Getting Health Insurance for Newborns
Having a baby is one of life’s biggest milestones—congratulations if you’re here because of a new addition to your family! As joyful as this time is, it also comes with important responsibilities. One of the most crucial is ensuring your newborn has health insurance coverage. Medical care for babies, especially in their first year, is vital for healthy development. From routine checkups to unexpected illnesses, having the right health insurance helps protect both your child’s health and your family’s finances.
In this guide, we’ll explain how newborn health insurance coverage works, how to add your baby to your plan, what it might cost, and what options are available. Whether you’re covered through your employer, the ACA Marketplace, or exploring public programs like CHIP, here’s everything you need to know to start your family off on the right foot.
Are Newborns Covered by Health Insurance?
Yes, but there’s a catch. Most insurance plans—employer-sponsored or ACA—automatically cover newborns for the first 14 days under the mother’s insurance. However, this is only temporary. To maintain coverage, you must add your newborn to your health plan within 30 days of birth.
Failing to do so could lead to retroactive denial of claims, even for services provided during the first two weeks. The 30-day period is a Special Enrollment Period (SEP), so take action quickly. This ensures your newborn continues receiving covered care without interruption or unexpected bills.
How Does Health Insurance Work for Newborns?
Once added to your plan, your baby’s insurance works just like yours. Your newborn will have access to the same network of doctors, hospitals, and prescription benefits included in your plan.
Preventive care—like well-baby visits and vaccinations—is usually 100% covered under ACA-compliant plans. Cost-sharing applies to other services, and your child will contribute to meeting your plan’s deductible and out-of-pocket maximum.
Since infants visit the doctor frequently in their first year, choosing a plan with the right cost balance is key to managing expenses and ensuring top-quality care.
How to Add a Newborn to Your Insurance
Having or adopting a child qualifies you for a Special Enrollment Period, giving you 30 days to add your baby to your insurance. If you have employer-sponsored coverage, notify your HR department right away. For Marketplace plans, update your account online or call your insurer.
You’ll need your baby’s birthdate and possibly a birth certificate. You can also switch plans during this SEP. A new family member often means new healthcare needs, so we recommend comparing other options. Health Plan Advocate is licensed with many of the top insurers in the nation. We have the options to bring the best fit for you.
How Much Does Newborn Health Insurance Cost?
Adding a newborn to your plan will typically increase your monthly premium. The exact amount depends on your state, household size, and the type of plan you have.
If you’re switching from individual to family coverage, expect to pay more. But you may also qualify for premium subsidies if you buy coverage through the Marketplace.
If affordability is a concern, consider programs like CHIP or Medicaid. And remember—plans with lower premiums often come with higher deductibles. If your baby needs frequent care, a higher-premium plan with lower out-of-pocket costs might be the smarter option.
When Should I Add My Newborn to My Insurance?
The answer is simple: as soon as possible. Although you have 30 days, waiting puts your baby at risk of lapses in coverage. Some parents choose to handle enrollment while still in the hospital.
If you wait too long, you could face delays in processing, denied claims, or even lose eligibility to enroll entirely. Hospital stays, early pediatric visits, and vaccinations can be costly without insurance. Mark your calendar and make this task a top priority once your baby arrives.
Is a Newborn Covered Under the Mother’s Health Insurance?
Yes, for the first 14 days after birth, most newborns are covered under the mother’s plan. This includes delivery-related care and the baby’s first exams.
However, after this grace period, you must add the baby to your insurance policy to maintain continuous coverage. If you fail to enroll your child in time, the insurer can deny claims retroactively, even those from the first two weeks.
To avoid surprise medical bills, formally enroll your baby in your plan as soon as possible.
What Is the Best Health Insurance for Newborns?
The best plan depends on your family’s medical needs and financial situation. If your baby is healthy and you want to keep monthly costs low, you can get away with low premiums. Lower premiums usually mean higher deductibles and costs for care.
If you frequent the doctor, having lower deductibles and cost-sharing often saves you money, despite usually meaning higher monthly premiums.
You can compare plans here for yourself, if you want to see what is available. However, if you’re unsure where to start, our team can help compare options and find the best plan for your baby and budget. Give us a call, it costs you nothing and if your in the best available coverage, we won’t change a thing.
Are There Newborn Health Insurance Plans?
Newborns can’t typically hold their own insurance policy. Instead, they must be added to a parent’s plan. But families needing affordable options should consider CHIP, the Children’s Health Insurance Program.
CHIP provides low-cost or free coverage for children up to age 19, depending on your income and state guidelines. Coverage includes doctor visits, dental, vision, and more.
If your income is very low, Medicaid may also be available for your newborn. These programs offer great support for families who may not have access to employer or Marketplace coverage.
Final Thoughts
Welcoming a new baby into your life is an exciting time—but it also comes with important steps to protect your child’s health. Make sure your newborn’s insurance is in place early, understand your options, and choose a plan that aligns with your family’s needs.
From private plans to public programs like CHIP, you have resources to help. If you’re unsure where to start or want personalized help, our licensed agents are here for you. Let us help you protect what matters most.
