pregnant-when will insurance kick in for baby?

Question

I just found out I'm pregnant...this was after we sent the insurance application in, but since the baby was concieved before then I know it's not covered. My question is when does insurance kick in for the baby? Right away after birth, or within a few weeks? Also, if I go into the doctor with a cold, while being pregnant, is that covered? I will be talking to my agent with this, but have to wait til Tues or so, so am curious. Thanks!

having a cold was an example of an illness not related to being preg-don't worry, I wouldn't go if I only had that...prob should have used something like pnemonia! (sp?) sorry ya'll!

Answer 1

Do you have a group policy (through an employer) or an individual policy (that you purchased on your own)?

If its an individual policy, there's a possibility that your newborn won't be covered until he/she passes a medical exam.

Answer 2

If you see your regular GP instead of your OB-GYN for a cold, it should be covered - because one has nothing to do with the other. (Unless there's some funky rider on your plan - in which case, your agent will be obilgated to tell you.)

As far as when your newborn gets added to the plan, this is the deal: they are techinically covered for the first 30 days under your ID number (if the plan has individual unique member numbers) but they are NOT automatically added to the plan - contrary to popular misconception. There are slight variations in the exact workings - based on employers - but you'll need to submit a copy of the baby's birth certificiate and social security number, along with enrollment papers. Most plans make you go thru HR at the employer, some plans will take it directly. The point is that you need to be dilligent in making sure the baby's added effective from their date of birth - mistakes do happen and the baby becomes effective the day after they're born, or even later than that. Make sure this doesn't happen to you! Otherwise, you can be on the hook for a LOT of money. You probably won't get the SSN or the birth certificate until your child is about 6 weeks old, but start the ball rolling on it early. Anything that gets billed to the insurance before the baby's "officially" added can be reprocessed - it may be denied initally, but if you call the plan once you get a bill from a provider and ask them to reprocess it under the baby's name, it shouldn't be a hassle. (Be aware though - some insurances process newborn claims under either mom or dad's name, so if the insurance tells you the claim isn't on file, ask them to look under yours or dad's names!)

Oh, and when you have the baby - just so you're not suprised - you're going to see claims filed for your OB-GYN, the hospital for you, the hospital nursery, the house pediatrician (may not be yours, necessarily), and any lab done in the hospital. Everybody concerned is a separate entitiy and will be billing individually! (My friend ended up with a file two inches thick!)

Answer 3

The answer may vary by policy and state law; asking your agent is really the only way to know.

Being pregnant doesn't impact your other coverage unless there is some link between your symptoms and the pregnancy. (If, for instance, you developed gestational diabetes during your pregnancy, that's specifically a result of the pregnancy would most likely not be covered. Incidentally, there's really no point in going to the doctor for a cold, but waste the money if it makes you feel better.)

When you contact your agent, you should also ask him if the insurance company will enforce their negotiated rates at network providers for the pregnancy even though they will not pay out claims on them. That can make a HUGE difference, because the uninsured are typically charged the highest rates (often as much as 10 times the negotiated network rates because they know they can sell the debt for 10 cents on the dollar to a debt collector if you don't pay.)

Also, be certain that you get these answers from your agent in writing. There is potentially a LOT of money at stake here and the best way to make sure that this agent has done his/her homework is to ask for an answer in writing. (Few people are willing to sign their names to any written document they haven't researched fully.)

Answer 4

1. I doubt insurance covers going to the doctor for a cold. Usually, there has to be a valid medical reason for the visit.

2. Some plans only exclude conditions that were diagnosed or treated before the plan took effect.

3. Newborns can usually be added to an existing plan at the time of birth, but you do need to add the newborn to the policy and pay an additional premium; it is not covered automatically.

Answer 5

Pregnancy is NOT a pre-existing condition and it cannot be held against you when being considered for insurance. This is a federal guideline. Your pregnancy expenses should be covered, depending on the plan (most plans cover pregnancy costs, but there are some independent plans that do not) (If you have an individual plan that does not, you have 30 days to change your mind about the plan) If it's a group plan, chances are that it covers pregnancy costs as a doctor's visit, and yes, that includes visits for a cold.

Insurance begins the moment the child is born (health insurance), usually. Again, this is something that you need to check your plan on.
Oh, congratulations! LOL

Answer 6

For MY plan, the baby is covered under MY policy for 30 days. If I don't add the baby within 30 days of the birth, I have to wait until open enrollment.

You'll have to check with your plan. I'm on a family plan to begin with. If you're a straight individual plan, there might not EVER be any add on available.

Why are you going to the doctor with a cold?? Seems like overkill. Might be the "I have insurance, I'm going to use it" mentality that drives up rates for everyone.

Answer 7

Most companies you have to wait 30 days after giving birth before you can get coverage on newborn

Answer 8

Just curious...

How do you ppl in US tolerate all this insurance problems when baby is born?
Instead of welcoming a newcomer to the world, instantly you have to worry about insurance.

It sure is lousy to be a mother in US considering benefits and what i read here.

Answer 9

It would depend on the policy.

I think your going to have to wait until Tuesday to find out for sure.