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Under the Affordable Care Act (ACA), maternity care and childbirth services are considered one of the 10 health essential benefits. Employer-sponsored and marketplace insurance plans must cover these services. (source: https://www.healthcare.gov/what-if-im-pregnant-or-plan-to-get-pregnant/)
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Colorado state law requires that newborn babies are automatically covered under the mother’s health insurance for the first 31 days of life. You are not charged for the coverage during this time.
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Even if the baby is not going on the same insurance at the mother, the baby is automatically covered for those first 31 days under the mother’s plan.
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To ensure your baby has coverage following the first 31 days, the baby must be enrolled with the carrier within 30 days after birth (you can usually do this through HR or your online benefits portal).
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You may want to contact the insurance company to double-check they received the claim for your baby’s birth and that the effective date of coverage matches your baby’s birthday.
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Keep in mind that you will need to provide the insurance carrier (and most likely HR) with the baby’s social security number when you receive it.
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After an uncomplicated delivery, claims for the baby are filed under the mother and the baby is not subject to his/her own deductible.
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If the baby needs additional care outside of a typical birth, the baby may be subject to his/her own deductible—extreme examples would be if the baby needs surgery or is transferred to the NICU.
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Having a baby is a qualifying event under Section 125, which usually means that you can make changes to your coverage, including plan changes if your employer offers more than one plan. Check with your HR department to see what changes are allowed.
If you have any specific questions regarding which plan is the best fit for your growing family, what services are covered while you are pregnant (midwife, doulas, etc), and after the baby is born, you should discuss them with HR, your medical carrier, and/or your insurance broker.
In addition to the above tips, we also recommend that you:
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Look into buying sufficient Life insurance for yourself (https://www.insure.com/life-insurance/pregnant-insurance-moves.html)
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Ensure your car and home insurance are adequate (https://www.insure.com/life-insurance/pregnant-insurance-moves.html)
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Find out if your employer has Short-Term Disability benefits and if it provides benefits for pregnancy.
We hope these tips make the insurance questions when having a baby easier and help you prepare financially for your new baby. If you have further questions, feel free to reach out to us!
