Newborn appointment and health insurance

[rbp]

I know that I need to add Baby Peppers to my health insurance within 31 days of his birth (I have confirmed this with my employer). But I can't do anything right now. How do I pay for his first pedi appointment? Won't they want insurance info or something?

[spanikopita]

No, don't worry about it. They'll take your insurance info. They do this all the time.

[rbp]

Jul 18, 2014 11:16:35 GMT -5 spanikopita said:

No, don't worry about it. They'll take your insurance info. They do this all the time.

I know they do...I feel really foolish asking this question. LOL

I'm getting antsy and thinking about all the things I should do ahead of time, but I guess this isn't one of them!

[swimmette]

Don't worry about it, you may get a "bill" but you call with the baby's insurance info one he/she is added to your plan and then they will bill the insurance company. I could add him once I got his SSN, which took about 2 weeks and then another week or so to get him added to the plan. Once he was good to go I just called the hospital and his pedi and they billed everything to the insurance co. I ignored all of the "bills" that were sent before he was put on my insurance.

[mandapanda18]

So, baby is covered under mom's health benefit for the first 60 days anyhow... give you a little wiggle room and time to get him/her on their own

[swimmette]

Jul 18, 2014 11:20:11 GMT -5 mandapanda18 said:

So, baby is covered under mom's health benefit for the first 60 days anyhow... give you a little wiggle room and time to get him/her on their own

Actually this is not always true, and was not true for us.  We got all bills as if he did not have insurance and was only able to be sent to my insurance after he was officially on the plan. If I did not call with insurance info I would have had to pay everything at the out of pocket amount.  It's not as if they would send to collections within the first 30-60 days, but the "bills" were sent out as a self-pay within about 2 weeks after delivery/pedi appointment (all within the same hospital system).

[arch01]

Jul 18, 2014 11:24:19 GMT -5 swimmette said:

Jul 18, 2014 11:20:11 GMT -5 mandapanda18 said:

So, baby is covered under mom's health benefit for the first 60 days anyhow... give you a little wiggle room and time to get him/her on their own

Actually this is not always true, and was not true for us.  We got all bills as if he did not have insurance and was only able to be sent to my insurance after he was officially on the plan. If I did not call with insurance info I would have had to pay everything at the out of pocket amount.  It's not as if they would send to collections within the first 30-60 days, but the "bills" were sent out as a self-pay within about 2 weeks after delivery/pedi appointment (all within the same hospital system).

Yep-my plan only covered DS for "typical" NB care on my plan as long as we were in the hospital. If he would've had anything out of the ordinary-testing, NICU, etc., it was not covered under my health benefit for the birth and subsequent stay. We paid OOP for his first 2 pedi visits because his plan hadn't kicked in yet.

If he was added to my plan, they would go back and retroactively cover anything as long as I had him on my plan within 30 days.

[sporklemotion]

We got bills but didn't have to pay them. It took some time to get her added because we needed something (I can't remember if it was a birth cert or SSN) that we didn't get right away. Once she was added, the office billed insurance.

[scsarah]

It sounds like all the plans are different, so it's definitely good to ask the question! For us, DS needed to be added to insurance within 30 days. Our pedi's office had all of our info and since they don't issue each person a separate insurance card, it just has all my information on it, they were able to take that and bill insurance no problem, because he was added pretty quickly.

Since you'll probably have a few pedi visits before it gets worked out, it's good to know!

[kershnic]

Our 1st pedi visit was billed under me. NICU was billed in their names (though I don't owe a deductible, go figure?). I couldn't do anything until I had a birth certificate and social - which I finally got on day 30. My employer told me if I didn't get the documents in time they could substitute a letter from the hospital saying I gave birth. You really can't fix this problem ahead of time, but don't delay any appointments because of it, as they know how to work it out.

[jene]

Our pedi just waited until we got our updated insurance cards to bill

[mandapanda18]

Jul 18, 2014 11:27:00 GMT -5 arch01 said:

Jul 18, 2014 11:24:19 GMT -5 swimmette said:

Actually this is not always true, and was not true for us.  We got all bills as if he did not have insurance and was only able to be sent to my insurance after he was officially on the plan. If I did not call with insurance info I would have had to pay everything at the out of pocket amount.  It's not as if they would send to collections within the first 30-60 days, but the "bills" were sent out as a self-pay within about 2 weeks after delivery/pedi appointment (all within the same hospital system).

Yep-my plan only covered DS for "typical" NB care on my plan as long as we were in the hospital. If he would've had anything out of the ordinary-testing, NICU, etc., it was not covered under my health benefit for the birth and subsequent stay. We paid OOP for his first 2 pedi visits because his plan hadn't kicked in yet.

If he was added to my plan, they would go back and retroactively cover anything as long as I had him on my plan within 30 days.

Man, I guess I am lucky then. Both my and my H's insurance are exactly the same on this matter, covered by me until enrolled themselves (by 60 days):

Adding Family Members

[arch01]

Jul 18, 2014 12:36:01 GMT -5 mandapanda18 said:

Jul 18, 2014 11:27:00 GMT -5 arch01 said:

Yep-my plan only covered DS for "typical" NB care on my plan as long as we were in the hospital. If he would've had anything out of the ordinary-testing, NICU, etc., it was not covered under my health benefit for the birth and subsequent stay. We paid OOP for his first 2 pedi visits because his plan hadn't kicked in yet.

If he was added to my plan, they would go back and retroactively cover anything as long as I had him on my plan within 30 days.

Man, I guess I am lucky then. Both my and my H's insurance are exactly the same on this matter, covered by me until enrolled themselves (by 60 days):

Adding Family Members

Yes, very!! I'm jealous!

[Stingyshark]

DD was her very own person on our policy the second she was born - We had 30 days to add her to the policy. The hospital actually billed some of the claims as "Baby Girl {our last name}" They didn't use her first name, they used "baby girl." I thought for sure those would be denied, but we had no problems getting our claims processed correctly; that's like a Christmas miracle!

[cricketwife]

Jul 18, 2014 11:15:23 GMT -5 rbp said:

I know that I need to add Baby Peppers to my health insurance within 31 days of his birth (I have confirmed this with my employer). But I can't do anything right now. How do I pay for his first pedi appointment? Won't they want insurance info or something?

Wait!  Did you have your baby?!!!!!!!!!!!!!!

[rbp]

Jul 18, 2014 12:46:51 GMT -5 cricketwife said:

Jul 18, 2014 11:15:23 GMT -5 rbp said:

I know that I need to add Baby Peppers to my health insurance within 31 days of his birth (I have confirmed this with my employer). But I can't do anything right now. How do I pay for his first pedi appointment? Won't they want insurance info or something?

Wait!  Did you have your baby?!!!!!!!!!!!!!!

No. Sorry, I wasn't trying to be coy or anything. Baby is still firmly inside, but my mind is racing through all the things that need to be done when he is born!

[ssmjlm]

I had to call within a certain time frame. I called the day after she was born (since I carry the insurance).

[cricketwife]

Jul 18, 2014 12:47:49 GMT -5 rbp said:

Jul 18, 2014 12:46:51 GMT -5 cricketwife said:

Wait!  Did you have your baby?!!!!!!!!!!!!!!

No. Sorry, I wasn't trying to be coy or anything. Baby is still firmly inside, but my mind is racing through all the things that need to be done when he is born!

Lol, I should have read the whole thread.  I was all like, wow, I went on vacation and rbp had her baby and I didn't even know!

But you're very wise to take care of everything that you can ahead of time and have a plan for the stuff that can't be done ahead.

[lg28]

I don't know how you guys deal with all thus stuff! Crazy.

Question - if the parents don't have health care, and the baby doesn't, what happens if the kid needs care? Is there some type of free care for kids?

[swimmette]

Jul 18, 2014 12:52:18 GMT -5 lg28 said:

I don't know how you guys deal with all thus stuff! Crazy.

Question - if the parents don't have health care, and the baby doesn't, what happens if the kid needs care? Is there some type of free care for kids?

Depends on your income.  Most hospital systems and their clinics will give "free" coverage if your income is under a certain percentage of the poverty level.  However, the hospital social worker would more than likely help apply for Medicaid in this case as the baby would be eligible.  If income is not low enough to be "free" then the financial department may work with the family for a reduced amount and/or payment plan.  This is not required of private practices, however. 

[shellbear09]

Yeah they just need your info. I will say though that I got a bill for dd's hospital stay because I guess she wasn't on the insurance yet when they billed it. I know I added her within a week. It wasn't a huge hassle but I had to call and have them reprocess it.

[shellbear09]

Jul 18, 2014 11:15:23 GMT -5 rbp said:

I know that I need to add Baby Peppers to my health insurance within 31 days of his birth (I have confirmed this with my employer). But I can't do anything right now. How do I pay for his first pedi appointment? Won't they want insurance info or something?

Oh and also well visits are free with my insurance so that might be the case for you.  The only time we pay is a sick visit.  

[starlily]

Check your plan. With mine (a HMO), anything related to L&D, like a NICU stay, was handled under my coverage. The kids were assigned a health record number, which was used for making appointments, but I had 30 days to add the kids & submit the necessary documentation, during which time I wasn't billed.

[lolo]

Jul 18, 2014 11:20:11 GMT -5 mandapanda18 said:

So, baby is covered under mom's health benefit for the first 60 days anyhow... give you a little wiggle room and time to get him/her on their own

This was true for us for 30 days. It is required by law in my state. Coverage is for baby mom's surname.