Health insurance for newborns

by Guest » Tue Jun 08, 2010 07:25 am

Is there any insurance protection for newborns? Will it affect my health insurance cost or it's benefits in case I add my newborn to my own policy?

Total Comments: 24

Posted: Tue Jun 08, 2010 12:04 pm Post Subject:

Well of course it's going increase your premium, you're adding another insured to the policy.

Posted: Tue Jun 08, 2010 10:57 pm Post Subject:

If you have current coverage, just about every state mandates automatic coverage for newborns and adopted children. This coverage begins immediately upon birth and covers all medical issues of the child, including any congenital or birth defects, etc. Adopted children are normally covered from the moment of placement into your home.

You are generally required to report the event to your insurer within 30/31 days to continue the coverage without interruption. If there is additional premium to be paid, it must also be paid within this period of time.

If your state adheres to these rules, and it probably does, there can be no exclusionary language attached to the child, such as exclusions for any pre-existing conditions, waiting periods, etc.

You need to let us know what state you reside in and whether you have any current medical coverage, and if so, EXACTLY what coverage you have and through whom. Individual policy? Group policy?

This info will help us help you!

InsTeacher 8)

Posted: Wed Jun 09, 2010 07:35 am Post Subject:

I'm from FL and I have health coverage through my employer. I work for 40 hrs a week.

Posted: Wed Jun 09, 2010 06:56 pm Post Subject:

Tampaflgi, thanks for the response. Here's a quote taken directly from the Florida statutes, specifically Title XXXVII, section 627.6575 Coverage for newborn children. It states (look for the emboldened portions that follow):

(1) Any group, blanket, or franchise health insurance policy providing coverage on an expense-incurred basis that provides coverage for a family member of the certificateholder or subscriber, or any group, blanket, or franchise health care services plan contract issued by a nonprofit corporation that provides coverage for a family member of the certificateholder or subscriber, must, with respect to the family member's coverage, also provide that the health insurance benefits applicable for children will be payable with respect to a newborn child of the certificateholder, subscriber, or covered family member from the moment of birth. However, the coverage for a newborn child of a covered family member of the certificateholder or subscriber terminates 18 months after the birth of the newborn child.

(2) The coverage for newborn children required by this section consists of coverage for injury or sickness, including the necessary care or treatment of medically diagnosed congenital defects, birth abnormalities, or prematurity, and also includes transportation costs of the newborn to and from the nearest available facility appropriately staffed and equipped to treat the newborn's condition if the transportation is certified by the attending physician as necessary to protect the health and safety of the newborn child. The coverage of transportation costs may not exceed the usual and customary charges, up to $1,000.

(3) The benefits required by this section also apply to holders of group certificates delivered or issued for delivery to residents of this state under group policies effectuated or delivered outside this state.

(4) A policy or contract may require the insured to notify the insurer of the birth of a child within a time period, as specified in the policy, of not less than 30 days after the birth. If timely notice is given, the insurer may not charge an additional premium for coverage of the newborn child for the duration of the notice period. If timely notice is not given, the insurer may charge an additional premium from the date of birth. If notice is given within 60 days of the birth of the child, the insurer may not deny coverage for a child due to the failure of the insured to timely notify the insurer of the birth of the child.

(5) If the policy or contract does not require the insured to notify the insurer of the birth within a specified time period, the insurer may not deny coverage for such child or retroactively charge the insured an additional premium for the child. However, the insurer may prospectively charge the insured an additional premium for the child if the insurer provides at least 45 days' notice of the additional premium required.

(6) This section does not apply to disability income or hospital indemnity policies or to normal maternity policy provisions applicable to the mother.

So, it looks as if Florida law (pretty much like other states) will cover the kid from the moment of birth. Make sure that you check your coverage for any specifics that may apply, but it looks as if all is good.

Hope this helps!

InsTeacher 8)

Posted: Thu Jun 10, 2010 10:17 am Post Subject:

In some cases your state laws will decide your rights, otherwise the Newborns' Act may apply. There are states that have regulations to cover the newborns and their mothers. You must go through your own policy and check if hospital-stays are shown as benefits to child birth.

Posted: Thu Jun 10, 2010 10:21 pm Post Subject:

Like I said, and answered in my last post, it's state specific. Specifically, I quoted the OPs state of residence.

InsTeacher 8)

Posted: Fri Jun 11, 2010 05:39 am Post Subject:

What's this Newborns' Act? I guess you're pointing at the Newborns' & Mothers' Health Protection Act. It's aimed at covering newborn babies and their mothers through their stay at the hospital.

Posted: Fri Oct 29, 2010 05:14 am Post Subject:

The coverage period begins starting from the moment of delivery, and since that time the mother is perfectly entitled to claim complete or partial compensation of her costs connected with delivery and medical care for the child.
Check with your medical care insurance provider if childbirth is enrolled into your group health plan or work out your individual health plan more elaborately, taking into account the great possibilities of maternity medical aid cost decrease.

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Posted: Sat Feb 12, 2011 01:21 am Post Subject: no coverage

I gave birth to my child on 1/5/11. I've received a bill from the hospital today 2/11/11 for $9,000. with my child's name. I sent a bunch of documents to my healthcare provider and now they are telling me that i did not enroll her within 30days. I thought that would be done automatically since insurance company was aware that i gave birth. I will have coverage for her next month.
My question is.....will insurance pay for my child'd bills from birth to the time she is enrolled under my plan next month? I live in NY.
Thank you.

Posted: Sat Feb 12, 2011 11:31 am Post Subject:

I understand your concern. In NY, an insurer may need you to get your child enrolled within a period of 30 days, so that the new born stays covered beyond that period. Please go through the insurance paperwork (if any) and get it confirmed. Have you discussed it with your agent?

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