Insurance - for the kids, you know?

November 15, 2007 9:58 PM

New baby, er, dependent child! How to insure?

We just had our first baby. My husband and I have separate health insurance policies through our respective employers. How does insuring the child work? Do you pick one insurance policy, or should the child be listed on both policies? We both have PPO flavor health insurance, if that is relevant.

posted by Wavelet to work & money (6 comments total)

Do either employers cover family member at no extra cost? I had to pay extra to add my daughter - and so did my husband - so we picked the one with the best insurance and put her there. If both are free - put the child on both - there is likely somethings that might be covered one place and not the other - or often one will cover the portion of something that was not covered by the other. Congratulations on the new baby!
posted by Wolfie at 11:55 PM on November 15, 2007

Depending upon your policies there can be benefits to having the child on both policies. One will cover the main costs, the other will pick up the copays etc. However, find out which one will be the main policy and whether the second one applies to what is left after the first one or if it only pays what the first one would have. For instance. If it is the latter and both policies pay 80%, then the second policy won't pay the 20% copay as the 80% was already paid. Ask your benefit folks about this. It matters with babies as they tend to be large consumers of health care.
posted by caddis at 4:45 AM on November 16, 2007

All things being equal, I'd add the child to your plan. It likely will making processing the childbirth claims easier.

Often, employers will have a contribution scenario with single and family rates and no difference in the family rates regardless of the number of dependents. If this is the case with either of your employers, you can add both the child and the spouse and all be covered under the same plan. The hitch is that the child can be added right away, but the spouse needs to wait until open enrollment (a lot of companies have January 1st medical renewals and open enrollment is either now or coming up). If you all have wacky-timed open enrollments, this isn't as great an option as you also have the issue of canceling the spouse's coverage which needs to be done at open enrollment.

I could go on and on. Basically, it's a money calculation. If health insurance is free for you and your husband and any dependents, you should add everybody to both plans. (Incidentally, that's the major reason why employers want you to contribute to the cost of the health insurance.) If one is cheaper, go with that one.
posted by MarkAnd at 4:45 AM on November 16, 2007

And you probably want to talk to your benefits coordinator.

On my plan, babies are covered for 30 days on the mother's plan: however , I didn't realize that I needed to call the insurance company and let them know that there was a baby who needed to be covered! (Stupid, I know, but it just didn't occur to me.) So later on, when all her claims were being rejected, I had to to a bunch of calling. So be aware of this!
posted by leahwrenn at 6:57 AM on November 16, 2007

Also, if you can get money back from your employer for not using the insurance, you will want to check whether it's cheaper for one of you to buy the family insurance plan and the other be insured on that plan. For our family of 3, I think we pay about $150/month because my husband is insured under my name.
posted by leahwrenn at 6:58 AM on November 16, 2007

The vast majority of insurance carriers allow non-open-enrollment of dependents due to Qualifying Life Events (marriage, birth, divorce, lack of coverage). I agree with the posters above, check with both your and your spouse's benefits departments to see which plan would offer the best coverage at the best cost. Many carriers will allow you to add both your child *and* your spouse as the result of your QLE (birth of the child), but double-check with HR to be sure.

I am an insurance dork (10 years in the eligibility department of a major insurer, where questions like this came up all the time), but I am not YOUR insurance dork.
posted by spinturtle at 3:20 PM on November 16, 2007