need some help - insurance for baby? when to inform ped that baby is coming?

I have some questions that I assumed my Dr's office would answer, but no luck there.

1) We're going to use the same pediatrics practice that my entire family uses. We know the Drs there for years and they've taken very good care of our family. When do I alert them that I'm popping out a kid? The ped usually meets the baby in the hospital within days after birth, right?

and

2) We're going to obtain baby's medical coverage through Child Health Plus. DH and I both have medical insurance through our own jobs (cheaper than family plan at JUST my job or JUST his), and adding a child is $400+ per MONTH. And then there are family deductibles to worry about too (over $1500).

With child health plus, there are no deductibles and no copays for the child.

Does anyone have any experience with the paperwork for Child Health Plus? When do I apply for it? Is this something I do BEFORE or AFTER the baby is born?



There are so many things I don't understand!!!

Thanks

Re: need some help - insurance for baby? when to inform ped that baby is coming?

I don't have any information on Child Help Plus. Sorry I can't help there.

But as for the pediatrician, as long as your pediatrician goes to the hospital you are delivering at (which I am pretty sure yours does) then they will see your little one at the hospital. Then they will tell you when to bring the baby into the doctor's office after you leave the hospital. As for alterting them, have DH call them once you deliver and they will try to schedule a time to come in an see the baby.

Re: need some help - insurance for baby? when to inform ped that baby is coming?

When I called the peds office when I was pg they said that the hospital SHOULD call when the baby is born...but that being said they also said to have DH call when he gets a min after the baby is born.

For child health plus you cannot submit the papers until after the baby is born. We had to put Kaydyn on DH's health ins for 30 days until we could get the paperwork for CHP to go through. B/c they said they could possibly not cover the hospital stay. We erred on the side of caution and just added her to his ins until we got CHP all set up (which ended up being a good idea b/c they lost our initial application, then gave us wrong instructions on sending in a new one and it took 3 months to finally get her on there). But since then it's been awesome to not pay any co-pays on anything. We don't qualify for reduced payments, but it still works out to a lot less then we'd pay for family ins.

Re: need some help - insurance for baby? when to inform ped that baby is coming?

Your DC will need to be added to one of your policies within 30 days of birth, otherwise the bills for the baby will not be paid for. Then you can cancel. CHP is not retroactive to birth, so it would begin the following month.

I went through this, I was told prior to giving birth that the baby was covered under my insurance for 30 days after being born. Everyone told me this, even hospital billing when I was having her. No one ever said the baby is only covered IF I'm adding that baby to my current policy. Needless to say, all the claims were denied, and I was almost stuck with thousands in bills. I appealed it, denied. Appealed again and ultimately won the appeal, since there was no specific language in my documents that specified she had to be added to be covered.

CHP is great insurance. I rec. using Americhoice United Healthcare though them, as you don't need a referral for anything. Empire is good too, but the referral thing is annoying.

Re: need some help - insurance for baby? when to inform ped that baby is coming?

If your pediatrician is not affiliated with the hospital in which you are delivering then they will not be able to see your baby at the hospital. Not to worry though, whatever staff pediatrician is on duty at the hospital while you are there will see your baby every day until you are released. Then you'll call the pediatricians office that you want to you take them to and make an appt. to go see them. You can make the appt as soon as they are born as well. Most peds will want to see you in their office soon after you are released and home. You might want to call the dr. office ahead of time though (before you deliver), whenever you get a chance, just to make sure they are taking new patients.

Re: need some help - insurance for baby? when to inform ped that baby is coming?

Nic-FM EmmaNick about CHP-I'm pretty sure thats what she uses and shes a smart cookie-she'll be able to tell you....Can't believe you are almost there!

I delivered early and did not even have a ped until the last day of NICU-it works out-the hospital is very on top of it and will handle contacting your ped for you.

Re: need some help - insurance for baby? when to inform ped that baby is coming?

1) As for the pediatrician, they will only visit the baby in the hospital if you deliver at one of the hospitals the Ped is associated with. For example, my Ped is in Plainview & I delivered at Stony Brook so our Ped didn't see the baby until we came home. He was seen by a staff Ped in the hospital. The hospital usually asks which Ped you've chosed & they are supposed to call after the birth. In my case, for some reason the hospital never called even though I was told they were going to

2) I sent you a FM about CHP!

Re: need some help - insurance for baby? when to inform ped that baby is coming?

Thanks everyone!

I called the 800# on the CHP site and was told that coverage starts right away as long as baby's hospital discharge papers with his full name and footprints are sent immediately. I specifically asked if I'd have to find other coverage for the first 30 days and was told "Absolutely not."

Now I'm wondering if the rep I spoke with wasn't accurate with her information!!

As far as the peds office, I called and s/w a receptionist. Made sure they accept the particular CHP carrier I was looking at (United - and they do accept it). She took my name and # and said the Dr himself would call me back because they have some questions for new mommies/babies. The practice IS associated with either of the 2 hospitals I'll deliver at, so that's not a problem at all.

Thanks for the help!

Re: need some help - insurance for baby? when to inform ped that baby is coming?

I would call and ask someone else because that's not accurate. It's not retroactive and will not pay for the birth of your baby, nor the nursery stay. Medicaid is retroactive if you qualify for that, and maybe that's what she thought you were talking about, as there is Child Health Plus through Medicaid. Once you complete your CHP paperwork, and if it's sent in prior to a specific date (I want to say the 20th), it becomes effective the 1st of following month.

The footprints thing is making me chuckle becuase that wasn't a requirement of neither of my children obtaining CHP

Message edited 6/1/2009 2:33:28 PM.

Re: need some help - insurance for baby? when to inform ped that baby is coming?

Posted by EmmaNick

I would call and ask someone else because that's not accurate. It's not retroactive and will not pay for the birth of your baby, nor the nursery stay. Medicaid is retroactive if you qualify for that, and maybe that's what she thought you were talking about, as there is Child Health Plus through Medicaid. Once you complete your CHP paperwork, and if it's sent in prior to a specific date (I want to say the 20th), it becomes effective the 1st of following month.

The footprints thing is making me chuckle becuase that wasn't a requirement of neither of my children obtaining CHP

Re: need some help - insurance for baby? when to inform ped that baby is coming?

Great topic as it made me question what I have as regards insurance for my new baby. I have empire and called to see what they say - they said the baby would be covered for the stay in the hospital if the baby was born without any complications and was basically in the hospital the same time as me - i.e no trips to the NICU etc.

I am going to call CHP to see what they say as I will be using CHP.

I will update with the version they give me once I get to make the call.

Thanks

Re: need some help - insurance for baby? when to inform ped that baby is coming?

Re: need some help - insurance for baby? when to inform ped that baby is coming?

No she said that they knew I was having a baby as they had to give authorisation to my hospital so they automatically covered the baby. Looks like i have more calls to make!

Re: need some help - insurance for baby? when to inform ped that baby is coming?

Okay so I called the CHP 1800 number and the coverage DOES NOT start straight away. They have to get the application by the 20th of the month and the policy goes into effect on the 1st day of the following month. So even if your child was born on the 19th of the month the chances are you are not going to have the paperwork into them by the following day so you would have to wait until the 1st of the second month for coverage ie.

I am due July 23rd - if I have the baby on the 23rd of July then I will have missed the deadline of July 20th in order to get insurance started by Aug 1st so the best I can hope for is to get coverage by September 1st. This means I will have no option other than to add baby to my personal policy which is going to cost $400 per month sucks but what can you do?

Re: need some help - insurance for baby? when to inform ped that baby is coming?

I'm going to call back later.

I'm due 8/12, so hopefully our coverage will kick in on 9/1.

Otherwise we owe the $400 monthly payment AND a $1500 deductible for the baby (through DH's coverage)! (on top of my 10% coinsurance for ME!)

Re: need some help - insurance for baby? when to inform ped that baby is coming?

Posted by Shorty



I'm going to call back later.

I'm due 8/12, so hopefully our coverage will kick in on 9/1.

Otherwise we owe the $400 monthly payment AND a $1500 deductible for the baby (through DH's coverage)! (on top of my 10% coinsurance for ME!)

Re: need some help - insurance for baby? when to inform ped that baby is coming?

Posted by beachgirl

Okay so I called the CHP 1800 number and the coverage DOES NOT start straight away. They have to get the application by the 20th of the month and the policy goes into effect on the 1st day of the following month. So even if your child was born on the 19th of the month the chances are you are not going to have the paperwork into them by the following day so you would have to wait until the 1st of the second month for coverage ie.

I am due July 23rd - if I have the baby on the 23rd of July then I will have missed the deadline of July 20th in order to get insurance started by Aug 1st so the best I can hope for is to get coverage by September 1st. This means I will have no option other than to add baby to my personal policy which is going to cost $400 per month sucks but what can you do?

Re: need some help - insurance for baby? when to inform ped that baby is coming?

More bad news - I called my insurer AND DH's insurer and NEITHER ONE offers coverage to a newborn unless the plan is converted to a family plan. Even if we DO convert DH's to a family plan (the cheaper plan), we can't get it back to a single plan to put baby no CHP unless there's a "life change". I asked (several times) if obtaining coverage through a different provider counted and was told NO.

I called the customer/social service # at the hospital and was told that if we can't get approved for Medicaid for the baby for those in-between weeks, we can apply for financial aid directly through the hospital and hope for good news.

I'm going to try and get ahold of someone at social services tomorrow and see if I can even apply for medicaid for an unborn child. Even if we CAN apply, I think our income is too high to be approved.

I'm getting a little overwhelmed

Message edited 6/1/2009 6:38:43 PM.

Re: need some help - insurance for baby? when to inform ped that baby is coming?

It will all work out.

The Medicaid limits are on the CHP website. I would contact your HR dept because you should be able to drop a dependent's coverage at any time. Many parents have done that on here and obtained CHP. They can't force you to keep insurance you can't afford to pay for.


ETA, you can't apply for Medicaid before a child is born. They need a birth certificate.

Message edited 6/1/2009 6:59:25 PM.

Re: need some help - insurance for baby? when to inform ped that baby is coming?

Posted by EmmaNick

It will all work out.

The Medicaid limits are on the CHP website. I would contact your HR dept because you should be able to drop a dependent's coverage at any time. Many parents have done that on here and obtained CHP. They can't force you to keep insurance you can't afford to pay for.


ETA, you can't apply for Medicaid before a child is born. They need a birth certificate.

Re: need some help - insurance for baby? when to inform ped that baby is coming?

I know it is late but can you try PCAP thru planned parenthood? It covers delivery, any possible NICU, and one year insurance for the infant

Re: need some help - insurance for baby? when to inform ped that baby is coming?

We met with our pediatrician once before the baby was born and then when we checked into the hospital they asked us for the name of our pediatrician. The hospital actually contacted the ped (because they were affiliated with the hospital) and the pediatrician came to see DS both days in the hospital. Then we went the day after we got home to the doctor's office.

Re: need some help - insurance for baby? when to inform ped that baby is coming?

I thought that there were qualifications for CHP, such as being below a certain income and NOT having insurance available thru either parent. I'm probably wrong because it seems like plenty of people here use it. I always thought it was just one of those programs for people who couldnt get insurance for their childrenn

Re: need some help - insurance for baby? when to inform ped that baby is coming?

I don't know about CHP. It was always our intention to have the baby on DH's insurance because it is much better than mine. However, they would not put the baby on DH's plan immediately because my birthday comes before his. We had to drop Abby from my plan and switch to his and afterwards, all of her bills were to be covered retroactively. However some of them are still in negotiation due to my insurance company's foul up. They did not drop Abby from the plan when my employer said they did. Now we are dealing with a logistical nightmare of red tape.

My point is just be be very careful and save each and every bill you get. Someone always screws up.

Re: need some help - insurance for baby? when to inform ped that baby is coming?

Child Health Plus Income Guidelines