Health Insurance for newborn at birth -- how does it work?

[Arlington22207]

I have a little bit of an odd situation with the insurance of my future newborn and am wondering if anyone has ever heard of something similar or possibly experienced it.

I am due August 21 and have and will continue to have my insurance coverage that is available through my employer. Unfortuantely, my employer is small and offers only coverage for employees, so adding the newborn to my policy is not possible.

Consequently, the baby will go on my husband's policy. However, there is a complication (nothing is ever easy, it seems!): My husband works for a larger company and currently has four different options of insurance plans. He is himself enrolled in the most inexpensive plan which has only a small network of doctors. The pediatrician we have selected is not one of them, so he plans to use the birth of the baby as a qualifying life event to change to a different insurance plan where the pediatrician is in-network, as well as add the new baby, all at the same time (right after the birth).

But he can't do that until the baby is born, and I assume the baby needs to have their own coverage from the minute they are born? His company says everything will be retroactive to the date-of-birth with the "new" plan...but what do I tell the hospital and pediatrician's office in the meantime when I pre-register? I'm afraid if I just say "I _PROMISE_ that the baby will be insured but I can't provide any information on it just yet" that won't go over too well. But if I provide my husban;ds current insurance, the pediatrician (if not the hospital) will just say that they don't accept that insurance.

I'm a bit confused and I'm not really sure how the billing and everything for the newborn will work. I think they need their own insurance from the minute the are born, right?

Any thoughts would be appreciated! Thanks.


Any thoughts?

[lizajane]

you have a certain amount of time to add them after birth. you can't provide key information like name and date of birth UNTIL the baby is born. so yes, the coverage is retroactive. no need to worry.

[HIU8]

:yeahthat: With DD and DS I had 30 days to get the insurance company the information and coverage was retroactive to the birth.

[deenass]

It is possible that you may have to pay out of pocket for pediatrician visits and be reimbursed by the insurance company. You can call the billing office at the ped and find out what their policy is.

You are not the first person dealing with this type of situation (beleive me, they see it ALL) so they should be able to tell you how they will handle billing.

The PP are correct, everything will be retrocactive (providing that your husband submits whatever necessary paperwork within the grace period allowed).

[AnnieW625]

It's 30 days I think. Good luck!

[DebbieJ]

usually the newborn is covered under YOUR plan for the first 30 days or so.

These are really questions you should be asking of the insurance plan folks, not us. The answers are different for every plan.

[kijip]

The hospital and pediatrician have seen this before. All babies can be added to their insurance (and the policy changed if that option is available, like it is for your spouse) within 30 days and it is retroactive. I have never had the hospital ask for insurance for the baby. When your husband adds baby and changes plans they will give you the group/policy/member id number and that can be given to the ped while the cards are being processed.

[Octobermommy]

Definitely don't worry. The new plan will cover the baby from the minute he is born. No need to explain as the doctors office deals with this all the time

[Momof3Labs]

When DS1 and DS2 were born, they were covered under my insurance automatically for 30 days - they were still considered a part of me, so to speak, for that period. During those 30 days, we put them on DH's plan due to the lower cost, and his insurance started paying at the end of the 30 days. You really need to call your health insurance co (not your employer) and ask them how they handle coverage for a newborn.

[BabyMine]

When both boys were born they told us to use my name until they got the name and SS#. PPs are right about the 30 days have your DH call his insurance.

[Arlington22207]

Thanks to all for your comments/advice. I apprecaite it. I will indeed contact the insurance company about this, but I wanted to clarify something since I'm not sure if it was clear to everyone based on a few of the comments. Clearly, we have 30 days to add the child to the policy. But in our case, my husband will be completely changing insurance companies AND adding the child, all at the same time.

I'm sure this sitauation has occurred with pediatricians and hospitals many times, but it still makes me nervous because I feel like there is a greater opportunity for some sort of mix-up!

[BabyMine]

We did that also. My husband changed insurance and added our new addition. It wasn't a problem.

[Arlington22207]

Thanks so much to everyone for all of your help!

[nupe]

Something else to consider:

DH and I both have our own plans. We decided to add DC to his plan. DC was covered automatically for 30 days under my individual plan, and then also under DH's family plan. So there were 2 policies on DC. They used the birthday rule, between me and DH to determine which was the primary and which was the secondary insurance, based on whose bday came earlier in the year (no one cared about the year).