Just Had a Baby? How and When to Make Important Health Insurance Policy Changes

health insurance changesAs you prepare to give birth to your little bundle of joy in the next few months, weeks or days, you are likely running through a huge to-do list: Diapers? Check. Formula? Check. More diapers? Check!

But one of the most critical decisions you have to make is how to ensure your baby will gain access to necessary health care. If you already have health insurance, your baby will need to be added to your policy.

Under normal circumstances, you can’t make health insurance changes outside of open enrollment. But when it comes to having a baby or making other important life decisions, adjustments are allowed; however, you must do so within a specific timeframe.

Does Health Insurance for Pregnant Women Cover Your Baby?

While preparing to call your health insurance company to find out how you can add your baby to your health insurance plan, you may be wondering whether your insurance covers your baby during pregnancy and delivery.

Health insurance for pregnant women under standard policies with maternity benefits or riders should cover most prenatal, delivery and postnatal care.

This type of coverage usually pays for part or all of the medical costs during pregnancy, including inpatient services (hospitalization for childbirth and physician fees) and outpatient services (prenatal and postnatal OB-GYN office visits).

Before assuming you’re covered, however, check with your insurer since some high-deductible plans have limitations on what and how much they will cover to avoid high out-of-pocket expenses.

Government data presented by WebMD estimates that prenatal care without insurance can cost an average of $2,000. The cost of an uncomplicated vaginal birth was about $9,600 in 2008 and an uncomplicated cesarean section averaged $15,800.

One thing to note is that health insurance for pregnant women — or insurance with maternity coverage — is harder to come by once pregnant.

Pregnancy is considered a pre-existing condition, which means if you try to acquire insurance while pregnant prior to the health care reform law taking full effect in 2014, you can be turned down.

It’s for this reason that experts recommend securing health insurance prior to getting pregnant (preferably six months to one year in advance), if possible. Also, keep in mind that health insurance with maternity coverage does not cover health care costs for your baby following your hospital release post-delivery.

Acquiring Health Insurance for Babies or Other Dependents

Now that you’ve taken your precious little one home, you have to feel confident that any health issues that arise, no matter how big or small, can be covered through your health insurance.

The good news is acquiring health insurance for babies through your current provider is a simple task.

Securing Coverage Under Your Employer’s Health Plan

Under normal circumstances, you would not be able to make health insurance changes until open enrollment, but when it comes to adding a baby to your coverage (or any new dependent or spouse), you typically have a window of 31 and 60 days to provide notification of this change.

The best way to know what timeframe of notification you’ve been granted is to contact your insurer, preferably before giving birth.

When making the call, find out what paperwork you must provide to add your baby to your coverage so that you don’t inadvertently miss the deadline, while in the process of pulling together required information.

Locating Free or Low-Cost Health Insurance for Babies

If you want to secure health insurance for your baby and you aren’t currently insured, you may benefit from low-cost health insurance resources in your area.

One of the most well-known is Insure Kids Now!, which is a national campaign linking families of uninsured children (ages birth to 18) with free and low-cost state health insurance programs.

In many areas, families can take advantage of Children’s Health Insurance (CHIP), which is a free/low-cost private health plan for children in families that meet specific family size and income requirements.

Families may also benefit from subsidies from local government agencies and organizations that help lower the cost of care.

The most important factor in securing health insurance for babies is being proactive. Acquire health insurance with maternity coverage as soon as possible to ensure you’re covered during your pregnancy, then contact your insurer immediately after giving birth so that your baby’s individual coverage can kick in.

If you take these steps as soon as possible, you should have no problem making important health insurance changes when the time is right.