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Insurance when
you've had a baby
By Insure.com
Last updated Oct. 4, 2008

Having a baby is a life-altering event. Lacking the proper health and life insurance can be, too. If you recently had a baby or are expecting, now is the time to examine your new insurance needs.

Life insurance

You have a new dependent who benefits from your wages. As your baby's main — or sole — financial support, you need to insure your potential future income against losses in the event of your death.

Calculating much life insurance you need to buy is the first crucial step. Financial advisors suggest a five-step analysis that adds up your short-term needs (final expenses, outstanding debts and emergency expenses), long-term needs (such as mortgage payment), education (dependents' college tuition), and family maintenance (child care, food, clothing, utility bills, insurance and transportation), then substracting assets such as savings, stocks, bonds, mutual funds and other life insurance. Insure.com's Life Insurance Needs Estimator Tool can help.

Typically you'd name your spouse as the beneficiary on your policy. If you're divorced, you'd likely still name your ex-spouse because they would care for your children in the event of your death. Don't name your minor children as beneficiaries: They cannot receive a life insurance benefit until they're age 18 unless you've set up a trust to hold the proceeds.

Adding your baby to your health plan

Most health plans will not include a baby on your health insurance policy if he or she is not added within the first 30 days of birth.

Soon after your baby's birth, you should apply for the child's Social Security number. You'll need to list this number on your tax return in order to take the dependency exemption for the baby. Most hospitals make the arrangements, but if yours doesn't, call the Social Security Administration at (800) 772-1213. Health insurers will also want your baby's Social Security number as soon as it's issued.

You might have as little as 30 days following your child's birth to add him to your group health insurance plan. If you miss this deadline, your health insurer might require you to wait until the next annual "open enrollment" period before you can add your baby to your health insurance plan. If your employer offers more than one choice of health insurance plan, open enrollment is a good time to evaluate your coverage and see if it meets your expanded family's needs.

If you don't have health insurance through work, can't afford an individual policy and don't meet low-income rules for Medicaid eligibility, you may be a prime candidate for your State Children's Health Insurance Program (SCHIP). The Robert Wood Johnson Foundation reports many children who qualify for state programs that provide health coverage to low-income families are not covered because their parents don't know about these programs. Your state insurance department can tell you if you qualify for such coverage.

More children in your future?

Even if you didn't have any problems with health insurance during pregnancy, there are many issues that can complicate your health insurance situation should you decide to have another child.

While federal law prohibits most group health insurers from denying claims related to your pregnancy, there are still a variety of loopholes that might mean you can still find yourself without health insurance coverage for your prenatal care and your baby's delivery.

No individual health insurer will issue you a health insurance policy if you are pregnant when you apply — even if you're not aware you're pregnant when you submit the application. So if you happen to lose your group health insurance, don't assume you can purchase an individual health insurance policy if you become pregnant again. Make sure you apply — and have your policy in hand — before you conceive.

No individual health insurer will issue you a health insurance policy if you are pregnant when you apply.

Bear in mind that individual insurers don't have to cover pregnancy at all, and if they do they might impose a 12-month waiting period after your health insurance kicks in before they will pay for pregnancy-related claims. As for group health insurance, there's no legal requirement that your employer offer health insurance at all. But if your employer opts to offer coverage, your health plan must comply with any state laws that mandate maternity coverage.

During your next pregnancy

Be careful if you switch jobs during your next pregnancy. Don't assume you'll automatically be able to pick up coverage. While the federal Health Insurance Portability and Accountability Act (HIPAA) says group health insurance plans can't consider pregnancy a pre-existing condition and can't exclude coverage for prenatal care or your baby's delivery, HIPAA's rules don't cover everyone. HIPAA applies to every employer group health plan that has at least two participants who are current employees, including companies that are self-insured. If you move from one individual plan to another or from a group plan to an individual plan, you might not get pregnancy coverage at all, or you might have to sit out a waiting period.

Even if you are eligible for health insurance under HIPAA, you might still have to sit out a new employer's mandatory waiting period for all new employees that can range anywhere from one to three months. Being uninsured is a risk any time, but especially when you are pregnant. If your new health insurance has not yet started, you'll have to foot the bill yourself.

One way to bridge this health insurance gap is to enroll in your former employer's COBRA health insurance plan. If your former employer has at least 20 employees and offers group health insurance, then it must offer you the chance to continue your health insurance coverage under COBRA for up to 18 months. Some states also have "mini-COBRA" laws that apply to smaller employers.

 

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