Newborns begin acquiring health care expenses at birth. Aside from preventive and wellness care, they may need medications or treatment for illnesses. Accidents can also happen and lead to steep bills. Having health insurance for babies can help you save on out-of-pocket expenses.
During the first 30 days, a baby is covered under their mother’s policy and deductible. However, the extension of coverage ends on the 31st day. Fortunately, childbirth triggers a health care special enrollment period. If you want newborn baby health insurance, you need to update your plan within 60 days after childbirth.
Typically, a parent has 30 days to add their dependent to their health insurance plan. In some cases, a parent has up to 60 days to do so. After the special enrollment period, the baby won’t be covered by their parent’s insurance.
Adding a dependent to a policy increases the premium. The average additional cost for an existing marketplace health insurance plan is $276 per month.
Parents can opt to purchase health insurance for babies as an individual health plan. Another option is to enroll in the Children’s Health Insurance Program (CHIP), which provides coverage to children up to age 18.
Obtaining Newborn Health Insurance Coverage
There are a few ways babies can be covered. If the mom has an insurance plan, the newborn is covered upon delivery and up to 30 days after. In some cases, plans allow this coverage to extend up to 60 days. If the parents are married and are both insured, the newborn will have dual insurance.
From there, health insurance for babies depends on the family’s situation. There are various ways to get health insurance in the United States. The right option for you will depend on employment status, income and other factors.
If One Parent Has Health Insurance Coverage
If the parents are unmarried, the baby is typically included in their mom’s insurance plan for the first 30 days. The newborn can go on the dad’s policy if paternity has been established. That said, this depends on the type of health insurance plan the father has. There may also be different regulations depending on the state.
For married couples, the baby can have dual insurance if both are insured. Otherwise, the baby can go to the parent who has coverage.
Rules on paternity and newborn health insurance may vary per state. In some states, the father has no legal rights if paternity is not established. In that case, the baby can’t be covered by the father’s insurance.
Establishing paternity can be as simple as naming the father on the baby’s birth certificate. In some cases, the father may need to sign a voluntary acknowledgment or declaration of paternity.
If Both Parents Have Health Insurance Coverage
If both parents have health insurance policies, the baby may be eligible for dual insurance. But that still depends on the situation.
Either insurance policy could cover the baby if the parents are unmarried. However, covering them on the father’s insurance may be harder.
The baby could have primary and secondary insurance coverage if the parents are married. The birthday rule may be used to determine which policy is the primary and which is secondary. The coverage is based on which parent’s birthday comes first.
If the child’s parents are divorced, the party responsible for the baby’s health insurance is pre-determined by the court through a Qualified Medical Child Support Order (QMCSO).
Whether you’re expecting or the parent of a newborn, it’s smart to learn about the standing birthday rule. This provision helps determine how health insurance benefits will work if both parents have coverage. Many parents are taken by surprise by this rule.
Currently, a newborn can have dual insurance if both parents have policies. The birthday rule will be used to determine which policy offers primary coverage and which one is secondary.
The primary coverage will come from the insurance plan of the parent whose birthday comes first in the calendar year. If the health care plans have significantly different coverage options, the parents may face unexpected expenses.
This rule may change in 2023 because of the Empowering Parents' Healthcare Choices Act. Under this act, parents with separate health insurance policies will have 60 days to decide which policy will provide primary coverage for their newborn.
If Neither Parent Has Health Insurance Coverage
In some cases, neither parent of a newborn has health insurance coverage. This isn’t an ideal scenario. Childbirth through uncomplicated vaginal delivery can cost $10,000–$15,000. Expenses can be higher for C-section deliveries and those with complications.
If you are expecting and uninsured, you may be able to find low-cost insurance. For instance, you can determine if your income makes you qualified for Medicaid services. The requirements vary per state.
If you’re not eligible for Medicaid, check the Children’s Health Insurance Program (CHIP). Depending on the state, eligibility requirements and coverages vary. In some states, CHIP also covers the child’s mother.
If you currently don’t work, you can also look for health insurance for the unemployed.
The Best Ways to Get Health Insurance for Babies
There are various ways to get health insurance for babies. Parents can add them as dependents to their existing health care plans. You may also find a separate policy for your baby.
Below are some plan types that cater to newborn health insurance coverage. Research these options and compare them to find the most suitable plan based on your needs and circumstances.
Best Places to Get Insurance for Babies
Check your company’s rules regarding adding a newborn as a dependent. In most cases, employer insurance plans automatically cover a newborn for a certain period after birth. This is usually within 30 days, but some plans may offer extra time for enrollment.
If you’re uninsured, you can look for individual health insurance for babies in the marketplace. There are also insurance providers offering child-only plans. However, these may cost more. Compare multiple quotes to find the best coverage at a fair price.
Medicaid services cater to low-income individuals, including children and pregnant women. Depending on the situation, Medicaid may pay for the entire cost or a small portion of the total cost of health care needs. Eligibility requirements and program rules vary per state.
If you need help but aren’t eligible for Medicaid, you can apply for your child to receive CHIP. In some states, low-income pregnant women may also qualify. CHIP provides coverage to an eligible child up to the age of 18. Qualified pregnant women may get coverage for prenatal checkups and care.
It’s possible to get insurance exclusively for a baby. There are two ways to do this. You can buy an individual plan through the marketplace or directly from an insurance provider. Another option is for you to enroll your child in CHIP. If you plan to do the latter, make sure you check the eligibility requirements in your state.
The best health insurance plan for newborns depends on preferences. For instance, the best coverage, rates and customer service may vary per person. That’s because needs and circumstances also differ.
How Much Is Health Insurance for a Baby?
Health care costs can be steep. Costs naturally increase with every child added. Prices can also vary widely depending on the source of insurance.
On average, a parent can expect a $276 increase in a marketplace plan when they add a baby or child to their policy. The table below shows how costs may change along with the number of children.
Note that these costs are estimations based on national marketplace averages for a 40-year-old couple. Ultimately, health insurance costs vary by state and personal circumstances.
Average Monthly Health Insurance Cost by Family Size
Average Monthly Premium
Couple With No Children
Couple With One Child
Couple With Two Children
Couple With Three Children
Parents can find lower-cost health insurance options for their newborns through various programs.
Medicaid typically has $0 deductibles and premiums. To qualify, you must meet the income limits set by the state based on poverty guidelines.
CHIP caters to children whose parents have low incomes, but it has higher income limits than Medicaid. Qualifications may vary by state.
Based on national averages, Medicaid and CHIP income percentages are 195% and 217%, respectively.
Depending on your financial situation, you may also be eligible for premium tax credits. This is capped at 400% of the federal poverty level. The requirement has been suspended for 2022.
Preparing to Add Newborn Health Insurance Coverage
Preparing for newborn baby health insurance coverage can be challenging and overwhelming. But knowing what to do and expect beforehand can help you make better decisions. Here are some simple tips to help you get started.
The first thing you will want to do is create a plan. Start comparing health care plans during pregnancy. Weigh your options. Discuss how the coordination of benefits works.
If you and your partner are both insured, figure out which is the more beneficial policy for a newborn. If possible, notify your insurer before the birth of the baby.
Submit enrollment paperwork for a new dependent
Decide how you want to insure your baby. You can add them to your policy or your spouse’s. You may also get new insurance during the qualifying enrollment period.
Inform the health insurance company before birth, if possible. Most insurers require you to add a newborn to your existing policy within 30 days after birth.
Send in your newborn's paperwork
Insurance companies may require you to submit documents to verify some information. These may include the infant’s Social Security number and birth certificate. Some insurers may also ask for the hospital where the baby was born or a copy of the hospital records.
There are different ways to get a baby covered. One good option is based on the parent’s employment and income. Preparing early can give you time to compare your options and find the right plan for your baby.
Frequently Asked Questions About Newborn Baby Health Insurance
Understanding how newborn health insurance works can help you find the right plan for your baby. To help you get started, here are some frequently asked questions parents have about health insurance.
About Mark Fitzpatrick
- U.S. Department of Health & Human Services, Office of Child Support Enforcement. "Department of Labor Booklet on Qualified Medical Child Support Orders." Accessed June 22, 2022.
- Congress.gov. "H.R.4636 - Empowering Parents’ Healthcare Choices Act of 2021." Accessed June 22, 2022.
- U.S. Department of Health & Human Services, Office of the Assistant Secretary for Planning and Evaluation. "Poverty Guidelines." Accessed June 22, 2022.
- Kaiser Family Foundation. "Medicaid and CHIP Income Eligibility Limits for Children as a Percent of the Federal Poverty Level." Accessed June 22, 2022.