The Importance of Health Insurance for Newborns
Bringing home a new baby is an exciting and busy time for new parents. Between feedings, diaper changes, and sleepless nights, making sure your newborn has health insurance coverage can easily fall through the cracks. But having health insurance for your baby from birth provides important protection and peace of mind.
Health insurance helps pay for routine newborn medical care like well-child visits, vaccinations, and sick care. Babies seem to catch every bug, so having insurance to cover unforeseen illnesses and trips to urgent care provides financial safeguards. Health insurance also provides access to specialists, therapy, and care for any birth defects or other medical needs that may arise.
No parent wants to think about worst-case scenarios, but having health coverage can be crucial if, god forbid, your baby faces a serious health issue or medical emergency. Neonatal intensive care and specialized pediatric services can rack up enormous medical bills. Health insurance helps reduce financial risks.
The good news is that the Affordable Care Act has made it easier than ever for newborns to get health insurance. Let’s walk through the key provisions and steps you need to know to get your little one insured. With some planning ahead, you can have peace of mind knowing your baby is covered.
Benefits of Enrolling Your Newborn in Health Insurance
Welcoming a new baby is an exciting and busy time for any family. While your mind is filled with feeding schedules, diaper changes, and sleepless nights, don’t forget about one very important task: enrolling your newborn in health insurance. There are many benefits to signing up your little one for coverage right away.
One of the biggest advantages is that health plans must now cover preventive well-baby visits and immunizations. Under the Affordable Care Act, these essential services are provided at no out-of-pocket cost to you. This means you can take your baby to regular check-ups and get recommended vaccines like polio, MMR, and hepatitis shots without having to pay deductibles or copays. Catching any potential issues early and following the immunization schedule will help keep your child healthy in those critical first years.
You’ll also have the peace of mind that comes with knowing your child is protected against the high cost of medical care. Whether it’s a persistent ear infection, breathing issues like RSV, or more serious conditions like leukemia, having insurance coverage means you can focus on getting your baby the care he or she needs without the added worry of overwhelming medical bills.
No Lifetime Limits
One of the most important protections of the Affordable Care Act is the elimination of lifetime limits on health insurance policies. Prior to the ACA, many insurance plans placed a dollar limit on how much they would spend on covered benefits over the lifetime of the policy. Once a patient reached that limit, the insurer would no longer pay for care.
This was especially problematic for babies and children born with health conditions requiring extensive medical treatment early in life. Costs could quickly reach the lifetime maximum, leaving families with no coverage just when they needed it most.
With the ACA’s ban on lifetime limits, parents of newborns with medical needs no longer have to worry about their child prematurely maxing out their policy. Health issues early in life will not exhaust their coverage or lead to denial of benefits. Families can access the care their child needs without hitting an arbitrary cap.
Obamacare’s removal of lifetime maximums provides peace of mind and critical financial protection for parents of infants and children with chronic health problems. Health Care needs early in life will not preclude coverage later on.
Obamacare Provisions
One of the most important parts of the Affordable Care Act, also known as Obamacare, is that health insurance plans are now required to cover preexisting conditions. This means insurance companies can no longer deny coverage or charge more for healthcare services related to any conditions your child had prior to enrolling in a plan. Whether it’s asthma, allergies, a heart defect, or anything else, your child’s preexisting condition will be fully covered by the plan once you enroll.
This regulation provides crucial protections for millions of families across the country. Before the Affordable Care Act, many children were excluded from coverage entirely if they had a preexisting condition, or their families were forced to pay exorbitant rates. Now there are no loopholes – insurance companies must provide comprehensive coverage regardless of your child’s medical history.
Having health insurance that covers preexisting conditions gives parents vital peace of mind. You’ll know your child can receive the care they need without accruing massive medical bills. This allows you to focus on your new baby rather than worrying about denied claims or unaffordable treatments down the line. Taking advantage of this important Obamacare regulation can truly make a difference for your family’s health and financial stability. Enroll your child as soon as possible to secure these protections.
Keeping Your Young Adult Insured
One of the most popular provisions of the Affordable Care Act (ACA) is the requirement that health plans allow young adults to stay on their parent’s health insurance plan until they turn 26 years old. This provision went into effect in 2010 and has enabled millions of young people to retain health coverage even if they are no longer students, live on their own, are married, or are financially independent.
Prior to the ACA, young adults were often dropped from their parent’s plans once they graduated from college. This resulted in a large population of uninsured young adults who were starting careers and independent lives but could not yet afford their own health insurance. Allowing young adults to remain covered by their parent’s plan until age 26 has dramatically reduced the number of uninsured Americans in this age group.
Even if your young adult child has access to health insurance through their job or school, staying on your plan can provide better coverage and reduce out-of-pocket costs. Most young adults will qualify for subsidized marketplace plans once they turn 26, but retaining parent’s plan coverage remains an excellent option for many.
As long as the child is under 26, they can join or remain on a parent’s plan, even if they are:
- Married
- Not living with their parents
- Attending school
- Not financially dependent on their parents
- Eligible to enroll in their employer’s plan
The parent’s plan must be an ACA-compliant plan for the young adult to qualify. If you have a young adult under 26 who needs health coverage, visit HealthCare.gov to explore your options together. Many young people are unaware they still qualify for a parent’s plan and miss out on this great benefit.
Medicaid Expansion Provides Coverage for More Families
A key provision of the Affordable Care Act is the expansion of Medicaid to cover more families and children. Prior to the ACA, Medicaid eligibility was restricted in many states; for example, in some states, only families earning less than 50% of the federal poverty level qualified.
The ACA expanded Medicaid eligibility to include all families and children earning up to 138% of the federal poverty level. This expansion opened up Medicaid to millions of previously uninsured low-income adults and children.
Under the expanded income limits, a family of four earning up to $33,948 would qualify for Medicaid, depending on what state they live in. Without the expansion, that same family may have earned too much to qualify for Medicaid but not enough to afford private insurance.
The Medicaid expansion aims to provide health coverage to the poorest and most vulnerable Americans. It gives more low-income parents the ability to get their children enrolled in comprehensive coverage. Medicaid provides important benefits, including regular checkups and screenings, immunizations, doctor visits, prescriptions, emergency care, and hospitalization.
Getting babies and children enrolled in Medicaid can ensure they have access to the health services they need for healthy development. The expanded eligibility guidelines open up coverage for millions of uninsured children. Medicaid expansion is a crucial benefit for new parents and their children.
Subsidies Available
The Affordable Care Act (ACA) provides financial assistance to help individuals and families obtain health insurance coverage. This assistance comes in the form of subsidies and tax credits to help lower monthly premium costs and out-of-pocket expenses.
One form of subsidy available is a premium tax credit, which helps eligible individuals and families making between 100-400% of the federal poverty level afford their monthly health insurance premiums purchased through the ACA marketplace. The amount of tax credit received is based on household income and size. Generally, the lower the income, the higher the subsidy amount.
To determine eligibility and estimate the tax credit amount, applicants must provide income information when applying for coverage on the marketplace. The tax credits can be taken in advance and paid to the insurer directly to lower the monthly premium cost. At the end of the year, individuals reconcile the advanced payments on their tax return. If the tax credit amount differs from the individual’s actual income for the year, adjustments will be made.
The ACA subsidies make health insurance coverage more attainable for millions of Americans by reducing the costs of premiums and care. Taking advantage of these subsidies can provide significant savings and make quality health coverage affordable.
Open Enrollment Periods
The open enrollment period is the time frame each year when you can sign up for health insurance or make changes to your existing coverage. Knowing the open enrollment dates and deadlines is important so you don’t miss your opportunity to get health insurance for your new baby.
For plans through the Health Insurance Marketplace, open enrollment for 2023 coverage starts on November 1, 2022, and ends on January 15, 2023. Outside of this window, you can only enroll if you qualify for a Special Enrollment Period due to a life event like having a baby, getting married, or losing other health coverage.
To sign up for Marketplace coverage during open enrollment:
- Visit ObamaCareQuotes.com to check plan options and prices and enroll online.
- Call the Obama Care Quote at 1-888-836-0035 to get assistance over the phone.
Medicaid and CHIP have rolling enrollment all year. You can apply anytime if you qualify based on your income. To enroll, visit your state Medicaid office or call 1-877-KIDS-NOW.
Knowing the enrollment periods and getting signed up on time ensures you have health coverage set for your new baby. Don’t wait—explore your options today!
Steps to Enroll
Enrolling your newborn in health insurance through the Affordable Care Act (ACA) marketplace is easy if you follow these steps:
Where to Apply
You can apply for coverage on The Insurance Guys Group marketplace website, ObamaCareQuotes.com.
What You’ll Need
When enrolling online or over the phone, you’ll need to provide some basic information about yourself and your household:
- Social Security Numbers for everyone applying for coverage
- Employer and income information
- Policy numbers of any current health insurance plans you have
- Information about any health insurance available from your job
- Legal residency status in the U.S.
Having this information ready will make the application process faster and easier. The website will walk you through the steps to input all the required details.
Next Steps
Now that you’ve enrolled your new baby in health insurance, here are some next steps to take:
- Schedule appointments with pediatricians and specialists that accept your insurance plan. Make sure to ask the provider’s office which plans they accept before making an appointment. You want to ensure your baby can see an in-network provider to avoid surprise medical bills.
- Understand what’s covered and not covered. Review your health plan’s summary of benefits and coverage to see what services, drugs, and care are covered. Know what the deductible, co-pays, and co-insurance will cost you out of pocket. Also, understand what’s not covered so you aren’t surprised by a denied claim.
- Add your baby as a dependent. Contact your insurer to add your baby as a dependent to your existing family plan. Provide your baby’s full legal name, birth date, and social security number. Adding your baby ensures he/she will be covered under your plan.
- Get an insurance card for your baby. Once you’ve added your baby as a dependent, you should receive an insurance card for your baby in the mail. You’ll need this card when bringing your baby to doctor’s appointments, so keep it handy.
- Pay premiums on time. Make sure to continue paying your monthly or yearly premiums on time to avoid any lapse in coverage. Set up autopay or automated reminders if needed.
Following up on coverage, scheduling appointments, and understanding costs will help you and your baby get the most out of your health insurance. Reach out to your insurer with any other questions!