If you’re having a baby (or adopting a baby) and are uninsured, or your current plan doesn’t cover family members, you’re probably looking to find some health insurance for your new family member. Here are nine frequently asked questions prospective parents have about health insurance for babies.
- When is the best time to get health insurance for my baby?
If you have an individual policy, the birth of a child opens up a Special Enrollment Period (SEP) to buy insurance. You have 60 days after the baby’s birth to add the child to your policy or purchase a new policy. If you’re on an employer-sponsored plan, find out if your health insurance includes coverage for your baby. If so, you can add your baby to your plan with the plan’s timelines.
- What if I don’t like my health insurance and don’t want to add the baby to my policy?
If you don’t like your current plan, the SEP triggered by your baby’s birth provides you with several coverage options. You could switch health insurance plans for your entire family or purchase a plan just for your baby, known as a child-only plan.
- What if I had a baby and didn’t get insurance for the baby the first year? You will have to wait until Open Enrollment to enroll the baby in a health insurance plan. In addition, you may be liable to pay the fee for not having insurance for the baby.
- Is it possible to get health insurance for babies before they are born? No, you need to wait until the birth of the baby.
- Can babies be covered on their grandparent’s health insurance plan?
Grandchildren can be covered on the grandparent’s family plan in the following circumstances –
- The baby’s parent is a covered on the parent’s plan and the insurance company allows it – for example, with Unity, this is allowed
- The health insurance plan includes grandchildren in their list of acceptable relationships for coverage
- The grandparents’ primary insurance is not Medicare
- What if I can’t afford health insurance for my baby? In this case, there are several options –
- Find out if you are eligible for subsidies – you can quickly find out if you're eligible for subsidies here. If so, a subsidized individual plan may be affordable
- Find out if you or your baby may eligible for BadgerCare Plus, Wisconsin’s version of Medicaid
- Find programs in your area that might help, such as the United Way of Dane County's HealthConnect Program or the Monroe Clinic and Hospital Foundation’s Share + Care program
- Find a free clinic in Wisconsin
- My employer doesn’t offer coverage for dependents. Does that mean I have to buy health insurance separately for my baby?
If your employer does not offer coverage to your dependents you can purchase an individual policy for your spouse and / or children. Based on your household income, the baby may be eligible to receive a tax credit to help pay the premiums of the individual policy.
- What if I want to get health insurance just for my baby?
You do not have to purchase a plan for yourself in order to get coverage for your baby. You can instead purchase a plan that will cover only your baby.
- What kind of insurance plan is best for a baby?
Because of the Affordable Care Act (ACA), all ACA-compliant health insurance plans must cover 10 essential health benefits. These benefits include coverage for babies and most preventive care is provided at no out-of-pocket cost to you. No matter what type of plan you choose, from bronze to platinum, your baby will have access to no-cost immunizations and screenings.
Want to find out about the benefits included with health insurance coverage for babies? Shop for baby health plans and get a quote now or give our helpful customer service representatives a call at 800.362.3310.