Let's Talk About Insurance

Having a baby can be expensive, and not just because of all of the nursery items and diapers you'll need. The costs of maternity and childbirth care can vary, and if there are any complications, those costs can skyrocket. Insurance can help reduce the expense of having a baby, but coverage can vary greatly depending on the state you live in and the kind of coverage you have. So if you're pregnant or planning to be soon, one of the first things you'll want to do is check with your health insurance plan to see what coverage it offers during your pregnancy, for childbirth, and for your newborn.

Getting started

The best place to start is by speaking with your insurance provider or your employer's benefits department. Asking the right questions can help you plan your budget and prepare for any unexpected costs. The following questions can help you get started:

Is there a deductible – and how much (this is an amount that comes out of your pocket)?
If there is a deductible, what percentage of your care is covered after the deductible is met?
Do you have a co-pay, and how much?
Is your preferred obstetrician covered under your plan, and does the obstetrician accept your plan?
Is the hospital or birth center you prefer covered under your plan? This is especially important to note because not all providers will cover delivery in a birth center. Be sure to check with the hospital or birth center you've chosen to make sure they accept your insurance, as well.
It's important to choose your baby's pediatrician well before your due date to assure that you can find a doctor you're comfortable with and who is in your provider network, as well, Again, also check that the pediatrician accepts your plan.
If both parents are working and have insurance plans, whose plan is the primary plan? What costs does that plan cover. What costs does the secondary plan cover?

What else is covered?

In addition to your pregnancy and childbirth, be sure to check that other services you may need before, during, and after delivery are covered by your plan:

Anesthesiologist
Hospitalist
Neonatologist and/or pediatrician
Unexpected services such as a C-section
Specialists for you or your baby
Maternal/fetal services for high-risk pregnancy, etc.

Don't assume that just because the hospital or your doctor is covered by your insurance that other medical staff will be. In fact, it's not uncommon for an in-network medical facility to use out-of-network practitioners. It's good practice to ask if a medical service or practitioner is in your network. But also be sure to ask your insurance provider what coverage is provided for any out-of-network services you may receive since any costs that aren't covered will be out-of-pocket costs for you.

Speaking of coverage, your insurance provider may offer help with estimating your pregnancy and delivery costs so you can plan ahead for any out-of-pocket costs you may be responsible for. You can usually find that information by calling your insurance's member services number or visiting member services on the insurance provider website.

When should I enroll my newborn?

Many people assume that they have lots of time after their baby is born to enroll them on their health insurance plan. This isn't the case. For the health of your baby and to make sure unexpected charges don't hit your budget, be sure to enroll your baby as soon as possible after the baby's birth.

Most insurance plans automatically cover newborns as an extension of the mother's insurance for a limited number of days beginning from birth, typically 30 days. However, this varies by insurance provider (it can be anywhere from 24 hours to 31 days) so it's best to enroll your baby right away. If you miss the baby's enrollment period you won't be able to cover your baby until your insurance provider's next open enrollment date.

Be sure to speak with your insurance provider or company benefits department well before your baby's due date. And don't just talk with them, make sure you clearly understand when you need to enroll your baby, and what documentation you must provide. In addition, you might want to have your provider on speed dial to ensure that your new baby is insured. Most babies are born strong and healthy, but it's always better to be prepared.

If both parents are working and have insurance coverage, be sure to check with both providers about when to enroll your baby.

Let's Talk About Insurance

Getting started

What else is covered?

When should I enroll my newborn?

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