Health Insurance for New Baby
Archived Q&A and Reviews
I'm looking for affordable health care coverage for my soon-to-arrive newborn. It turns out that coverage under my plan at work (HealthNet) as well as my husband's (Kaiser) are a lot more expensive than I expected ($400+/mo). The only better coverage I've found so far is Blue Shield for $272. Any other suggestions? Thanks!
We were in a similar situation 2 years ago. We went with an individual Kaiser plan, the ''$50 co-pay plan'' which came to about $150/mo. (Well baby visits are always free, you only pay the $50 for sick visits and other services.)We are happy with the care at Kaiser. Another Mom
Hi there. My husband and I are expecting our first baby (a little girl) in April and are trying to figure out health insurance. We're both independent school teachers and so while we're not below the poverty line (not eligible for medi-cal or Healthy Families or anything like that), we're not exactly rolling in the dough either. To add our daughter through either of our jobs would be close to $500/month! This would be a huge financial strain on us. I have Kaiser and I'm really pleased with it and when perusing the individual plans, they look much more reasonable than going through my group plan. I know one has to be careful not to overlook any loopholes or gaps that may not be obvious until it's too late, though. Has anyone else faced this situation and/or have any advice on how to proceed? Thanks very much! Clueless Mom-to-be
Hi There, My husband and I were in a similar situation 2 years ago. We choose a Kaiser individual plan for our son. It's about 160/month w/ 50 dollar co-pays after the first 2 years of routine well-child visits (which had no-copay.) I too am overall very satisfied with Kaiser. Although it's a little impersonal at times, I appreciate the concentration of services. For example, whenever we've inquired about a specialist of any kind from our Pediatrician it's been no problem to get right in with them. No paperwork or complicated referrals. The only down side to our son's plan is that it has no prescription benefits with it. So far that's been fine, he's had antibiotics only twice in his life and it was less than 15 bucks each time. Best of luck to you! Best of luck to you!
both myself and my husband held individual insurance when my first kid was born so I just bought my kid his own plan too as it was way cheaper. So as long as your kid is healthy should be no issue (and if they are not you can just add them to your plan). Also I thought it was lower risk to each have a say $2000 deductible than a family $6000 one. it can get really sticky around the birth though if you have high deductibles- because you are not adding the kid to the plan I. with my first kid I didn't add them and they left my deductible alone. with my second kid they doubled my deductible for the birth even though I didn't add the kid (by law they are automatically covered for 30 days and this applied). I am still fighting them on that one. so be prepared for some more administrative hassle around the birth (what's your charge versus what's the babies) but other than that no problems for us. Also you'll have to act fast (and you'll have just had a baby) - it takes a few weeks to get their own plan and if they get turned down you'll need the back up adding to your own plan which means you'll need to get it all done in 30 days so start the process the day after the kid is born! good luck!
I do not know what your combined income is, but you might want to look into Kaiser's Low Cost Health insurance for kids up to 19 y.o. My husband lost his job 1+ yrs ago and after much hastle w/trying to get onto Healthy Families, we found this Kaiser plan & it is only $8/month and covers a lot. I think this amount is for the lower income folks (us now!), but that you pay more if you make more. I don't think they advertise it much, but it was very easy to apply and the application process took only approx. 3 wks - compared to HF which went on for 4-5 mo. and then we were wait listed....all the while my daughter was uninsured! This health insurance thing is crazy, so the best of luck to you and hope you find something that works......... anon
Anybody aware of a health insurance company who offers insurance for a new baby that is lower than the almost $300/month (ridiculous) it will cost to add him to my insurance? Any suggestions would be appreciated. Thanks. anon
I chose Kaiser for my new baby. They have some very affordable plans: we have one that is just $114 monthly. just be careful! when you first begin insuring a baby on their own plan, it takes a few weeks to go into effect. We went to the Dr before the insurance went into effect, and had to pay full price even though we had thought we were insured. good luck! dani
Check out Kaiser. I have also hear Blue Cross has some programs too. I happen to be with Kaiser and like them. lisa
As a parent and an HR administrator, I can advise you that we recommend to all new parent/employees to research individual plan insurance for their newborns. Our monthly group coverage premium is also very high for children and unless you have three or more kids is financially impractical. Personally, I have had my son on an individual Health Net plan since he was a newborn, he is now 11 years old. Just to give some perspective on coverage ''safety'' and cost, he was diagnosed with type 1 diabetes in February of this year and we only saw a $10 increase in annual premium at renewal. Currently, we pay $174 per month for his PPO coverage with pharmacy benefits. The plan started at about $80 per month when he was a newborn, a premium this low is not available now, but it shows how the costs have increased over 10 + years. One caveat to this advice, this type of coverage would probably not be available if your newborn has any pre-exhisting conditions. Good Luck! HR Mom
We recently enrolled my son in Blue Shield. The premiums are $57 a month, and his office visit copays are $40. Blue Shield specializes in children's plans. I strongly recommend getting in touch with an insurance broker (I went to Jean Sturges in Berkeley, 510-845-6688) who can review the different plans with you. Jennifer
I am a student and expecting my first baby by the end of September. This is about my baby\x92s insurance. I have a good insurance coverage through my work as a student researcher at UC Davis, which is a Blue Cross PPO type of coverage. I am told by UCD that my insurance, unlike to the most of plans, doesn\x92t cover the baby except for the day of delivery. Also, UC doesn\x92t provide family plans to students, and it means that I have to buy individual coverage for the baby separately. I have tried several ways to do that or to get information such as Blue Cross, Health Net, Healthy Family, DMHC, and etc. and the bottom line is that my baby cannot have coverage sooner than two weeks after birth. That\x92s because all these plans need to have the birth certificate to be able to do the paperwork and activate the coverage for the baby as an individual. So, as you can see from the day after delivery until two weeks in the best scenario the baby won\x92t have insurance.
I even tried to buy another coverage for myself and add the newborn on that, but my situation is considered as pre-existing condition and again the baby cannot get coverage through me.
The whole concern is if something happens during the delivery or in the first two weeks that get the baby to NICU or hospitalization. We are willing to pay as much as needed now to find any type of insurance and not to take the risk of unexpected situations.
Honestly, I am hopeless regarding this issue and have spent lots of time calling people. I I hope maybe someone has had a similar situation or know a way that may help me. I would greatly appreciate any thoughts or suggestions you might have, B
Is the office totally sure that babies aren't covered beyond the first day? My newborn was covered by UC Berkeley's SHIP insurance (Blue Cross) for a couple of weeks when I was a grad student in 2003. (It seemed to be a confusing process for them to put in place, and we did have some mix-ups to correct, but at least she was covered.) Have you talked to the highest-level people you can to confirm? insured, luckily!
You should not have to wait for the birth certificate. I work for San Francisco State University, and have Blue Sheild HMO. I gave birth August 3rd at Alta Bates in Berkeley and the hospital gave me a formal hospital letter verifying the birth of my baby, specifically for forwarding to my insurance company to get my baby added to my coverage. I was given the letter when I was discharged. (You didn't mention it, but if you are giving birth in a hospital, they will probably give you one, too). I then gave this letter to my benefits coordinator to forward to Blue Shield for me. Your benefits or HR specialist should be able to advise you as to how to forward this letter to the Blue Shield PPO.
BTW: are you *sure* your baby is only covered up to birth? I was told that mine was covered, automatically, up to 30 days after birth, so I just had to make sure she was added by that point. Also, I was told that if she wasn't on there by the time of her next doctor appointment (because of a mix-up with the paperwork on my part, she might not be added quite in time), that was okay, the appointment would be retroactively covered, I would just have to have the claim resubmitted by my HR benefits specialist. Worth looking into?
Best, of luck. Most likely (unless you have a pre-existing medical condition that you know will probably cause problems) everything will be fine, and you won't need it anyway! Alesia
Hi! I feel your pain! My insurance covers the baby for the remainder of the month they are born, which in the case of my first son was no big deal, as he was born on May 16th. However, this preg. is due February 27th! So the possibility of being stuck is definetly at the front of my mind.
That being said, my first child is under Healthy Families, which (theoretically) starts 13 days after they recieve the birth certificate, which can be faxed from the hospital the day of the birth if you like and have the wherewithall to get that together. However, if you have to front anything between the birth and the coverage, I was told they would reimburse you later. You might have to talk to quite a few people before you get a straightforward answer on that policy...
Also, if you're willing to front some money, Kaiser has an individual child health plan that you can sign up for beforehand and pay for monthly until you are able to get a cheaper alternative together... plus Alameda county Healthy Families uses kaiser if you like, which means no switching pediatricians, etc when it comes to fruition. Beware the Healthy Families Bureaucracy, though!!!!! It took us FIVE MONTHS (Three prior to birth and two after) to get everything finalized!
Feel free to email me if you have anymore questions regarding Kaiser, HF and the like... I'm more experienced with them then I wish to be, but am happy with both presently... as long as this next baby is born March 1st! Sarah
Have you tried Medi-Cal? No matter how late you are in your pregnancy, if you are income-eligible, they will cover you and your baby until you can get a birth certificate. It doesn't matter if you have insurance already. I am in a similar situation and this is what I ended up with. Good luck! Anonymous
My understanding was that it is the law that YOUR health plan must carry the baby for the first 30 days of life. This is what I was told as a student at UCB when I had my son and had their insurance. After the first 30 days (maybe it was 14, but it was enough time for the paperwork to transfer) it was my responsibility to have him covered by another plan but MY plan had no choice but to cover those first few days. If you get stonewalled at UCD ( and I got A LOT of bad/wrong info before I just demanded to talk to the person in charge of insurance for all of UCB) try calling the local insurance comissioner to check on the laws about this. Best of luck. know it's crazy making
My wife and I (both graduate students covered by GSHIP) are expecting a child. We're looking for affordable health insurance for our baby, since the health plan for dependants of graduate students offered by the university is quite expensive. Any suggestions or recommendations, please? Rolando
I shopped around for insurance for my second child who is UNDER ONE, but most stuff seemed about the same price or more than the University's DHIP (about $100/month). Until your child turns one, DHIP might be a good deal. (I am personally pretty annoyed with DHIP because my baby had to pay $145/month not $100. I guess there's a $45/month penalty for having 2 children on DHIP and for a while I was unknowingly paying the $245/month for two!)
But consider this: If you make less than around $2500/month (it's $2700 for a family of 4), you could probably get no-cost Medi-Cal for the child's first year. Medi-Cal is a PAIN! (E.g. some workers don't realize that recipients are now allowed to have large savings.) But eventually they have to pay your bills if you qualify. Call Healthy Families (in phone book) and ask for a mail-in application. Lara (Or see Recommendations for the Healthy Families Program
Depending on your income level I would look into:
o Blue Cross of California (in the yellow pages)
o The Healthy Families program (http://HealthyFamilies.ca.gov/> ) The Healthy Families Program is a state and federal funded health coverage program for children with family incomes above the level eligible for no cost Medi-Cal and below 200% of the federal income guidelines ($27,756 for a family of three). Caroline
I have to admit I'm not in touch with the range of health insurance prices, but I suggest you check out Blue Shield. We have their HMO insurance for our son and it's $63/month for a 5+ year old (somewhat more for younger children). Kaiser might also cover individual children, and if they do, they may be cheaper. It seems that not many companies will give minors their own policy. Fran
If your income is within 150 or 200% of the poverty line, I would strongly recommend you apply for Healthy Families, a state run program which we use for our son, and that you can link to via the parents web page, I believe. We were able to keep him with Kaiser, with basically the same coverage we had when my wife worked there, but the program allows you to use anyone of many HMOs and PPOs. It costs us $7/mo. (sliding scale, I think), with the fourth month waived if three months are payed ahead of time, or smthg like that. The copays are nominal. Also, remember that the state has a similar program for pregnant women, in case the GSHIP doesn't have good coverage for pregnancy. Good luck. Eric
Strangely enough, I got information about a program called AIM (Access for Infants and Mothers) when I bought some diapering products at Safeway the other day. The income guidelines appear to be between 200-300% of what is considered the poverty line. It's worth investigating anyway. Here's their web site: http://www.mrmib.ca.gov/MRMIB/AIM.html#AIMIntro Myriam