Health Insurance Plans for Babies
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Health Insurance Plans for Babies
Hi there. My husband and I are expecting our first baby (a
little girl) in April and are trying to figure out health
insurance. We're both independent school teachers and so
while we're not below the poverty line (not eligible for
medi-cal or Healthy Families or anything like that), we're
not exactly rolling in the dough either. To add our daughter
through either of our jobs would be close to $500/month!
This would be a huge financial strain on us. I have Kaiser
and I'm really pleased with it and when perusing the
individual plans, they look much more reasonable than going
through my group plan. I know one has to be careful not to
overlook any loopholes or gaps that may not be obvious until
it's too late, though. Has anyone else faced this situation
and/or have any advice on how to proceed? Thanks very much!
Hi There, My husband and I were in a similar situation 2
years ago. We choose a Kaiser individual plan for our son.
It's about 160/month w/ 50 dollar co-pays after the first 2
years of routine well-child visits (which had no-copay.) I
too am overall very satisfied with Kaiser. Although it's a
little impersonal at times, I appreciate the concentration
of services. For example, whenever we've inquired about a
specialist of any kind from our Pediatrician it's been no
problem to get right in with them. No paperwork or
complicated referrals. The only down side to our son's plan
is that it has no prescription benefits with it. So far
that's been fine, he's had antibiotics only twice in his
life and it was less than 15 bucks each time. Best of luck
Best of luck to you!
both myself and my husband held individual insurance when my
first kid was born so I just bought my kid his own plan too
as it was way cheaper. So as long as your kid is healthy
should be no issue (and if they are not you can just add
them to your plan). Also I thought it was lower risk to each
have a say $2000 deductible than a family $6000 one.
it can get really sticky around the birth though if you have
high deductibles- because you are not adding the kid to the
plan I. with my first kid I didn't add them and they left my
deductible alone. with my second kid they doubled my
deductible for the birth even though I didn't add the kid
(by law they are automatically covered for 30 days and this
applied). I am still fighting them on that one. so be
prepared for some more administrative hassle around the
birth (what's your charge versus what's the babies) but
other than that no problems for us. Also you'll have to act
fast (and you'll have just had a baby) - it takes a few
weeks to get their own plan and if they get turned down
you'll need the back up adding to your own plan which means
you'll need to get it all done in 30 days so start the
process the day after the kid is born!
I do not know what your combined income is, but you might want to look into
Kaiser's Low Cost Health insurance for kids up to 19 y.o. My husband lost his
job 1+ yrs ago and after much hastle w/trying to get onto Healthy Families, we
found this Kaiser plan & it is only $8/month and covers a lot. I think this
amount is for the lower income folks (us now!), but that you pay more if you
make more. I don't think they advertise it much, but it was very easy to apply
and the application process took only approx. 3 wks - compared to HF which
went on for 4-5 mo. and then we were wait listed....all the while my daughter
was uninsured! This health insurance thing is crazy, so the best of luck to you
and hope you find something that works.........
Anybody aware of a health insurance company who offers insurance
for a new baby that is lower than the almost $300/month
(ridiculous) it will cost to add him to my insurance? Any
suggestions would be appreciated. Thanks.
I chose Kaiser for my new baby. They have some very affordable
plans: we have one that is just $114 monthly. just be careful!
when you first begin insuring a baby on their own plan, it takes
a few weeks to go into effect. We went to the Dr before the
insurance went into effect, and had to pay full price even though
we had thought we were insured.
Check out Kaiser. I have also hear Blue Cross has some programs
too. I happen to be with Kaiser and like them.
As a parent and an HR administrator, I can advise you that we
recommend to all new parent/employees to research individual
plan insurance for their newborns. Our monthly group coverage
premium is also very high for children and unless you have
three or more kids is financially impractical. Personally, I
have had my son on an individual Health Net plan since he was a
newborn, he is now 11 years old. Just to give some perspective
on coverage ''safety'' and cost, he was diagnosed with type 1
diabetes in February of this year and we only saw a $10
increase in annual premium at renewal. Currently, we pay $174
per month for his PPO coverage with pharmacy benefits. The plan
started at about $80 per month when he was a newborn, a premium
this low is not available now, but it shows how the costs have
increased over 10 + years. One caveat to this advice, this type
of coverage would probably not be available if your newborn has
any pre-exhisting conditions. Good Luck!
We recently enrolled my son in Blue Shield. The premiums are $57
a month, and his office visit copays are $40. Blue Shield
specializes in children's plans. I strongly recommend getting in
touch with an insurance broker (I went to Jean Sturges in
Berkeley, 510-845-6688) who can review the different plans with you.
I am a student and expecting my first baby by the end of
September. This is about my babyís insurance. I have a good
insurance coverage through my work as a student researcher at UC
Davis, which is a Blue Cross PPO type of coverage. I am told by
UCD that my insurance, unlike to the most of plans, doesnít cover
the baby except for the day of delivery. Also, UC doesnít provide
family plans to students, and it means that I have to buy
individual coverage for the baby separately. I have tried several
ways to do that or to get information such as Blue Cross, Health
Net, Healthy Family, DMHC, and etc. and the bottom line is that
my baby cannot have coverage sooner than two weeks after birth.
Thatís because all these plans need to have the birth certificate
to be able to do the paperwork and activate the coverage for the
baby as an individual. So, as you can see from the day after
delivery until two weeks in the best scenario the baby wonít have
I even tried to buy another coverage for myself and add the
newborn on that, but my situation is considered as pre-existing
condition and again the baby cannot get coverage through me.
The whole concern is if something happens during the delivery or
in the first two weeks that get the baby to NICU or
hospitalization. We are willing to pay as much as needed now to
find any type of insurance and not to take the risk of unexpected
Honestly, I am hopeless regarding this issue and have spent lots
of time calling people. I I hope maybe someone has had a similar
situation or know a way that may help me.
I would greatly appreciate any thoughts or suggestions you might
Is the office totally sure that babies aren't covered beyond the first day? My
newborn was covered by UC Berkeley's SHIP insurance (Blue Cross) for a couple of
weeks when I was a grad student in 2003. (It seemed to be a confusing process for
them to put in place, and we did have some mix-ups to correct, but at least she was
covered.) Have you talked to the highest-level people you can to confirm?
You should not have to wait for the birth certificate. I work for San Francisco
State University, and have Blue Sheild HMO. I gave birth August 3rd at Alta
Bates in Berkeley and the hospital gave me a formal hospital letter verifying the
birth of my baby, specifically for forwarding to my insurance company to get
my baby added to my coverage. I was given the letter when I was discharged.
(You didn't mention it, but if you are giving birth in a hospital, they will
probably give you one, too). I then gave this letter to my benefits coordinator
to forward to Blue Shield for me. Your benefits or HR specialist should be able
to advise you as to how to forward this letter to the Blue Shield PPO.
BTW: are you *sure* your baby is only covered up to birth? I was told that mine
was covered, automatically, up to 30 days after birth, so I just had to make
sure she was added by that point. Also, I was told that if she wasn't on there by
the time of her next doctor appointment (because of a mix-up with the
paperwork on my part, she might not be added quite in time), that was okay,
the appointment would be retroactively covered, I would just have to have the
claim resubmitted by my HR benefits specialist. Worth looking into?
Best, of luck. Most likely (unless you have a pre-existing medical condition that
you know will probably cause problems) everything will be fine, and you won't
need it anyway!
Hi! I feel your pain! My insurance covers the baby for the remainder of the month
they are born, which in the case of my first son was no big deal, as he was born on
May 16th. However, this preg. is due February 27th! So the possibility of being stuck
is definetly at the front of my mind.
That being said, my first child is under Healthy Families, which (theoretically) starts
13 days after they recieve the birth certificate, which can be faxed from the hospital
the day of the birth if you like and have the wherewithall to get that together.
However, if you have to front anything between the birth and the coverage, I was
told they would reimburse you later. You might have to talk to quite a few people
before you get a straightforward answer on that policy...
Also, if you're willing to front some money, Kaiser has an individual child health plan
that you can sign up for beforehand and pay for monthly until you are able to get a
cheaper alternative together... plus Alameda county Healthy Families uses kaiser if
you like, which means no switching pediatricians, etc when it comes to fruition.
Beware the Healthy Families Bureaucracy, though!!!!! It took us FIVE MONTHS (Three
prior to birth and two after) to get everything finalized!
Feel free to email me if you have anymore questions regarding Kaiser, HF and the
like... I'm more experienced with them then I wish to be, but am happy with both
presently... as long as this next baby is born March 1st!
Have you tried Medi-Cal? No matter how late you are in your
pregnancy, if you are income-eligible, they will cover you and
your baby until you can get a birth certificate. It doesn't
matter if you have insurance already. I am in a similar
situation and this is what I ended up with. Good luck!
My understanding was that it is the law that YOUR health plan
must carry the baby for the first 30 days of life. This is what
I was told as a student at UCB when I had my son and had their
insurance. After the first 30 days (maybe it was 14, but it was
enough time for the paperwork to transfer) it was my
responsibility to have him covered by another plan but MY plan
had no choice but to cover those first few days. If you get
stonewalled at UCD ( and I got A LOT of bad/wrong info before I
just demanded to talk to the person in charge of insurance for
all of UCB) try calling the local insurance comissioner to check
on the laws about this. Best of luck.
know it's crazy making
My wife and I (both graduate students covered by GSHIP) are expecting a
child. We're looking for affordable health insurance for our baby, since
the health plan for dependants of graduate students offered by the
university is quite expensive. Any suggestions or recommendations, please?
I shopped around for insurance for my second child who
is UNDER ONE, but most stuff seemed about the same price or more than
the University's DHIP (about $100/month). Until your child turns one,
DHIP might be a good deal. (I am personally pretty annoyed with DHIP
because my baby had to pay $145/month not $100. I guess there's a
$45/month penalty for having 2 children on DHIP and for a while I was
unknowingly paying the $245/month for two!)
But consider this: If you make less than around $2500/month
(it's $2700 for a family of 4), you could probably get no-cost Medi-Cal
for the child's first year. Medi-Cal is a PAIN! (E.g. some workers don't
realize that recipients are now allowed to have large savings.) But
eventually they have to pay your bills if you qualify.
Call "Healthy Families" (in phone book) and ask for a mail-in application.
(Or see Recommendations for the Healthy Families Program
Depending on your income level I would look into:
o Blue Cross of California (in the yellow pages)
o The Healthy Families program (http://HealthyFamilies.ca.gov/>)
The Healthy Families Program is a state and federal funded health
coverage program for children with family
incomes above the level eligible for no cost Medi-Cal and below 200% of
the federal income guidelines ($27,756 for
a family of three).
I have to admit I'm not in touch with the range of health insurance prices,
but I suggest you check out Blue Shield. We have their HMO insurance for our
son and it's $63/month for a 5+ year old (somewhat more for younger children).
Kaiser might also cover individual children, and if they do, they may be
cheaper. It seems that not many companies will give minors their own policy. Fran
If your income is within 150 or 200% of the poverty line, I would strongly
recommend you apply for Healthy Families, a state run program which we use
for our son, and that you can link to via the parents web page, I believe.
We were able to keep him with Kaiser, with basically the same coverage we
had when my wife worked there, but the program allows you to use anyone of
many HMOs and PPOs. It costs us $7/mo. (sliding scale, I think), with the
fourth month waived if three months are payed ahead of time, or smthg like
that. The copays are nominal. Also, remember that the state has a
similar program for pregnant women, in case the GSHIP doesn't have good
coverage for pregnancy. Good luck. Eric
Strangely enough, I got information about a program called AIM (Access
for Infants and Mothers) when I bought some diapering products at Safeway the
other day. The income guidelines appear to be between 200-300% of what is
considered the poverty line.
It's worth investigating anyway. Here's their web site:
this page was last updated: Apr 19, 2010
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