Are Newborn Babies Covered by Health Insurance?

Investing in your baby’s health and wellness should always be your top priority as a parent. Apart from giving him healthy foods and teaching him healthy habits, getting him a healthcare insurance is also a way to realize this priority. Whether you are a first-time parent or not, this article could answer the most important question you have in relation to health insurance and your newborn – are newborn babies covered by health insurance?

Yes, babies’ health insurance is automatically covered by the parents in the first thirty (30) days after birth, only if the parents have existing coverage. This is commonly covered under maternity benefits. After the said time frame, the babies will be out of the health insurance coverage. Meaning, you have to expend extra effort in order to cover your baby’s health insurance up to the succeeding years. 

From the primary benefits that your baby should be receiving to the application of your baby’s coverage – all you need to know about your baby’s health insurance is indicated in this article.

What Is a Health Insurance?

Health insurance is one type of insurance that pays for the surgical and medical expenses of the insurer. If an insured pays for a hospital or any medical bill that is supposedly funded by the insurance company, it can still be reimbursed by following a process dictated by the company.

To simply speak, health insurance can pay your medical fees directly to the provider or through reimbursement.

What do “provider”, “insured”, and “insurer” mean? A “provider” can be a hospital, clinic, pharmacy, doctor, laboratory, or any health practitioner that extends their health care product or service to the insurer.

On the other hand, the “insured” is the one who owns the health insurance and is covered by all services provided by the insurer or the insurance company. Lastly, the “insurer” is the one who provides the health care insurance. In can be a private insurance company or any government branch.

Commonly, health insurance is provided by employers to their employees as part of the benefits package. This benefits package also differs depending on the company of the employees.

However, there are still some who prefer to enroll in a private insurance company than to rely on the company’s insurance or any government-owned insurance. The reason is primarily that certain providers treat people differently depending on the type of coverage they own.

What Are the Types of Health Insurance?

There are two (2) main type​​​​​s of health insurance. The one is the private health insurance, while the other is public or government health insurance. However, there are also some subtypes that are defined by insurers to better communicate with the providers. All their differences will be discussed below:

  • Private health insurance

    This type of health insurance refers to the health insurance plans offered by a private health insurance company or industry, as opposed to government-run insurance packages and programs. This similarly gains a large number of insurers as the public health insurance.

    Some prefer private health insurance more given that they can customize what services they want to receive. Some of these include hospital cover, general treatment cover, supplies and equipment cover, and ambulance or transport cover.

  • Public or government health insurance

    This type of health insurance is the one being subsidized by the state. Meaning, your health care services, and products from a provider will be paid from the government’s fund. Basically, all citizens of a particular state an acquire this type of health insurance so long as they comply with the government’s requirements.

  • Managed care plans

    This first subtype of the health insurance plan. In this type of plan, the insurer, whether a public or private company, will gain a network of providers by which they can make a contract with. This contract will then contain the agreement between the two to give lower cost medical care to the insured.

    In some cases, low-cost providers agree with the contract but will require additional costs to be paid by the insured. Despite this, the provider will still ensure to provide quality treatment to the insured. Most of the time, the higher an insured pay, the more benefits he gets.

  • Indemnity

    Indemnity is also called as the fee-for-service plan. In this case, all insured will receive equal treatment from the healthcare providers but is still required to pay some amount. Typically, the insurer will pay for at least eighty (80) percent of the cost, while the insured pays for the remaining costs to the provider.

  • Health Maintenance Organizations or HMOs

    This type of health plan is commonly communicated through the employer. In this case, a dedicated primary care physician or provider takes care of all the medical needs of the employees.

    All necessary care by the insured is also covered by one designated provider. Most of the time, the HMO negotiates a definite limit to the cost of each medical service. Meaning, any amount that exceeds the given cost, agreed between the HMO and the provider, will be covered by the insured. Usually, HMO is considered the cheapest type of plan.

How Do You Cover Your Newborn Baby’s Health Insurance?

As mentioned, your baby’s health insurance is automatically covered by you as his parent. This commonly falls under the maternity benefit. However, the health insurance of your baby under your coverage is only valid in the first thirty (30) days after birth; and if and only if the parents have existing coverage.

After the said time frame, your baby will be out of the health insurance coverage. Meaning, you have to expend extra efforts in order to cover your baby’s health insurance up to the succeeding years. As you continue reading this article, you will be taught how to do it.

​Also, it is recommended that you process your baby health insurance coverage within the thirty (30) days for a smoother application. As we now get to the main point, here are the things you have to do in order to cover your newborn baby’s health insurance:

  • Apply your baby’s health insurance to your own coverage

    This is only applicable if the parents have existing coverage. Therefore, if you currently have your existing coverage, it can be a great option to just apply your baby’s health insurance to your own. As his parent, his health insurance will be automatically covered by you in his first thirty (30) days.

    This is more commonly identified as your maternity benefits. To continue this coverage, notify your insurer that you will be adding your newborn baby to your plan. Make sure to do this within the thirty (30) days time frame as your carrier must honor your request within this period.

  • Apply for a family floater health insurance

    This kind of health insurance plan is tailor-made to cater health insurance of the families. Technically, its principle and package are similar to individual health insurance. The only difference, in this case, is that this type of plan is more central to your entire family.

    This covers you, your spouse, as well as your children. Hence, if you want to let your newborn be covered in your health insurance, you might as well consider applying for a family floater health insurance instead.

  • Apply for your baby’s own health insurance

    Apply for your baby’s own health insurance. In this case, you can go to a private health insurance company or institution and allow your baby to have his own. This option is commonly applicable if your baby seems to be unhealthy. Say, for example, he needs to undergo surgery and be in the emergency room for quite a period of time.Unlike if your baby is healthy, most doctors just recommend that you let your baby be added on your existing coverage. This gives you more convenience and fewer hassles.

What Are the Tips to Consider Before You Apply for Your Baby’s Health Insurance?

There are valuable tips you have to consider if you want to avoid the hassle in applying for your baby’s health insurance. Since the delivery is already considered challenging, we want to at least lessen the burden when we finally talk about the topic of health insurance. Hence, here are the important tips to consider about your baby’s health insurance:

  • Be proactive and evaluate your coverage

    Before your baby even arrives, make sure that you and your husband lend some time to evaluate your health coverage. Review all your options especially if one of you contains baby health insurance in the package.

    Since some insurance industry has a limit in the number of dependents, you may want to follow up on the number of dependents you have in your account. At the same time, you may also notify your insurer in advance that you will be adding up your infant. In this case, you can now already get a picture of the process you will go through once you decide to enroll your baby to your coverage.

  • Know how much it will cost you

    If in case you were approved by your employer to add up your baby into your coverage, you should also prepare yourself from additional cost. Hence, check on your insurer regarding the amount of your pay increase. At the same time, ask how each price vary in the type of benefits your baby will receive.

  • Keep all the documents you will be needing

    Although you still have a buffer of thirty (30) days to apply your baby to your coverage, you still need to prepare all the necessary documents as early as possible. Henceforth, keep all the documents you will be needing in one place. Some of these documents are the notarized letter from the hospital, birth certificate, and others. At the same time, prepare all your papers that prove your enrollment to a particular plan. As you will be adding up your baby under your coverage, the insurer will also collect necessary papers to prove that you are really one of their insured.

If you will let us choose which one is the most important among all the tips mentioned above, we will choose the first one. This is primarily because being proactive and preparing in advance is the key to keep yourself away from all the hassles.

Preparing before the problem has arrived will give you enough time to think of the possible problems you might face. In advance, you already figured out the ways on how to solve it. In this case, your baby’s health insurance should also be on the top list of the things you should prepare and evaluate as parents.

What Are the Scope of Your Baby’s Health Insurance?

Everyone, including your newborn, must have access to comprehensive health care that ensures their optimal health and well-being. Whether it is from a private or public health insurance company or institution, the list of benefits must strictly follow a full range of medical support.

Further, this medical support should be delivered by a certified and credible provider with an experience and integrity. At the same time, the provider’s support should be delivered within an efficient time without compromising the quality of care.

Therefore, the list of benefits below should be present in your baby’s health insurance, but not limited to this:

  • Medical care

    This benefit includes the provider’s supervision with your baby’s health and giving out preventive measures like immunization. Aside from which, health insurance should cover the diagnosis and treatment of acute and chronic illnesses.

  • Pediatric care

    This benefit includes the pediatric care for your baby whether it is critical or not, or it requires surgery or not. Basically, all the pediatric needs will be under this care. At the same time, the insurer should cover the necessary payment whether your baby is under the outpatient or inpatient setting.

  • Surgical care

    This benefit includes surgeries and operations depending on your baby’s case. This is mostly applicable to those babies who are born unhealthy or with certain complications. Also, it is a must that your health insurance covers the postoperative care that your baby needs every after surgery or operation.

  • Mental health care

    This benefit includes the future psychosocial concern of your baby. This involves your baby’s therapy, treatment, and other needed residential care. Hence, in case this happened, the health insurance will cover the bills on the provider’s products and other services.

  • Infant supervision

    This benefit includes the management and attendance of the provider on your delivery especially if your delivery has high risks counterpart. At the same time, the insurer should include your baby’s health supervision from birth to the succeeding years. All services to be provided by the insurer are medical and surgical services, newborn intensive checkups, and a lot more.

  • Prescription drugs

    This benefit includes the drugs and medicines prescribed by doctors during checkups. It also includes the nutritional supplements needed by your baby to sustain his health. Lastly, the immunization injectant to counter viruses should also be included in the package

  • Medical supplies

    The health insurance should also cover rental or purchase of medical supplies and equipment for your baby’s needs. The medical supplies mentioned could be corrective eyeglasses, hearing aids, breast pumps, ventilators, inhalers, and a lot more.

Services should include all these but not limited to this list. Meaning, when enroling or applying your baby to health insurance, you have to check if they include each benefit to your baby’s health care. After all, it is your baby’s health and wellness that we are talking about.

Further, some benefits mentioned above are applicable when your baby grows older. In this case, there are some benefits that you still want to add up to maximize his health care insurance in the long run.

What Are the First Steps in Your Baby’s Birth and His Health Insurance?

After your successful delivery, every service and product that your baby will receive soon after birth will be covered by your health insurance. Whether it will happen in the nursery or beside you, these are the preliminaries that the provider will give your baby:

  • Measurement

    Soon after birth, your baby will be measured in weight, height, and head circumference. Aside from knowing if your baby is underweight, in normal weight, or exceeds the average weight, this will also give your physician a chance to easily track your baby’s physical development.

  • Temperature, breathing, and heart rate

    Taking your baby’s temperature, breathing, and heart rate are also vital to be checked after birth. This dictates whether your doctor will be giving follow up treatments and medical prescriptions for your baby.

  • Skin color

    Your baby will also be checked by your doctor by watching the skin color of your baby. This way gives your doctor the idea of whether your baby suffers infection or any organ failure from the womb. Similarly, your newborn’s activities will be observed and analyzed by the doctor.

  • Eye drops

    After your baby got out of your womb, he will be given eye drops or ointment to help him avoid eye infections and irritations. This is primarily because your baby’s eyes can still be sensitive when finally got out of your womb.

  • Vitamin K

    After which, your baby will be given Vitamin K shot from the provider. This shot is given to all babies in order to lessen the risk of fatal bleeding caused by Vitamin K deficiency also known as Vitamin K Deficiency Bleeding (VKDB). This VKDB can cause bruising and bleeding in your baby’s internal organs. Sometimes, it even involves bleeding in the brain which will then turn into brain damage.

  • Vaccines

    The provider will also be giving your baby a vaccine of Hepatitis B within his first twenty-four hours stay in the hospital. As this only serves as a preliminary, there are still lots of immunization vaccines that your baby will receive in the next few days.

What Are the Next Steps for Your Baby and His Health Insurance?

On three to five (3-5) days after your baby’s birth, you should now comply with one of the most important requirements on your baby’s insurance. This is his first checkup with the doctor. Henceforth, these are the first few exams that your doctor will most likely do:

  • Measurement

    In the first checkup, your doctor will once again run an analysis of your baby’s weight, height, and head circumference. This mean allows your doctor to check if your baby is underweight, in normal and healthy weight, or exceeds the average weight, this will also give your physician a chance to track your baby’s physical development easily.

  • Physical exam

    The doctor will also be measuring your baby’s reflexes, vision, as well as his hearing capabilities. This exam can be done in different procedures provided by the doctor. Further, your doctor will also be doing a complete physical review for your baby’s body.

  • Reminders

    Apart from running the exams, you and your baby will also be given reminders and essential information that you need. Some of these are the things you should expect with your baby for the upcoming months. It can also be some tips for you on your baby’s feeding, bathing, playing, and a lot more activities.

  • Other vaccines

    Aside from the first Hepatitis B vaccine, your baby will also be provided with other vaccines by the doctor. Some of these can be influenza vaccine, chicken pox vaccine, measles, mumps and rubella vaccine, hepatitis vaccine, and a lot more. There are still some vaccines that your baby will be taking but require your baby’s body to develop still.

What Are the Vaccines that Your Baby Should Receive?

Breastfeeding is also essential in stimulating the production of antibodies to your baby’s body. These antibodies provide your baby with the immunity against infections and several diseases. However, you still should not rely fully on breastfeeding.

The answer for your baby’s full protection is through giving him vaccines. Since these vaccines are covered by your baby’s health insurance, we have provided you the type of vaccines and the right age of your baby to get these vaccines:

  • During your baby’s birth.

    The vaccines that your baby should be receiving in the first twenty-four hours is the Hepatitis B. This is important in giving him the protection from virus and other possible infections. However, you do not have to worry if your baby hasn’t received this vaccine yet as you can still do in his first month or once he gets discharged in the hospital.

  • On your baby’s one to two (1-2) months.

    After receiving the first dose of the Hepatitis B, wait for at least one to two (1-2) months before your baby gets his second dose. This is effective in keeping your baby’s liver healthy and maintaining the full protection you have started for your baby.

  • On your baby’s two (2) months.

    The vaccines that your baby should be receiving in his second month are the Diphtheria, Tetanus, and Acellular Pertussis or DTaP vaccine, the Haemophilus Influenzae Type B or HiB vaccine, the Inactivated Poliovirus or IPV vaccine, the Pneumococcal Conjugate or the PCV vaccine, and the Rotavirus or the RV vaccine. The DTaP vaccine is responsible from keeping your baby free from diphtheria, an infection that causes breathing problems; tetanus, an infection or disease to an open wound; and pertussis, a respiratory illness that leads to severe coughing.

    On the other hand, HiB vaccine frees your baby from meningitis. The IPV helps your baby to be protected from Polio that will lead to permanent paralysis. Further, the PCV vaccine protects your baby from possible pneumococcal infections, while the RV vaccine prevents your baby from getting rotavirus which causes serious vomiting and diarrhea.

  • On your baby’s four (4) months.

    The vaccines that your baby should be receiving in his fourth month are the second doses of Diphtheria, Tetanus, and Acellular Pertussis or DTaP vaccine, the Haemophilus Influenzae Type B or HiB vaccine, the Inactivated Poliovirus or IPV vaccine, the Pneumococcal Conjugate or the PCV vaccine, and the Rotavirus or the RV vaccine.

  • On your baby’s six (6) months.

    The vaccines that your baby should be receiving in his sixth month are the third doses of Diphtheria, Tetanus, and Acellular Pertussis or DTaP vaccine, and the Pneumococcal Conjugate or the PCV vaccine. The third doses of the Haemophilus Influenzae Type B or HiB vaccine and the Rotavirus or the RV vaccine can also be given to your baby depending on your doctor’s prescription and the brand you use.

  • On your baby’s six (6) months and annually.

    The vaccine that your baby should receive in his sixth month is the influenza or flu vaccine. It is recommended to be injected by your baby in his sixth month and annually. The flu vaccine can be received by your baby into two (2) ways: through needle injection or nose spray. If your child is younger than nine (9) and he will get his vaccine for the first time, get two (2) separate doses at least one (1) month apart. If he is still younger than nine (9) that already got twice flu vaccine, you will only need one (1). If kids are already nine (9), your baby will only need one (1) dose. Nevertheless, the influenza or flu shot is necessary for all children as it is proven safe and effective.

  • On your baby’s six (6) to eighteen (18) months.

    Another dose of Hepatitis B can also be given to your baby. At the same time, the Inactivated Poliovirus or IPV vaccine can also be in the second dose for your baby.

  • On your baby’s twelve (12) to fifteen (15) months.

    In this month, another dose of the Haemophilus Influenzae Type B or HiB vaccine and Inactivated Poliovirus or IPV vaccine will be given to your baby. In addition, Measles and Mumps (MM) vaccine and Chickenpox vaccine will be given to your baby.The MM vaccine frees your baby from possible infections like measles and mumps infections throughout your baby’s lives. On the other hand, the Chickenpox vaccine protects your baby from chickenpox which is viral and contagious in children.

  • On your baby’s twelve (12) to twenty-three (23) months.

    In your baby’s twelfth to the twenty-third month, Hepatitis A vaccine will be given for your baby. In his span of babyhood, he will be expected to receive two (2) shots for at least six (6) months apart.

These vaccines that are needed by your baby should strictly be added on his health insurance. As it is all proven safe and effective, it gives you more complacence that your doing the right decision in raising your child.

At the same time, having all these in your hand is very light on your budget. As soon as your baby needs health assistance, you can go directly to the provider and have an exemption to some or all of your expenses.

Related Questions

How much does it cost to add a newborn to health insurance?

Typically, adding your baby to your family’s health insurance coverage will cost in the neighborhood an additional $200 to $450 a month. This is because aside from paying for your life time insurance and other members of the family, you also add up a baby to pay for baby care.

Can I add newborn to insurance without social security number?

Yes. As a matter of fact, you do not need to wait up for your baby’s Social Security Number (SSN) to add your baby to your family’s health insurance coverage. All you have to do is to show your insurer the Identification Card and allow your baby’s SSN to be followed up.

How long are newborns covered under mother’s insurance?

As mentioned above, your baby’s health insurance is automatically covered by the parents in the first thirty (30) days after birth, only if the parents have existing coverage. This is commonly covered under maternity benefits. After the said time frame, the babies will be out of the health insurance coverage.

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