Health Insurance For Newborn Babies
BY Anna Porretta Updated on January 21, 2022
When you are expecting a child, there are many things that might be on your mind during your pregnancy. One of those concerns could be healthcare coverage for your baby. Fortunately, this is one concern you may put to rest.
If you have your own healthcare plan, you andyour child will have coverage immediately following birth. If you or yourspouse have health insurance through an employer, you will be able to changeyour plan right away, since having a child is a qualifying life event thattriggers a special enrollment period. That special enrollment period alsoallows you to enroll in a plan to get the coverage you and your baby need.
If you are looking to find a family health insurance plan or need help figuring out which type of health plan is right for you, eHealth is here for you. Compare affordable plans in your area with out comparison tool or speak to a licensed agent online or over the phone today.
What Are The Risks Associated With Not Having Newborn Coverage Post The First 90 Days Of Birth
After the arrival of your newborn baby, you will be confronted with many new joys and responsibilities, and having health insurance that covers newborns is a great relief, however, if you do not have it, then you might face financial stress due to the following reasons.
- A financial burden is created due to the postnatal expenses, and in case they do not get covered under the health plan, it gets a bit hard for the mother and newborn baby to avail quality health care.
- It is possible for complications to arise during delivery, requiring immediate hospitalisation. It may become necessary for you to arrange money on an urgent basis if you do not have proper health coverage for your newborn.
- Without having proper health insurance cover, the newborn would not get supervision of the doctor, which is crucial to have a faster recovery post the delivery complications.
- Without getting your newborn insured under a health insurance cover, you could end up meeting the hefty medical bills that can pose a financial strain on your growing family.
How To Get Coverage
Start by calling the customer service number on your insurance card or contact the Human Resources department of your employer to see what information they require to have the baby added.
The hospital will provide you with a hard copy or email you a verification of birth letter when youre discharged. Some insurance companies require your newborns birth certificate and Social Security number in order to enroll. The hospitals medical records department should have assisted you with completing and submitting these forms.
- If for any reason the Social Security number form was not submitted, please go to SSA.gov/Forms/SS-5.pdf. Download the form and mail or deliver it to your local Social Security office.
- To order a copy of the birth certificate in the state of Michigan:
- VitalChek is the only Michigan Vital Records authorized online service provider. Michigan Vital Records orders placed online through VitalChek are considered rush requests. Go to VitalChek.com or call
- Another good resource is the State of Michigan Vital Records Office. Go to Michigan.gov/VitalRecords or call
- If your baby needs to be enrolled in Medicaid or you would like to be screened for Medicaid, please call the number below for your hospital.
- DMC Huron Valley-Sinai Hospital:
- DMC Sinai-Grace Hospital:
- DMC Hutzel Womens Hospital:
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Childrens Health Insurance Program
If youre not eligible for Medicare, CHIP is a comprehensive program you can consider that covers newborn health insurance. Your child will receive coverage up to the age of 18, and you can also receive prenatal checkups and care. Your newborn will also benefit from coverage for:
- Routine checkups
- Emergency services
- Doctor appointments
Although routine doctors visits and checkups for your infant are wholly covered by CHIP, as is dental when your child grows older, your state may charge you a monthly premium fee for CHIP coveragebut it shouldnt total more than 5 percent of your yearly income.
You can either call CHIP to enroll on 1-800-318-2596 or create a Marketplace account and fill out an application on Healthcare.gov. If you are eligible, your state CHIP agency will reach out to you regarding how to get started.
Getting Affordable Maternity Health Coverage
Sincepregnancy and giving birth are mandatory health benefits under the ACA, gettingaffordable maternity health coverage is as simple as finding the right healthinsurance plan for you and your growing family.
Youcan start shopping for a health insurance plan that fits your budgetary andcoverage needs at any point in the year. However, you can only enroll eitherduring the annual open enrollment period which runs from November 1stthrough December 15th in most states or during a specialenrollment period.
intuitive site and license health insurance agents help you compare your healthinsurance plan options to help you find the plan that suits you best. Keep inmind that eHealths help is completely free, you will not pay more for a planpurchased through eHealth than you would if you were to purchase it anywhereelse. Additionally, eHealths agents are always here to help you with questionseven after youve purchased a plan.
Startshopping for plans available in your area by entering your zip code below.
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Q Doesn’t The Government Already Know About This Death A Death Certificate Has Been Issued
It is important to notify the ministry as soon as possible when an insured person dies. The attending physician forwards this information to the ministry but this may take some time and the doctor is not responsible for the collection and return of the health card. The person who is looking after the affairs of the deceased must return the health card to the ministry.
Special Enrollment Having A Baby Or Adopting A Child
Congratulations! Welcoming a new child into your home is an exciting time with many things to consider. We’re glad you’re thinking about your child’s health insurance. Adding to your family size is a qualifying event. This means you can enroll in or change your health insurance coverage during a special enrollment period.
Additionally, if you were ordered by a court to provide health care coverage for a dependent, you may also qualify for a special enrollment period.
Keep in mind you only have 60 days to enroll in health insurance after your baby is born or adopted or you gain a dependent through a court order. After that, you’ll have to wait until open enrollment.
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If You Currently Have Marketplace Coverage
- If you want to keep your current Marketplace coverage, donât report your pregnancy to the Marketplace. When filling out your application for Marketplace coverage, select the âLearn moreâ link when we ask if youâre pregnant to read tips to help you best answer this question.
- If you report your pregnancy, you may be found eligible for free or low-cost coverage through Medicaid or the Childrenâs Health Insurance Program . If you are found eligible for Medicaid or CHIP, your information will be sent to the state agency, and you will not be given the option to keep your Marketplace plan.
- If you keep your Marketplace coverage, be sure to update the application after you give birth to add the baby to the plan or enroll them in coverage through Medicaid or CHIP, if they qualify.
Q How Do I Change My Name On My Health Card Upon Dissolution Of My Marriage
To change your name on your photo health card to reflect your birth name or a previous married name, you must visit a ServiceOntario centre, complete a Change of Information and present the original of one of the following:
- A divorce certificate which includes your previous name and the requested name
- A marriage certificate which includes your previous name and the requested name
- Birth certificate
- Change of name certificate
If you do not already have a photo health card, you must also provide three original documents to prove citizenship, Ontario residence and identity.
If you have any questions regarding your own specific situation, call the ServiceOntario, INFOline at 1-866-532-3161.
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Chip And Medicaid Eligibility Requirements: Citizenship Status
Federal law restricts many legally residing immigrants from qualifying for Medicaid or CHIP coverage, or requires immigrants to wait five years before granting them access to coverage.
However, some states do provide Medicaid or CHIP coverage to legally residing pregnant women and/or children:
- CA, CT, DE, DC, HI, ME, MD, MA, MN, NE, NJ, NM, NY, NC, TX, WA, and WI provide coverage to both legally residing pregnant women and children.
- CO provides Medicaid/CHIP coverage to lawfully present immigrant pregnant women only.
- MT, IA, OR, RI, and VA provide Medicaid/CHIP coverage to lawfully present immigrant youth.
At present, Deferred Action for Childhood Arrivals is not an eligible immigration status for applying for health insurance, as federal law prohibits undocumented immigrants from either enrolling in Medicaid or CHIP programs, or shopping in the government marketplaces.
When Can I Start Using My Insurance
Once you’ve signed up for a plan and paid the first month’s premium, you or your child can start using the insurance. The insurance company should send you and everyone covered by your policy insurance cards with your policy number and other information. If you or your child need to see a doctor or go to a hospital before you receive your card, call your insurance company first to make sure your family has been entered into their system.
You should also make sure that any doctor you choose for you or your child is in your insurance plan’s network. A network is made up of doctors, specialists, and other health care providers who have agreed to work with your insurance company when it comes to payments and services. If you take your child to a doctor who isn’t in your plan’s network, you may have to pay full price for some services.
Ask around and learn what you can about the primary care physicians in your plan’s network, and then choose a doctor you like. Once you’ve done that, schedule checkups and use your insurance to help keep your family healthy.
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Is It Permissible For My Health Plan Insurance Company Or Hmo To Require Me To Get Permission For A 48
No. Plans, insurance companies and HMOs cannot deny your coverage for the 48-hour hospital stay based on a failure to show medical necessity. However, plans, insurance companies, and HMOs can deny coverage for any portion of the stay that is longer than 48 hours based on their determination of whether it is medically necessary.
In addition, a plan may require you to give notice of pregnancy before admission to the hospital in order to obtain more favorable cost sharing. However, a plan may not reduce your benefits because your pregnancy began before the first day of coverage and you failed to give notice of the pregnancy before becoming covered under the plan. This type of plan provision operates as a preexisting condition exclusion and these exclusions cannot be applied to pregnancy.
What Services Can I Expect To Be Covered
Maternityservices covered by health plans include:
- Outpatient services These services include prenatal and postnatal doctor visits, gestational diabetes screenings, lab studies, medications, etc.
- Inpatient services such as hospitalization, physician fees, etc.
- Newborn baby care
- Lactation counseling and devices
Its important to keep in mind that your coverage may vary depending on what plan you have since insurers can choose how they cover these benefits. Additionally, out-of-pocket costs are dependent on several factors, such as the metallic tier of coverage you have, deductibles, copayments, and which providers you choose.
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Checking Your Baby’s Hearing
Your baby’s ability to hear your voice and other sounds clearly may be affected for a variety of reasons. Doctors can test a baby’s full range of hearing to detect problems.
To help detect any hearing problems:
- Pay attention to your baby’s response to sound.
- If you have concerns, ask your doctor to refer you to someone who can test young infants for hearing impairment.
The sooner hearing loss is detected and treated, the better your child’s language development will be. Some hospitals even test babies’ hearing in the hospital before they are discharged!
Coverage For Infertility Treatment May Be Very Limited
Approximately one in 10 women in the United States struggle with infertility, according to The Office on Women’s Health. If you are one of them, you’ll want to check your insurance coverage very carefully to see what infertility coverage — if any — is available.
Many insurance policies provide very limited coverage for fertility treatments, or provide no coverage at all. If this is the case, you could be looking at paying tens of thousands of dollars out of pocket for the care you need to get pregnant. You may need to take out a personal loan to finance your fertility treatments, or you can consider working with a clinic that provides financing or offers a shared-risk program.
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What If I Cant Afford Health Insurance For My Child But Dont Qualify For Medicaid
Many people, especially young people, fall into this category: they may have an inexpensive , catastrophic insurance plan to cover their own needs, but covering the medical needs of an infant is not always in the budget.
Luckily, the government has a program for this situation as well: its called the Childrens Health Insurance Plan . If you enroll in Medicaid, your children are automatically screened for CHIP eligibility. You can also enroll your children in CHIP on their own while keeping your Marketplace plan.
If you qualified for Medicaid during your pregnancy, your child is automatically eligible for CHIP without an application, but the coverage will only last for one year. Be sure to either reapply or find different coverage before their first birthday.
CHIP covers all the essential benefits for children, including medical, dental, and vision needs. You may still be required to make copayments for certain services, however.
Health insurance for a newborn is important, and its important to understand that youre not on your own in this situation. Your state and federal government have a wide variety of plans to help you keep your baby insured, whether you need to cover the few weeks after birth, or their entire first year. With the right insurance, you can set your baby on the path to a happy, healthy future.
Key Resources:
Talk To Your Insurance Company
Since your health insurance company will get a bill for your maternity care and birth costs, you might assume theyll have all the information they need once your baby is born.
Unfortunately, its not that easy and nothing happens automatically.
Instead, you need to reach out to your insurance provider to tell them about the birth of your baby and start talking to them about options for coverage.
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Can I Get Health Insurance For Just My Baby
Yes, you can get health insurance for just your baby. There are a few options to consider regarding health insurance for your baby. First, you can purchase an individual health plan and only include your baby in the coverage. Your baby also may be eligible for free or low-cost coverage if you fall below specific income limits. This coverage is provided through Medicaid and the Childrens Health Insurance Program . Check to see what level of Medicaid and CHIP coverage is provided by your state to see if you qualify.
Important Information For New Or Soon
If you have health coverage and are pregnant, you and your new child may be entitled to a 48-hour hospital stay following childbirth . If your employer or your spouses employer offers a health plan, birth, adoption, and placement for adoption may also trigger a special enrollment opportunity for you, your spouse, and your child, without regard to any open season for enrollment.
The Affordable Care Act adds important protections related to employment based group health plans that will improve health coverage for you and your family. Many of these protections are available now including extending dependent coverage until age 26, prohibiting preexisting condition exclusions for children under 19, and banning lifetime limits on coverage for essential health benefits. Additional protections will be available in 2014. This publication does not reflect the provisions of the Affordable Care Act. For more information, visit the Employee Benefits Security Administrations ACA Web page at dol.gov/ebsa/healthreform.
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Health Insurance For Infants: Before And During Delivery
Luckily, your health insurance has you covered from the moment you discover youre pregnant. Prenatal care is considered a preventative service, which your insurer will pay for even before you meet your deductible. This includes things like ultrasounds, chorionic villus sampling , and amniocentesis, which serve to monitor your babys health and alert you to any issues well before delivery day.
When the day finally arrives, youre still covered: maternity and newborn care are one of the ten essential benefits all Marketplace plans are required to offer by federal law. If you are uninsured and do not qualify for a Special Enrollment Period, you may qualify for Medicaid under state law. Insurers also cannot reject your enrollment due to pregnancy, though you are still limited to applying during the Open Enrollment Period in most cases.
Be aware that you may need to pay a deductible before your insurance covers maternity services fully.