newborn/health insurance question

[sguitarist18]

I know the mother's insurance has to cover the baby for the first 48 hours, even if they don't add the baby to their health plan (in this case, I did, not sure if that helps or hurts); but does the care for the baby get charged under the mother's deductible and out-of-pocket maximums, or as another individual on the plan?

[larryilo]

Actually having very big issues with this.

This 48hour thing is not applicable to New Yorker per Oxford! That's number 1

[ExGingi]

I know the mother's insurance has to cover the baby for the first 48 hours, even if they don't add the baby to their health plan (in this case, I did, not sure if that helps or hurts); but does the care for the baby get charged under the mother's deductible and out-of-pocket maximums, or as another individual on the plan?

Are you talking group insurance (family or parent/children coverage) or individual policy through marketplace?

[ExGingi]

Actually having very big issues with this.

This 48hour thing is not applicable to New Yorker per Oxford! That's number 1

The Oxford brand is only used for small (2-50, or maybe 2-100) group health insurance in NY.

As such, in order to have the child covered, you must have either Employee+Children or Family coverage, and you need to update through your employer within 30 days.

If you need to discuss a specific issue you can PM me.

[sguitarist18]

Family plan.

[pixi]

I know the mother's insurance has to cover the baby for the first 48 hours, even if they don't add the baby to their health plan (in this case, I did, not sure if that helps or hurts); but does the care for the baby get charged under the mother's deductible and out-of-pocket maximums, or as another individual on the plan?

AFAIK the baby is covered under his/her mother's insurance policy for the first 30 days. My baby had to say in hospital for a few weeks after he was born, a year later I got a bill of  30k (yea..  30k) I called in and gave my wife insurance policy information (she has Oxford)  and since then I never heard from them.

[elit]

I know the mother's insurance has to cover the baby for the first 48 hours, even if they don't add the baby to their health plan (in this case, I did, not sure if that helps or hurts); but does the care for the baby get charged under the mother's deductible and out-of-pocket maximums, or as another individual on the plan?

IIRC you don't pay deductibles for the baby

Actually having very big issues with this.

This 48hour thing is not applicable to New Yorker per Oxford! That's number 1

Don't know specifically Oxford but my insurance gave me a hard time about not telling them (which is ridiculous bc how was i supposed to know that i have to) but eventually after enough back and forth between the state and insurance they covered it

[yoruel]

Is there charity program for copays?

[sguitarist18]

Probably depends on the hospital. The hospital I was in had a charity program for coinsurance, not deductibles, and not sure about copays. But even if those are the official rules, it can sometimes be worthwhile to apply anyway.

You can PM me for more details.

[VLK]

My wife is iyh due in the next few weeks
I was told that being that me and my wife are each still on our parents plans (Oxford) our baby cannot be added to the plan and we need to take out a policy speacial for the baby before my wife gives birth. Anyone have any experience with this?
Thanx in advance

[nescafe]

My wife is iyh due in the next few weeks
I was told that being that me and my wife are each still on our parents plans (Oxford) our baby cannot be added to the plan and we need to take out a policy speacial for the baby before my wife gives birth. Anyone have any experience with this?
Thanx in advance

depends which Insurance you plan on geting for your baby

[VLK]

Please explain

[MisterHock]

My wife is iyh due in the next few weeks
I was told that being that me and my wife are each still on our parents plans (Oxford) our baby cannot be added to the plan and we need to take out a policy speacial for the baby before my wife gives birth. Anyone have any experience with this?
Thanx in advance

Is medicaid an option for the baby? Once baby gets approved, they should backdate to date of birth.

[yr]

Is medicaid an option for the baby? Once baby gets approved, they should backdate to date of birth.

Or can mom get on medicaid as secondary? I think that if she can get on, then the baby will automatically be enrolled in Medicaid. Also note that I think it might be easier to get approved for Medicaid for pregnant women.

[mgarfin]

Medicaid is the way to go as @ExGingi has said Medicaid is the Rolls-Royce (in NY).

In a situation where the parents are on private insurance or even essential and child/baby is to go on child health plus you can have the babe uninsured anywhere between 3-6 weeks

[ushdadude]

Medicaid is the way to go as @ExGingi has said Medicaid is the Rolls-Royce (in NY).

In a situation where the parents are on private insurance or even essential and child/baby is to go on child health plus you can have the babe uninsured anywhere between 3-6 weeks

sad but true

[dsw193]

Or can mom get on medicaid as secondary? I think that if she can get on, then the baby will automatically be enrolled in Medicaid. Also note that I think it might be easier to get approved for Medicaid for pregnant women.

Wasn't automatic for us. Son ended staying in NICU over a month. Thank God for them backdating.

I believe you need to let them know that you're expecting from what I understood.

[ExGingi]

Medicaid is the way to go as @ExGingi has said Medicaid is the Rolls-Royce (in NY).

sad but true

Here's another factoid:

In NY Medicaid eligibility is based exclusively on MAGI. So one can be super wealthy, and even earn a lot of money, but if their MAGI is below the threshold for Medicaid, they qualify! Case in point, a client of mine recently called me (after the noise from Lakewood) to verify that everything is Kosher with him being on Medicaid. His W-2 income was below $25k (for a household of 6), on a schedule E he showed over $70k of cash coming in, but a most if not all of that was offset by depreciation, so he legally qualifies for Medicaid in NY, despite the fact that he is bringing in over $90k per year!

[yelped]

Here's another factoid:

In NY Medicaid eligibility is based exclusively on MAGI. So one can be super wealthy, and even earn a lot of money, but if their MAGI is below the threshold for Medicaid, they qualify! Case in point, a client of mine recently called me (after the noise from Lakewood) to verify that everything is Kosher with him being on Medicaid. His W-2 income was below $25k (for a household of 6), on a schedule E he showed over $70k of cash coming in, but a most if not all of that was offset by depreciation, so he legally qualifies for Medicaid in NY, despite the fact that he is bringing in over $90k per year!

Same in NJ. Thing is, in NY they're way more advanced. Everything is automatic. Here you have to explain to the Social Services office the rules...

[ExGingi]

Same in NJ. Thing is, in NY they're way more advanced. Everything is automatic. Here you have to explain to the Social Services office the rules...

In NY in most cases one would enroll through the exchange, and a determination is made based on income.

Problem is whenever there's a change of income mid-year, one could get messed up by the review department, and it's a big hassle to get them to straighten things out, as we recently experienced with a fellow DDFer. (BH managed to get everything straightened out - though even at that stage they made an error, but since it was minor, and in the consumer's favor, wasn't going to waste time having them correct it).