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When do you get health insurance for a newborn?

Dino Christoforakis
Dino Christoforakis

Editor in Chief & Licensed Insurance Agent.

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  • Newborns are automatically covered under their parent(s)’s insurance plan for the first 30 days
  • Children new to your family by birth or adoption are both eligible for retroactive coverage
  • The cost of pre-natal care and delivery for mothers and newborns can easily be of thousands of dollars even without complication.
  • Obtaining a social security number for your child is the first step toward obtaining dependent care coverage


The anticipation of a new addition to the family brings great joy and a long list of things to do. From buying clothing and furniture to making sure the baby’s room looks just right, the most important thing on the list is your child’s health. While all of the care received during a pregnancy is for the baby and keeping mom healthy, the medical costs for the baby after its birth are an often overlooked concern.

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Do I Have to Get Health Insurance for My Baby Before it is Born?


The topic of insurance can be a complicated and confusing conversation. The great news is you don’t have to worry about getting health insurance coverage for your baby before he or she is born.

With the Affordable Care Act (ACA or Obamacare), new parents—whether by birth or adoption—have 30 days to obtain coverage for their new baby. Expenses incurred within those 30 days will be covered retroactively.

This means that if your baby is born on the first of the month, you have until the 30th of that month to let your insurance company know your child’s name, date of birth, and social security number.

Insurance companies understand that your baby will undergo standard tests and immunizations before the 30th of the month. Those expenses incurred during your child’s first 30 days will be eligible for coverage as long as you enroll by day 30. So don’t worry about that first check-up and immunizations; you’ll have plenty of time to cover it.

What Medical Care Expenses Will I Need to Anticipate for My Newborn?

Your baby will undergo a wide variety of care and testing in its first hours of life to help to make sure they’re in perfect health and to detect any previously undiagnosed concerns.

  • Apgar Test — This immediate “check-up” will take a look at your baby’s skin coloration, breathing, heartbeat, and other characteristics to determine if there are any urgent health concerns.
  • Vitamin K shot — Babies are often low on Vitamin K – which helps with blood clotting, so they receive a boost to help them thrive.
  • Antibiotic eye drops or ointment – With all of the potential contaminants that babies are exposed to during birth, the eyes are a particular concern. Most babies will receive eye drops or ointment in order to minimize the potential for a medical issue.
  • Hearing Test — All newborns undergo a hearing test.
  • Immunizations — The Unites States has a list of required and recommendations for immunizations that babies should receive. The first shot is recommended within the first few weeks of your child’s life.

Babies will also go through various screenings for any conditions you could potentially pass on or that are if concern to the physician.

What is Covered According to the Affordable Care Act?


Care an expectant mother or her baby receives is considered essential health benefits. That means that health plans are required to cover the cost of care for both you and your newborn, with the exception of some grandfathered plans.

Even if you are pregnant before you obtain coverage, the ACA ensures that your pre and post-partum care will be covered. To this end, it is important to remember that you are entitled to a minimum hospital stay of 48 hours for both you and your baby. This timeline was determined and is protected by the Newborns’and Mothers’ Health Protection Act of 1996.

Additionally, as long as a child is enrolled within 30 days of birth or adoption, no limitations can be placed on care regardless of any condition with which your child may be born.

What are the Most Important Things to Review When I Shop for Coverage?

– Summary of Benefits

The most important thing for you to review while you compare plans is the summary of benefits. This document is available for every plan and will detail what is or is not covered. Included in the Summary of Benefits will be co-pays and what percentage of particular types of care will be covered. Additionally, the summary of benefits will detail any exclusions or limitations on the coverage.

– List of Participating Providers

If you already have a pediatrician selected, check the list of participating providers to ensure that your choice accepts your new plan. It’s a good idea to make sure that you have several participating providers in your area in the event that your physician exits the plan or you want to change offices.

– Co-pays and Premiums

Closely review the co-pays and premium amounts to make sure that your child’s healthcare will be sufficiently covered. With seven doctor visits recommended before age one, expenses add up quickly. There are a lot of immunizations and frequent infant wellness visits that first year, so you want to make sure that your plan fits your budget.

Take a Breath Before You Get Started


Your child will receive the care he or she needs. Give yourself some time to breathe and enjoy these precious first moments. Don’t rush into purchasing the easiest coverage; make sure to find what is right for you.

When you are in the hospital, take advantage of applying for a Social Security Number for your baby when you complete the forms for a birth certificate. Your nurses should be able to help you get all of the information and paperwork you need. Once you have the number, contact your chosen provider and give your child the gift of health insurance while giving yourself peace of mind.

Give your family the best start to its new chapter with the right healthcare plan. Enter your zip below to compare quotes from top carriers for free!

[su_spoiler title=”References:” icon=”caret-square” style=”fancy” open=”yes”]

  1. http://www.wsj.com/articles/SB10001424052702303325204579463670573697000
  2. http://www.hhs.gov/blog/2016/05/06/taking-care-of-your-health-and-your-babys.html#
  3. http://www.hhs.gov/opa/affordable-care-act/index.html
  4. https://www.dol.gov/agencies/ebsa/about-ebsa/our-activities/resource-center/publications/protections-for-newborns
  5. http://my.clevelandclinic.org/childrens-hospital/health-info/ages-stages/baby/hic-Newborn-Care-in-the-Hospital
  6. http://kidshealth.org/en/parents/first-day.html#
  7. http://www.womenshealth.gov/pregnancy/childbirth-beyond/baby-first-hours.html
  8. https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/ehb-2-20-2013.html
  9. http://www.cdc.gov/vaccines/parents/downloads/parent-ver-sch-0-6yrs.pdf
  10. http://www.marchofdimes.org/baby/routine-medical-care-for-children-from-1-month-to-2-years-old.aspx
  11. https://www.ssa.gov/pubs/EN-05-10023.pdf


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