Having a baby? Read these important tips regarding your health insurance before you deliver your baby.
1. Coverage for your hospital stay. If your obstetrician is out-of-network, it’s your responsibility to pre-authorize your hospital stay before you check in. You can find the pre-authorization telephone number on your health insurance identification card, and you should call in the weeks prior to your expected delivery. If your obstetrician is in network, it’s his or her responsibility to make sure you’re pre-authorized.
2. Make sure to review the pre-admission packet that you’ll receive from the hospital or birthing center in the weeks before your expected delivery date. If necessary, contact your carrier to verify your coverage and benefits so you understand what your out-of-pocket expenses will be, if any.
3. Whether you’re utilizing an in-network or an out-of-network hospital or birthing facility, you should contact them prior to your
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anticipated delivery date and request an anesthesiologist (if necessary) that is in your network. The services of an-out-of network anesthesiologist could result in significant out-of-pocket expenses, and you can’t assume your anesthesiologist will be in your network, even if you’re at an in-network facility.
4. Enrolling your baby in your plan. Many group health insurance plans (coordinated through employer) require that you enroll your baby in your health plan within 30 days of birth. Don’t wait until “things calm down” – make this call when you get home from the hospital. If your health insurance doesn't have your baby enrolled, your baby's medical claims will be denied. It is also extremely important that you notify your employer group when your baby has arrived. Contact your employer’s Human Resource Department or your Benefits Administrator.
5. We recommend that you research and understand your plan’s coverage for your baby in the months before your expected delivery – knowing the details ahead of time will make the process easier once the baby has arrived. Consult the list of local pediatricians that are a part of the plan’s network so you can find a pediatrician that you like and trust. Check your plan to understand the types of services that your plan covers for babies and children. Does your plan cover immunizations? Well-baby visits? If yes, how many (not all insurance plans cover well-baby visits in the first 30 days)? How much are co-payments and what is your deductible?
Off Your Desk is a new service that manages all the health insurance paperwork for busy individuals and families. Our specialists leverage their experience working within the insurance industry to advocate for our members and ensure they get back all that they deserve from their carriers. Our experts fight for you until all the issues are resolved and you get back all the money you’re owed.
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Author : Diba Tillery RN, BSN, IBCLC, CPST