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I just had a baby boy and in between trying to figure out how to be a mom, I know I need to figure out health insurance. Help! How do I sign him up for health insurance? I know I can call my insurance company, but I don't know if my plan is best . . . or if I should look into a different plan? Does my baby need health insurance when he's so little?
Congratulations on your little man! Having a baby is a very exciting time. But it can also be overwhelming, can't it? The good news is that if you have comprehensive health insurance (in other words, not a short-term health plan or a catastrophic plan) your son was covered by your insurance company from the moment he was born. But this train will leave the station in 30 days.
That's right, the clock is ticking. Having a baby is a qualifying event, and therefore gives you a 30-day window to enroll your son in coverage and even change your health plan.
There are two options you should consider: add your son to your health plan or switch plans altogether.
1. Add your newborn to your health plan
If you want to put your baby on your health plan, call your insurance company and have his birth certificate and social security number ready. Tell them you just had a baby and would like to add him to your health plan. If you have a health plan through your job, then you'll need to notify your HR department or whoever is in charge of benefits about your son's birth. Let them know that you'd like to add your son to your health plan. In both scenarios, it would be good to inquire about cost. And don't miss the 30-day window!
Once your son is enrolled in a health plan, this plan covers him retroactively. What this means is from the moment he was born, his new health plan covered all his checkups, procedures and any other medical costs--regardless of when you sign him up during the 30-day period. He will have his own deductible, coinsurance and out-of-pocket maximum. If he's healthy, hospital will typically bill all the care at the hospital under you. But if he's sick, the hospital will likely bill all the hospital care under his deductible.
Now, let's look at another option for getting your baby coverage.
2. Switch health plans
Since having a baby is a special event that allows you to change your health plan, it would be a good idea to compare adding him to your health plan to signing up for a different health plan altogether. Maybe you talk to your HR department and find that employee + family coverage is really expensive. Or maybe you have never liked your health plan and want to enroll in a better strategy for you and your family. Whatever the situation, there is always a reason to look into a better health plan. You could save money or find more inclusive coverage, or both.
Before you start looking at new health plans, here are some good questions to answer:
- How much am I willing to pay in monthly premiums?
- What doctors and hospitals are important to me?
- What kind of prescription drugs do I take?
- How much do I estimate to spend on health care expenses?
- Do I prefer paying copays for visits and prescriptions or having an HSA to pay for health care expenses?
- What are some aspects of my current plan that I don't like?
After you answer these questions, you can compare marketplace plans or off-exchange plans to your employer plan.
Just like adding your baby to your current health plan, you have 30 days after his birth date to enroll in a new plan. The coverage for this new plan will also be retroactive, meaning it will cover him starting at birth.
Having a baby is exciting, but there are a great deal of health insurance questions that arise. Try not to let health care confusion overshadow this special time. If you need help comparing health plans, you know where to reach us.
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