newborn health insurance

mirigirl · August 2014

Hey ladies,

So I have NO baby care under my insurance, only maternity. It will cost us about $200 a month to add a child to DH's insurance plan through his work. I am hoping to possibly find another option as his works health insurance has a $3500 deductible. Are any of you ladies getting a child-only insurance plan for your newborn? If so, with what company and about how much do individual child-only plans run per month?

Thanks so much!

kefttsc · August 2014

This is a question I keel meaning to post and ask. Thank you!
I didn't even know that baby care was an option on some plans. I guess I need to see if baby coverage is part of my horrible plan.....

LilTiger15 · August 2014

I'll be buying my baby their own policy as I don't have employer provided health insurance. In my state, SC, Blue Cross Blue Shield doesn't even sell family plans anymore, so each person in the family has their own policy.

mirigirl · August 2014

I would, but I am still under 26, so I am on my parents plans for free

babybou3 · August 2014

Mirigirl- did you check that your expenses are covered for dependent maternity? Some plans don't offer dependent maternity and if they do, once the cord is cut your baby is his/her own person, will have their own medical claims. Most policies won't allow a grandchild to be added to the policy. I'm not sure if your LO will b on your SO policy but if not, something I suggest looking into.

I work for an insurance company and I get this question weekly.

kln215 · August 2014

Yes, that's true. I'm 25... And I'll be 26 in Feb after baby is due. My parents insurance pays for all my prenatal, but won't pay for baby! My husband and I are picking up insurance on me and baby in Jan! Which ins, NO CLUE. So very expensive!

mirigirl · August 2014

babybou3 said:
Mirigirl- did you check that your expenses are covered for dependent maternity? Some plans don't offer dependent maternity and if they do, once the cord is cut your baby is his/her own person, will have their own medical claims. Most policies won't allow a grandchild to be added to the policy. I'm not sure if your LO will b on your SO policy but if not, something I suggest looking into. I work for an insurance company and I get this question weekly.

Hey there, oh ya. I have known that since we started trying a year ago =]. I made sure to know what all of my insurances covered and didn't and all of that. I am a planner haha. So now we either have the option to add baby to my DH's work insurance which is horrible, or get them onto a child-only plan. So I am wondering if anyone has looked into any and how much they run (average). Just starting to get my feet wet in the huge pool of insurance

Oh and my insurance does cover maternity even though I am a dependent. So that's a positive haha

Sahara6971 · August 2014

All I can say is think twice before going on the exchange! I have it and it has been a total and complete nightmare!! And now I can't even get rid of it!

mirigirl · August 2014

sarabell52 said:

mirigirl said:

I would, but I am still under 26, so I am on my parents plans for free

Not to nitpick, but when you say "free" you mean free to you. It's not that your parents pay $0 premium for your health insurance.

To address your original question -
There are important factors beyond premium and deductible. For instance, a lot of the plans (that I've seen) include preventive care for children at no cost to the subscriber- meaning all your well-checks are covered 100%, including immunizations. What's the copay for sick visits? What's your out-of-pocket max (you want this number to be manageable) and what's the maximum dollar amount of coverage (you want this number to be high or state "no max")?

No, when I say free, I mean free. He can have an unlimited amount of dependents on his insurance at no extra cost. His wife however is not free on his plan.

jennypolkadots · August 2014

Yeah, we looked into all of this before getting pregnant. To add a child to either of our work plans, it would be $750/month. Yeah, $750!! Because our work pays 100% for our insurance but nothing for family/kids. We have Aetna PPO with $300 deductible. Awesome maternity coverage so that's good.

So we looked into single child options. Blue Cross Blue Shield has pretty good plans ranging from $120-$175. We are in Alabama though so these prices will be higher is higher cost areas. We are probably going to go with their gold plan for the first year that is around $175 and may reduce coverage later on depending on health needs.

mirigirl · August 2014

jennypolkadots said:

Yeah, we looked into all of this before getting pregnant. To add a child to either of our work plans, it would be $750/month. Yeah, $750!! Because our work pays 100% for our insurance but nothing for family/kids. We have Aetna PPO with $300 deductible. Awesome maternity coverage so that's good.

So we looked into single child options. Blue Cross Blue Shield has pretty good plans ranging from $120-$175. We are in Alabama though so these prices will be higher is higher cost areas. We are probably going to go with their gold plan for the first year that is around $175 and may reduce coverage later on depending on health needs.

OMG!! $750?!?!? I thought DH's was bad! YIKES! Thanks for the tip for BCBS, I will look into it. I think the open enrollment period is up, but it doesnt mean I can't add baby later

.

cinderella4282 · August 2014

When we had DD 2.5 years ago our insurance went up to the family plan which covers the entire family so Baby #2 is covered as well.

We have a $2500 deductible per person, BUT all the preventative care is covered. I just have to pay the co-pay at $20 per office visit. The vaccines and all that are covered. It is definitely worth it as newborns are in the doctor a lot for wellness checks the first year. Not to mention getting colds or sick just because their immune systems are new.

Insurance plans sometimes cover prescriptions as well, so that's a help because those medications if needed can be pricey. I would look at all your options and price it out, but it would be dangerous to not have your little bean covered.

Also check to see if your family plan has a max out of pocket.......Ours is $4,500. So at that point - regardless of meeting the deductible for each person - your care is covered. That was nice in 2012 when DD was born - we met that quick!!!

Good luck

jennypolkadots · August 2014

You may want to contact your dad's insurance. I am not aware of any providers who will knowingly allow an adult married child to be counted as a dependent. Besides, I wouldn't want to be on a parents plan where they can see details of my medical charges. You may look into getting your own plan and adding your child to it.

With BCBS of AL here are some details on plans, many of which look better than your husband's.

The most expensive plan is "Blue Choice Platinum" at $204.36/mo. The deductible is $100 individual, $20 copay, and $4K max out of pocket per year. The cheapest is "Blue Saver Bronze" at $105.86/mo. The deductible is $6350, $40 copay for first 3 visits then no coverage, and $6350 annual max. So after the first 3 visits you would pay 100% of office visits until you reach your max or deductible. Most plans are somewhere in between, balancing cost with coverage.

If you have a healthy baby and normal delivery, you really want the cheapest plan with the lowest office copay. Of course things can happen, but if you can reasonably afford the out of pocket max then that is what matters. Something like this would probably be best for most cases:

"Blue Secure SIlver" at $140.19/mo. $2000 deductible, $40 copay, and annual max of $6350.

There are other providers but for the most part you can expect to pay $100-$200 for infant single coverage, unless you get some sort of subsidy for low income situations.

mirigirl · August 2014

cinderella4282 said:

When we had DD 2.5 years ago our insurance went up to the family plan which covers the entire family so Baby #2 is covered as well.

We have a $2500 deductible per person, BUT all the preventative care is covered. I just have to pay the co-pay at $20 per office visit. The vaccines and all that are covered. It is definitely worth it as newborns are in the doctor a lot for wellness checks the first year. Not to mention getting colds or sick just because their immune systems are new.

Insurance plans sometimes cover prescriptions as well, so that's a help because those medications if needed can be pricey. I would look at all your options and price it out, but it would be dangerous to not have your little bean covered.

Also check to see if your family plan has a max out of pocket.......Ours is $4,500. So at that point - regardless of meeting the deductible for each person - your care is covered. That was nice in 2012 when DD was born - we met that quick!!!

Good luck

Oh not having insurance for the baby is NOT an option for us. We know how important insurance is :-*

DH's insurance is just terrible, so I was hoping to find a child-only plan that is less expensive monthly, with a lower deductible. But it seems like most open enrollment periods are over. we may just have to add the baby to DH's plan. It doesn't sound like much, but the baby will cost $220 a month on DH's plan, but with an OUTRAGEOUS deductible and super high copays ($80), its just isn't a very attractive option

:-q

thanks!

jennypolkadots · August 2014

No, you don't have to wait until open enrollment. Birth is a qualifying event with all insurance carriers. You open the policy within 60 days after the birth. Most people do it around day 30 so they can first just use the mother's insurance as coverage. You can price it out online using a birth date of today just to get an idea, but you can't sign up for a policy for someone who has not yet been born.

The info I provided shows you can definitely get way better coverage for less than your husband's plan. If his employer does not pay 100% of his plan, I would also consider getting him better coverage too. I have never in my life heard of a $80 copay.

mirigirl · August 2014

jennypolkadots said:

You may want to contact your dad's insurance. I am not aware of any providers who will knowingly allow an adult married child to be counted as a dependent. Besides, I wouldn't want to be on a parents plan where they can see details of my medical charges. You may look into getting your own plan and adding your child to it.

With BCBS of AL here are some details on plans, many of which look better than your husband's.
The most expensive plan is "Blue Choice Platinum" at $204.36/mo. The deductible is $100 individual, $20 copay, and $4K max out of pocket per year. The cheapest is "Blue Saver Bronze" at $105.86/mo. The deductible is $6350, $40 copay for first 3 visits then no coverage, and $6350 annual max. So after the first 3 visits you would pay 100% of office visits until you reach your max or deductible. Most plans are somewhere in between, balancing cost with coverage.

If you have a healthy baby and normal delivery, you really want the cheapest plan with the lowest office copay. Of course things can happen, but if you can reasonably afford the out of pocket max then that is what matters. Something like this would probably be best for most cases:

"Blue Secure SIlver" at $140.19/mo. $2000 deductible, $40 copay, and annual max of $6350.

There are other providers but for the most part you can expect to pay $100-$200 for infant single coverage, unless you get some sort of subsidy for low income situations.

Under the health care reform act, regardless if I am married or not, as long as I am under 26, I can still be on my dad's plan. I am a pretty open book so I dont mind if the doctors office slips up and sends him a bill.

But thanks so much for all of the BCBS info! That was very helpful!

jennypolkadots · August 2014

Sorry for ANOTHER comment but I want to help. Just wanted to also clarify that no insurance can exclude preexisting conditions now (yay!) and by 30-60 days after birth you will have a pretty good idea of what coverage will work best for your child. If, god forbid, they are in the NICU and expecting a long recovery then the most expensive plan with the lowest yearly our of pocket makes sense. Or if a heart condition or spinal cord issue is detected. Most big issues will be figured out before that 30-60 days. But, for a healthy baby just going in for normal checkups and shots, you can get the much cheaper plans and be well covered.

mirigirl · August 2014

jennypolkadots said:

No, you don't have to wait until open enrollment. Birth is a qualifying event with all insurance carriers. You open the policy within 60 days after the birth. Most people do it around day 30 so they can first just use the mother's insurance as coverage. You can price it out online using a birth date of today just to get an idea, but you can't sign up for a policy for someone who has not yet been born.

The info I provided shows you can definitely get way better coverage for less than your husband's plan. If his employer does not pay 100% of his plan, I would also consider getting him better coverage too. I have never in my life heard of a $80 copay.

I know, its horrendous.

Interesting that it says birth is a qualifying event. I went on many insurance carriers websites and they specifically said birth is not a qualifying event. Perhaps I was in the wrong area. Hmmm, need to recheck.

thanks for the info!

mirigirl · August 2014

jennypolkadots said:

Sorry for ANOTHER comment but I want to help. Just wanted to also clarify that no insurance can exclude preexisting conditions now (yay!) and by 30-60 days after birth you will have a pretty good idea of what coverage will work best for your child. If, god forbid, they are in the NICU and expecting a long recovery then the most expensive plan with the lowest yearly our of pocket makes sense. Or if a heart condition or spinal cord issue is detected. Most big issues will be figured out before that 30-60 days. But, for a healthy baby just going in for normal checkups and shots, you can get the much cheaper plans and be well covered.

Don't be sorry! I am glad for the help =]. That is a good idea. Can you possibly send me the link where you priced out all of those plans under BCBS? I tried to find it but it kept taking me in circles.

jennypolkadots · August 2014

Birth is always a qualifying event lol how could a baby get an insurance plan before they were born? Or how could they be added to your insurance otherwise?

I'm not sure what you read but just call the carriers you are looking into. Explain you are due in February and looking for insurance options. This is what I did last year before we were even trying yet because we wanted to budget. I bet you will get all the info you need pretty quick and be able to compare apples to apples.

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