New parents have plenty to do to prepare for their new addition, not least of which is arranging health care for your new baby. Not only do you want to ensure your little one will benefit from health insurance coverage as they grow up, but you need to prepare for well-baby checkups during your child’s first year of life.
We share how to acquire health insurance for newborns and what you can anticipate in terms of coverage. Let’s learn more about health insurance for newborn babies, and which programs offer health insurance plans if you need assistance.
Will Your Health Insurance Cover Your Newborn?
Yes, regardless of whether you have an individual or family health insurance plan, your newborn will be covered for the first 30 days of life. At this time, nothing about your policy or deductible will change as checkups and other care for your baby are included within the mother’s coverage.
After that, securing ongoing health insurance coverage for your newborn will require that you speak to your insurance company and update your insurance policy to a family plan. Unfortunately, ongoing care after day 31 of your child’s life isn’t deemed essential.
As for eligibility, note that having a child is considered a qualifying life event in the same category as marriage, divorce, and citizenship changes. That means you can take advantage of a 60-day special enrollment period to update your health insurance plan to include your infant.
Will Your Health Insurance Cover Birth?
Under the Newborns’ and Mothers’ Health Protection Act (NMHPA), your hospital stay during childbirth will be covered for at least 48 to 96 hours, depending on whether delivery is vaginal or via C-section.
How Can You Make Sure Your Newborn Is Covered?
Remember that your infant should automatically receive coverage for at least the first 30 days of life. You’ll want to ensure your baby gets covered after that—the cost of essential immunizations, screenings, and other necessary medical exams can mount up.
The earlier you start inquiring about newborn health insurance to continue coverage after day 30, the better. Check in with your insurance provider about the terms of their special enrollment period for qualifying life events.
If you’re currently not covered by any plan, several government programs can cover essential health services for your infant.
What Programs Help With Health Insurance for Newborns?
Several programs can help if you’re under a certain income threshold. Remember that you should disregard the standard open enrollment periods, as you will qualify for special enrollment after the birth of your baby. These include:
Affordable Care Act (ACA)
Where it concerns newborns, the ACA—better known by the nickname “Obamacare”—can add protective coverage to your existing health plan and reduce existing costs.
The majority of insurance providers must abide by the ACA, where it concerns providing some essential services after birth without charging you extra. The exact items eligible for coverage vary from state to state but can include the following services for newborns:
- Blood screening
- Sickle cell screening
- Hypothyroidism screening
- PKU screening
- Fluoride varnish to protect teeth
- Oral health risk assessment
- Iron supplements
ACA also covers ongoing care throughout your child’s life, such as developmental and behavioral screening and immunization up to age 18. To enroll in the ACA, you can apply on Healthcare.gov—any US citizen is eligible.
It’s important not to confuse Medicaid with Medicare, the insurance coverage offered to Americans over the age of 65. Medicaid is for individuals under the age of 65 who are under a certain income threshold.
Medicaid services for newborns are much the same as what is offered by the ACA. As with the ACA, the exact list of newborn health services you can benefit from will depend on your state. Similarly, services that are covered without an additional cost will vary depending on your state.
Pregnant women and children are among the mandatory eligibility groups that can apply for Medicaid. You can reach out to your state’s local Medicaid agency on Healthcare.gov.
Children’s Health Insurance Program (CHIP)
If you’re 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
- Vision care
- Dental care
- Doctor visits
- Prescription drugs
- Laboratory tests
- X-ray services
- Emergency services
- Doctor appointments
Although routine doctor’s 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 coverage—but it shouldn’t 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.
Planned Parenthood can provide low-cost or free prenatal care for mothers on a limited income. You can also look into your local family planning clinics and see if you’re eligible for lower-cost essential services before and after birth.
Finding the right health insurance plan for your newborn might be daunting, but can also significantly reduce your expenses long-term.
You can get personalized estimates of Marketplace health insurance prices on Healthcare.gov. Alternatively, use its Plan Finder tool to see what private plans are available.
In a Nutshell
Pregnant parents have enough to worry about without adding health insurance for newborns to the list. You’ll have 30 to 60 days to add your baby to your health plan, depending on whether you’re insured through your employer, or you pursue the 60-day special enrollment period in your state.
Suppose your income is below a certain level. In that case, you might be able to take advantage of the Affordable Care Act (ACA), Medicaid, or the Children’s Health Insurance Program (CHIPs) to secure coverage. Ideally, it would be best if you started looking into your options before your little one’s birth.