Hospital/Insurance - I'm confused

blue_elle

A Humana rep had told me months ago that the baby would be considered as part of my coverage and not treated separately as far as deductibles, etc. are concerned. I would then have 30 days to add the baby to my plan for ongoing care (everything post-hospital). I called today to confirm since the hosptial sent me a pre-payment request that didn't seem to line up with this.

Now a rep is telling me that my plan will only cover up to the actual birth. I've asked her for clarification and I'm not getting a straight answer. Does mom's insurance cover the baby (even if as a separate person with own deductible) for the routine care as part of delivery, irregardless of who we decide to use for coverage going forward for his care after he's born (post-routine delivery/hospital), or do they only pay the baby's portion of the routine hospital care if we enroll the baby with them within 30 days? In other words, if we opted to go with DH's insurance for well-baby care, would my insurance not pay for the "baby" part of the hospital bill?

I know nobody can get me a definite answer as all plans differ, but what have been your experiences, or what has your insurance company told you? It wouldn't be a big deal except we're in limbo on which insurance baby will be put on for routine care and may not have the plan docs before he makes his arrival. 

rowanthefrog

My experience was that baby was included in my care and under my insurance up to and including the birth and we had a certain amount of time to add him to our insurance plan after the birth.

I would probably call your insurance back and get someone on the phone and grill them until you understand what you are responsible for. I hate how confusing it can get.

A

mj0413

Insurance companies blow. 

It definitely depends on your specific company & plan, but I'd think you'd have a set amount of time to report the baby to your insurance to have him/her added on. It's not like they don't know you're pregnant or anything. 

CeeJC121013

With DS, baby was treated separately. We had to call and add him to our insurance as soon as a we were able (I think the deadline was 30 days though.) Luckily, we did not have a deductible, be we did have to pay a separate copay for his and for my hospital stay, which was billed afterwards. I don't know of this is helpful at all, as I did not have Humana.

I would call again because the only people who can really answer this for you is them. Hopefully you get someone more competent this time. I have had a few ordeals with my ins company where different people have told me different things.

csandroo

Ugh insurance is such a PITA ... The way my plan works is that baby and I are covered under MY plan for labor and delivery and all post partum care that is part of that same hospital visit ... Then after we bring baby home we have 30 days from his birth day to add him to my SO's plan and all dr's visits and Lo's care will then be under his plan. The hospital stay and circumcision and all that will be billed under mine ... Any Care after hospital will be under SO's.

Jackapatamus

Just checking to see if this is what you mean....... Since you have 30 days to add the baby, you wanted your health care to cover the costs while at hospital (birth, basic care, stay etc). After you leave the hospital, you wanted your husbands insurance to cover your little one (future dr. Appts, etc?). I think when you asked if your insurance covers, then yes, the delivery is covered under your "bill". But everything for baby after that, will be covered as if baby was a patient- for example, if baby had circumcision at hospital- that would be covered as if baby was a patient, or if baby has jaundice, then baby would need treatment and baby's insurance would pay for treatment. Because having a baby is a life changing event, you have 30 days outside of your "open enrollment" period to add the baby so that yes, your insurance covers the baby while in the hospital. If you want the baby to be covered by your insurance, then you need to add them to it (making it a family plan or worker+children plan) . If you want your husbands insurance to cover, then add lo to his plan. When I had DS, (c-section) my hospital bill was paid for. But once DS was born, he ended up in NICU and having a circumcision- and he was billed separately. for all of this (under his name, on my insurance plan). We had to meet his deduction separately from mine. And once I added him to my plan (starting with his birth date) I would not be able to change him to my husbands insurance until another life changing event/open enrollment. Hope this is helpful! Good luck,

ac1259

So the way it went when DD was born was that technically baby is "covered" under the mom during L&D and hospital stay but you have to add the baby to whatever insurance you're adding him/her to within 30 days and they will cover everything from birth....like they'll backdate the insurance to the day of birth and cover from there on. I know for ours we had to wait until we had a SS card and birth certificate to add her and her pediatricians office had to resubmit charges a few times but we got it all squared away. I'm pretty sure she got her own deductible too but obviously that isn't paid until the insurance kicks in and they start paying the bills. FWIW, my DD had her own hospital admission after I was discharged so she wracked up quite a bill while we were in the hospital..but the insurance wound up taking care of it- the bills basically just get put on hold for a month and everyone involved is aware that that is how it will go with a new baby. But thats just my experience which might be weird because DD was covered under a self insured hospital insurance (I worked for the hospital and they had their own health insurance). 

blue_elle

So sounds like it really just depends on the policy. I've called back Humana twice more and talked to two different reps who have said confidently that the routine baby part of delivery (blood test, eye ointment, general care related to delivery) is covered under my plan w/o separate deductible. If there are services outside of routine or the baby is kept when I'm discharged, those items will not be paid under my individual policy, but would be covered under the baby's when he's added. 

We'll see how it works out. What a PITA.

slmille4

I just called mine today and confirmed. Th baby is covered under mine for 31 days post delivery. Maybe call again and rephrase the question? From what it sounded like when DH was trying to price out his vs mine as far as to put the child under later they said that we have 30 days to decide because baby is covered under mothers for 30 days. He had HAP I have BCBS and it sounded like it was just how it was with all insurances.

brideandbreve

blondie7385 said:

Also, when you call, write down the name of the person you talk to, and the time. Even see if you can get a reference number. I got royally screwed but not doing this. 

This. And if the person you're talking to says they can't give you a reference number, call bullshit. Ask to speak to their supervisor.

I used to work in the billing department for a hospital processing denials, and I can't tell you how many times I talked to someone (ie; Melinda) and then referenced our conversation later, only to be told that "no Melinda works here."

MissRdotS

For my insurance, baby is covered for everything until we leave the hospital after he is born. So if I'm in the hospital for two days, the baby is covered for two day, up until we walk out of the doors of the hospital and are discharged. I do know many insurance companies are different though.