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Baby on board? When to get health insurance for your newborn Posted: June 2nd, 2011

By Maryalene LaPonsie

It probably wouldn't surprise too many people to know that 43 percent of expectant mothers spend five hours or more shopping for baby accessories and furniture. But did you know that only 29 percent of expectant mothers spend more than an hour reviewing their health insurance during pregnancy? That's according to a 2005 survey conducted by Aetna and the Financial Planning Association.

Adding a newborn to an existing health insurance policy

With Aetna and the Health Insurance Association of America calculating the average cost of an uncomplicated, natural birth to be in excess of $6,000, it pays for new parents to spend time contemplating who will pay for their newborn's medical expenses.

If you have medical insurance already, getting coverage for your newborn is as simple as adding him or her to your existing policy. However, don't make the mistake of waiting too long. Most health insurance companies and employers require that they be notified within a certain period of time following the birth of a child.

For example, Ellen Laden, Director of Public Relations for UnitedHealthOne, states that those with individual health insurance policies have 90 days to contact the insurer and pay premiums to add newborns to their health plans. However, other health insurance companies may have different requirements for their individual policyholders.

In addition, Laden cautions that for those with employer-sponsored group insurance, plans can vary even among the same carrier, depending on the employer's preference. "Doing your homework and checking with the human resources department is the prudent thing to do," she advises.

The best time to shop for newborn health insurance

Without a doubt, the best time to find health insurance for your newborn is before pregnancy. Adding a newborn to an existing health plan is the easiest way to guarantee that your little one's health is protected. When an infant is added to an existing plan, coverage is retroactive to the date of birth so there is seamless coverage for your baby.

Mothers-to-be may be tempted to shop for health insurance with maternity coverage after they find out they are expecting, but don't count on finding coverage. Pregnancy is considered a pre-existing condition by most health insurance companies, and expectant mothers face extreme difficulty finding coverage on the individual market.

Once a baby has arrived, parents can shop for a health plan, but coverage will not be retroactive to the birth date. That means that infants born with medical conditions can rack up significant medical bills prior to the start of insurance coverage.

Your rights as a new parent

Federal law does give new parents certain rights to ensure they are able to find health insurance for their children. For example, the Health Insurance Portability and Accountability Act (HIPAA) allows parents a special enrollment period for their employer's group insurance. Even if a parent is not currently covered by the employer's group health insurance, the employee, the spouse and the newborn can enroll within 30 days of the child's birth. This special enrollment is available to eligible workers, regardless of when the next open enrollment season is scheduled.

HIPAA also prohibits medical insurance companies from imposing pre-existing condition exclusions on newborns enrolled in a plan within 30 days of their birth. Furthermore, federal health reform provisions prohibit health insurance companies from denying coverage to children with pre-existing conditions.

Parents who encounter difficulties in adding their newborn to an existing policy may be able to find assistance through the government. According to Gloria Della, Director of Public Affairs for the U.S. Department of Labor, "[Parents] can contact the Employee Benefits Security Administration toll-free at 1-866-444-3272 for help with questions or problems relating to coverage under a group health plan." Those with individual health plans may be able to seek assistance through their state's insurance department or commission.

Ultimately, the best advice for new parents is to spend time upfront to ensure that your baby's medical needs will be covered. As Laden suggests, "Be a wise consumer and on your baby checklist, make a point to call your insurer or human resources office to avoid surprises down the road."