When should I add my newborn to my health insurance?
30 days following birth or adoption
You must add your newborn child to your plan within 30 days after the birth of your child in order to have coverage effective on the newborn’s birth date. If adopting, you must add your adopted child to your plan within 30 days of securing the adoption. If you are not sure how to do this, it is important to contact your insurance plan sponsor or benefit administrators right away.
Refer to The Newborns' and Mothers' Health Protection Act
It’s important to know your rights. If your plan provides maternity benefits, you should be entitled to a minimum hospital stay of 48 hours following a vaginal delivery and 96 hours following a cesarean delivery. Learn more below and at www.dol.gov.
Special Enrollment Period
Birth and adoption qualify for a special enrollment period. Even if you are not currently enrolled in an employer’s health plan or your own individual plan, you may enroll yourself, your spouse, and your new child upon the birth or adoption. Since this is a special enrollment, you will not need to wait until open enrollment to enroll in benefits.
Frequently Asked Questions (FAQ)
The Newborns’ And Mothers’ Health Protection Act (Newborns’ Act)
How does the Newborns’ Act affect my health care insurance if I’m pregnant?
It’s important to know your rights! The Newborns’ Act ensures the amount of time you have in a hospital following the birth of your child. If your health insurance plan provides maternity benefits, you are likely entitled to a minimum hospital stay of 48 hours for a vaginal delivery and 96 hours for a cesarean delivery.
You cannot be required to obtain preauthorization from your plan in order for your 48-hour or 96-hour stay to be covered.
You and your baby may be released earlier than the allotted time given if your attending provider consults with you and reaches this decision, however, the attending provider cannot under any circumstance receive incentives or disincentives to discharge you or your child earlier than the 48 or 96-hour period.
When does the 48-hour or 96-hour period begin?
If you deliver your child in the hospital, the 48 or 96-hour period starts at the time of delivery. For example, if a woman is admitted to the hospital for labor at 10 a.m. on March 1st, and gives birth at 2 p.m. on March 2nd, the 48 or 96-hour period (depending on delivery type) starts on March 2nd at 2 p.m.
If you would like to discuss your insurance needs with an insurance specialist, please contact us today.
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