilizing childcare can make a change in their flexible spending accounts per qualifying life event rules.

Impact on Premium Costs

The monthly premium costs for newborn baby health insurance coverage may be higher if this is your first child. You probably had individual, or husband wife coverage, and now are moving to single parent or family coverage. There will be an increase premium to cover your newborn baby.

If this is your second or third child, you may already have a single parent or family plan in place. Most carriers charge the same monthly premium amount for plans with dependent coverage. A family with one child pays the same monthly premium as one with five children. If you are adding your newborn to a plan covering your other children, there may be no incremental costs.

Premature Newborn Babies Coverage

Newborn baby health insurance coverage is vital should your child require care in the Neonatal Intensive Care Unit (NICU). Expenses can add up quickly. Don’t forget to contact your carrier within 30 days. You don’t want to lose coverage for an infant that is seriously ill.  Having your newborn confined to a NICU has impacts on supplemental coverage, your FSA elections, and exchange implications.

Supplemental Coverage

Supplemental hospital indemnity covers mom’s stay at the hospital and will pay an additional benefit should your infant require special care. Most policies may cover your infant during the first 30 days. Be sure to file a claim for your newborn if time is spent in the NICU. An extra benefit may be paid for multiples that require specialized care. Multiples are frequently born pre-term.

You may add your child to your policy if medical underwriting is met. Coverage must begin prior to conception.

FSA Elections

Having a newborn confined to a NICU may result in added expenses. Parents might have some left-over medical bills associated with child birth: hospital deductibles, co insurance, out of network fees, etc. Pre-tax dollars can cut costs not covered by your newborn health insurance. Make sure you change your annual election to cover the extra costs.

Many children born pre-term go on to health healthy normal lives. Many others have ongoing medical issues. Should your child show signs of developmental delays you may quickly find yourself immersed in a variety of diagnostic testing – much of which may not be covered by your policy. Learn to use your flexible spending account to stretch your resources.

State Health Insurance Exchanges

Premium and cost sharing subsidies by income

Passage of the Affordable Care Act opens up many new opportunities for parents to find newborn baby health insurance coverage through state exchanges.

Children with preexisting conditions can’t be denied coverage or charged a higher premium rate. But limitations apply such as purchasing your policy during open enrollment periods. If your newborn baby has serious medical conditions make sure to purchase an exchange based policy right away – while the qualifying life event rules allow.

Change in Subsidies

The state exchange plans offer parents a possible increase in premium and cost sharing subsidies. The Affordable Care Act provides subsidies based upon income. As family size grows the income levels needed to qualify for subsidies grows in tandem. Plus, when an infant is born preterm one or both parents may need to stop working, which lowers income further.

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