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.
Can Babies Be Covered By Health Insurance Before Theyre Born
No, but babies are covered retroactively for the first 30 days after birth as long as the child is enrolled in health insurance during this timeframe. This includes checkups, tests, and other medical procedures.
Additionally, the newborn will have their own deductible, coinsurance, and out-of-pocket maximum.
Adding A New Baby To Your Insurance Plan
Congratulations! There is nothing sweeter than welcoming a new baby into your home. You probably already had a checklist of everything you needed to do pack the hospital bag, install the car seat, and of course, dont forget about adding your newest bundle of joy to your health insurance plan.
The process of adding a new baby to your insurance plan is different based on what kind of insurance plan you have. Group members are enrolled in a group plan, usually offered by an employer. Direct enrolled members purchased their health insurance off marketplace.gov or directly through our website.
Group members:
If you currently have a policy that covers child, the newborns coverage is effective on the birth date. However, a phone call or a change form will still need to be submitted to add the child within 60 days of the date of birth.
If your current policy does not cover children, you may either call our office at 1-800-432-3990 or send in a change form within 60 days of the babys birth in order to change your policy to one that does cover children. If a call is placed to add the child, follow up with your group and send in a change form signed by you and your group leader.
To obtain a copy of the change form please contact your group administrator or contact us.
Direct enrolled members:
If you currently have a policy that covers child, the newborns coverage is effective on the birth date. However, a change form or a phone call will still need to be made to cover the child.
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Events Most Likely To Result In Addition Of Dependent
If any of these events listed below occur, you may request coverage for an eligible dependent.
| Event | ||
|---|---|---|
| No later than 60 days from date of eligibility | Group determines but not to exceed 90 days from date of hire. | |
| Within 31 days following marriage/civil union. | First of the month following marriage/civil union. | |
| 32 to 60 days following marriage/civil union. | First of the month following receipt. | |
|
Birth |
Within 60 days following birth. | Date of birth for child and 61st day after the birth for the membership type change. |
| 61 to 90 days following birth. | First of the month following receipt. | |
|
Adoption |
Within 60 days following adoption . | Date of adoption . |
| 61 to 90 days following adoption . | First of the month after we receive the request. | |
|
Qualifying Loss of Coverage |
Within 31 days after loss of coverage. |
Changes To Nj Newborn Mandate
On , New Jersey updated the existing NJ Newborn Mandate that provides coverage for all newborns from the moment of birth for the first 31 days to provide coverage from the moment of birth for the first 60 days. The newborn child of the subscriber or his or her spouse is covered for injury or sickness, including the necessary care and treatment of medically diagnosed congenital defects and abnormalities. This mandate does not apply to newborns born of dependent children.
For coverage to continue beyond 60 days after the date of birth, the contract or policy may require the subscriber to notify the health plan of the birth within 60 days of birth, and may require payment for the addition of the newborn to the policy.
A group plan that includes coverage for the subscriber only is not required to add this dependent coverage.
This legislation is effective:
- For fully insured groups the mandate will be applied on renewal on or after
- For self-insured health plans on renewal on or after . Self-insured health plans may opt out of the revised mandate and have been advised by their Horizon BCBSNJ sales executive or account managers on their options and next steps.
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I Purchased Coverage Through The Health Insurance Marketplace
Go to healthcare.gov or call the Marketplace at 1-800-318-2596 to determine if you are eligible for a special enrollment period.
If you are eligible for a special enrollment period because you had a baby, adopted a child or got married, you have 60 days after the life event to add a family member to your coverage.
For more information about enrollment periods, please review your Benefit Booklet by logging in to your account at YourWyoBlue.com.
What If I Dont Qualify For Special Enrollment
Depending on your income, you may qualify for Medicaid or CHIP. There is no special enrollment period for those government offered coverage options you can apply at any time.
Members of American Indian and Alaska Native tribes can enroll any month, not just during open enrollment. You can even apply for cost assistance.
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Specific Benefits Of The My Pregnancy App
Access to credible information related to breastfeeding, labor and delivery, pregnancy symptoms and more
Gain insight into questions you may want to ask your doctor, and add them to your Q-list
Speak with a Blue Cross NC nurse 24 hours a day, 7 days a week by tapping a single button
Regular use will help you identify potential risks and quickly connect to a nurse
Enjoy features including the Baby Boost relaxation tool, Kick Counter and Due Date Calculator
It’s free, confidential and there are no pesky pop-up ads
Changes That Have A Deadline
Sometimes you need to add someone to your plan, or you cant keep your current plan. For example, you may need to:
- Add a baby or spouse to your plan
- Get a new plan because you moved out of the area your current plan covers
- Buy your own plan because you lost insurance you had through an employer
In these cases, you have a limited amount of time to act. Members who:
- Get insurance through an employer or group usually have 30 days after the event to make changes
- Buy their own insurance can make changes 60 days before and after qualifying life events
Its important to be aware of these deadlines. If you miss them, you may have to wait until the next open enrollment period.
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How And Where To Make Changes
To change your email address:
- Log in to your member account. If using our website, go to Account Settings if using the Blue Cross mobile app, go to My Account
- Or, call the number on the back of your Blue Cross ID card
If you bought your plan on the Marketplace, and want to update your email there too, youll have to log in to your healthcare.gov account.
How Do I Change My Information And Coverage
Who is this for?
Blue Cross Blue shield of Michigan and Blue Care Network members under age 65.
Maybe you want to let us know you changed your name.
Maybe you got married, moved, and want to add your spouse to your health insurance.
When, how and where you can make changes depends on:
- If you get your insurance through an employer or group, or buy it yourself
- What it is youre changing
First we’ll explain when you can make changes, then we’ll tell you how to let us know.
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Banking And Payment Information
Submit this form if you want to change previous banking information or give permission for Alberta Blue Cross to withdraw monthly payments FROM your account and TO directly deposit claims to the same or different bank account. Or, save time and stamps by registering for direct deposit online through the plan member secure site.
Wedding Bells Diapers And Qualifying Life Events
The summer season is upon us, and to many people that brings one thing: wedding season. The summer season is replete with flowers, veils, cake and potentially, a new Blue Cross Blue Shield health insurance plan for the happy couple.
Between that new cutting board and a check from Great Aunt Sally, couples who get married before the next open enrollment period in November may qualify to purchase health insurance coverage and receive financial assistance – through the Healthcare Marketplace.
Though open enrollment will not begin again until November, getting married is considered a qualifying life event. For those without insurance coverage through an employer, that means you are allotted a 60-day special enrollment period to add your spouse to an existing plan or shop for new coverage.
Dont let your window of opportunity slide while youre on your honeymoon or gazing at wedding photos – once your 60-day special enrollment period ends, youll have to wait until November to sign up for or change your coverage.
Another common qualifying life event is the birth, or adoption, of a child. In that case, the special enrollment period allows you to add the child as a dependent on your plan within 60 days of his or her birth or adoption date.
The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies.
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Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
Attention: This website is operated by Blue Cross and Blue Shield of North Carolina and is not the Health Insurance Marketplace® website at HealthCare.gov. This website does not display all Qualified Health Plans available through HealthCare.gov. To see all available Qualified Health Plan options, go to the Health Insurance Marketplace® website at HealthCare.gov. Also, you should visit the Health Insurance Marketplace® website at HealthCare.gov if you want to enroll members of your household in dental coverage.
1 Weâre sending you to HealthSherpa to purchase your Blue Cross and Blue Shield of North Carolina health plan. HealthSherpa is a CMS-certified vendor that Blue Cross has selected to make the enrollment process easier for you. Note that you will be leaving BlueCrossNC.com and Blue Cross NCâs website. Health Sherpa is responsible for the site you will be directed to, including the privacy policies that govern the site
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Precious Additions Gives You Access To Tools And Resources That Can Help You Get The Pregnancy Support And Information You Need When You Need It
If you need help finding a doctor or other health care professional to support you during your pregnancy, visit HorizonBlue.com/doctorfinder or download the Horizon Blue app. To get the app, text GetApp to 422-272, or go to the App Store® or Google Play. There is no download charge, but rates from wireless providers may apply.
App Store® is a service mark of Apple Inc., registered in the U.S. and other countries. Google Play is a trademark of Google LLC.
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How Newborn Baby Health Insurance Can Support First
Having a baby is a hectic time. But even though members with newborns are sure to be preoccupied and sleep-deprived and may be out on leave there are steps they should take to get their newborn baby health insurance.
The union board is well-positioned to guide its members as they welcome a new addition to their family. Planning ahead not only supports growing member families but also strengthens the member-union relationship.
Understand Why Planning Ahead Matters
Members who are first-time parents may not realize that insurance companies don’t automatically add a new baby to a parent’s policy. The policyholder has to actively add their baby after birth. Then, plan coverage is applied retroactively for the baby’s care in the hospital and for their multiple pediatrician appointments once they’re home.
If a member forgets to add their baby to their policy within the allotted number of days, it can lead to unnecessary stress. Insurance may not cover the baby’s hospital stay or initial doctors’ appointments. If they miss the window, parents may even have to wait until the next open enrollment period to get their newborn baby health insurance, which would mean both having to figure out how to protect their baby’s health without health care coverage and worrying about how to pay for birth-related costs out of pocket.
Offer a Checklist
The My Pregnancy Program Also Includes:
Obstetrics case management
Blue Cross NC offers OB nurse managers, when appropriate, to make sure members have access to the support they need. These services are provided on all high-risk pregnancies.
Postpartum phone calls
After delivery, most women will receive a phone call from Blue Cross NC. This call is a great way for us to check in and see how things are going.
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities.Learn more about our non-discrimination policy and no-cost services available to you.
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Blue Cross NC offers wellness solutions as a convenience to aid our members in improving their health results may vary. Blue Cross NC reserves the right to change or discontinue wellness solutions at any time. Decisions regarding care should be made with the advice of a doctor.
BLUE CROSS®, BLUE SHIELD®, and the Cross and Shield symbols are registered marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. All other marks are the property of their respective owners. Blue Cross NC is an independent licensee of the Blue Cross and Blue Shield Association. U13620, 6/18
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