How do I get health insurance for my new baby?

After you bring your baby home, you'll likely have a few more to-dos in between all that sweet snuggle time. But there’s something to keep on the top of your list – adding your little one to your health insurance coverage.

The process is relatively easy, assures Adria Gross, CEO of MedWise Insurance Advocacy in Monroe, New York, and author of Solved! Curing Your Medical Insurance Problems. Birth and adoption are considered qualifying life events. That means you can add your baby or adopted child to your plan within a certain window of time.

When does the special enrollment window start?

If you have an employer-based health plan, the special enrollment period is at least 30 days after your child’s birth or adoption. If you have a federal or state marketplace health plan, it’s 60 days.1 And not to worry — no matter when you enroll your child during that window, the policy will start covering the medical bills from the day of their birth or adoption, explains Gross.

To make everything go as smoothly as possible, here are some steps to guide you.

Adding a child when you have job-based health insurance

Consider changing health plans

Because having a child is a qualifying event, you can switch plans too, notes Gross. If both parents have employer-based health insurance, compare each company’s plans. “Take some time to do some research and figure out which one is really the best,” advises Gross. Consider premium costs and copays. Also look at the doctors, hospitals and medications covered in each plan.

Call your health insurance company directly

Whatever plan you pick, contact your company’s human resources department to enroll your baby, Gross advises. Let them know you just had a baby and that you’d like to add them to your plan. Don’t forget to ask about potential costs.

Gather the necessary paperwork

Get in touch with your insurance company to check what paperwork you need. It differs based on the type of insurance and the insurance company. Most of the time, you’ll just need your baby’s birth certificate or proof of birth, says Stacy Edgar, co-founder and CEO of Venteur, an employee benefits brokerage company in San Francisco. The hospital where you gave birth can help you complete and submit these forms. Just be aware that it usually takes a couple of weeks to get them. If you’ve adopted your baby from outside the U.S., you’re usually asked to submit the official adoption papers.2

Check your new premiums

Sometimes family plans allow for new dependents at no additional charge. But other times premiums can increase significantly, says Gross. Take the time to figure out your expenses and prepare for any cost changes.

Adding a child when you have a federal or state-based marketplace health plan

The same rules apply – you may need to have your baby’s Social Security number and birth certificate before you can enroll. Ask if it’s possible to start this process while you’re at the hospital – it could save you time if so.

Some options you can consider with marketplace plans:

  • Keep the same plan and just add your baby
    When you update the application, your coverage options and savings may change. You may also qualify for subsidies, which could lower your monthly premiums.
  • Find a separate plan just for your baby or adopted child
    Only your baby qualifies for a special enrollment plan. You can revisit coverage for the rest of the family during the next open enrollment period.3

Adding a child when you have Medicaid or Children’s Health Insurance Program (CHIP)

Both programs provide free or low-cost health coverage to millions of Americans, including pregnant women.

If you were eligible during pregnancy, you’ll be covered for 60 days after you give birth. After that, you may not qualify. Your state Medicaid or CHIP office will get in touch to tell you. The good news? Your little one still will be on Medicaid for at least a year.

Do your research before you sign up for a plan for your new baby

Wherever you get health insurance, keep these things in mind:

  • Your current plan may not be the cheapest. If the premiums are high or your child’s doctor isn’t in the network, “it may not make sense to add your baby to your current plan,” says Gross. Do your homework and compare any alternatives.
  • Make sure the plan is a qualified health plan. That means it’s certified by the Health Insurance Marketplace and meets the Affordable Care Act’s minimum required coverage. It will provide essential health benefits, including well-child visits and vaccinations. These plans also have limits on deductibles, copayments and out-of-pocket maximums.4

Adding a baby to the family is a big milestone. Adding them to your health insurance is an investment in their future health and happiness. And it will feel good to get another big “to do” checked off the list.

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