Infants require more health care in the first year of life than they will, in most cases, for the next 18 years. Well-baby checkups and treatment for normal illnesses are vital, and for an infant born with any type of medical condition, weekly doctor’s visits are not out of the question. The only way most people can pay for this care is through health insurance.
It is very important to have health insurance for your baby as well as yourself. However, you have a limited amount of time to enroll your baby in your health care coverage program. Many companies have a 30-day limit in which you can add the baby to your policy. If you fail to meet this deadline, you may have to wait for the next open enrollment period, a yearly window in which you can make changes to your policy. However, if you act within the 30-day time limit, the insurance company must allow you to make changes to your policy immediately to add your infant.
If you do not have insurance or your coverage is too costly, here are some ways you can find affordable infant health care coverage.
1) Medicaid
Medicaid is a program designed to provide health care coverage to those with low incomes. Medicaid may be available for your child even if you do not qualify yourself. In order to find out if you, your child or other members of your family qualify for Medicaid coverage, visit your local Department of Health and Human Services. You will be asked to provide income verification and other information related to the income and assets of your household. If your child qualifies for Medicaid, you will receive most health services at no cost, including pediatric care, hospitalization coverage, and prescription medications.
2) State-Sponsored Healthcare Plans
Because the income limits for Medicaid are very low, it is difficult for working parents to qualify. Therefore, many states sponsor low-cost health care designed specifically for infants and children. Your state Department of Health and Human Services will have information on these programs, which allow you to qualify much more easily than federal programs. You can work and earn up to a certain salary and still get coverage for your children. Local health departments are also run by the state and can provide immunizations and basic health care at a very low cost.
3) Local Plans Sponsored by Private Organizations
Some cities or counties also sponsor child health-care plans for residents who need coverage for their children. Hospitals, for example, may reduce the cost of services under indigent care programs. Your doctor should have information on these programs.
4) Women, Infants and Children Program (WIC)
Women’s Health notes that this government program not only provides women and children with food and nutritional counseling but also access to healthcare services.
5) Private Health Insurance
Many women who work have health care coverage options through their employers. However, these options may be expensive. According to a report by the Kaiser Foundation, the following are averages for single and family coverage for employer-sponsored health plans:
- Average annual premiums in 2012 were $5,615 for single coverage and $15,745 for family coverage. This means that singles pay about $468 per month and families pay about $1,312 per month. Premium averages indicated a three percent increase for single coverage and a four percent increase for family coverage over 2011 prices.
- Average premiums for firms with less than 200 workers were lower than those for larger firms by about $700 per year.
6) The Affordable Care Act
The Affordable Care Act or ACA was passed in 2010 and is beginning to be phased in as of 2012. Under the ACA, women and children may have more protection and options when it comes to healthcare coverage. Highlights of the Act include:
- Pre-existing conditions are no longer a reason for denial of coverage. Prior to the ACA, insurance companies could not legally deny coverage to children with pre-existing conditions. As of 2014, this exemption is expanded so that women or anyone else with pre-existing conditions cannot be denied coverage because of the condition
- Parents can choose any doctor. You can choose your baby’s pediatrician in your health plan’s network without a referral
- Insurance companies must provide preventive care without co-payments. Well-baby visits must be covered if you joined a healthcare plan after March 23, 2010. However, your old plan may be grandfathered, meaning that they can continue to charge co-pays until they make significant changes to the plan or increase premiums by more than four percent
- Women cannot be charged more for health care premiums than men. In the past, gender could be considered a factor in determining premiums, and women sometimes paid 1.5 times what men paid for the same coverage. Now, insurance companies cannot legally charge women more for their coverage
- Children can be kept on their parents’ plans until age 26
- You cannot have your insurance capped because your child becomes ill. If your baby requires expensive procedures or care, you no longer have to be concerned that your health insurance will be cancelled.
With all the changes going on in healthcare, it pays to understand your rights and options when it comes to covering your child. While private insurance is expensive, you do have choices as to how your child receives coverage for health care.
