Seven Key Factors To Get California Baby Health Insurance

Baby Dreams
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Congratulations of the birth of your new baby!  Hopefully you and the baby are healthy and doing fine.  After the first week of getting adjusted to a new schedule of feedings and diaper changes, it’s time to begin planning what to do about baby health insurance for your newborn.  We’ll give you the key facts you need to be aware of, then look at what your options are and when you need to make decisions in order to keep the process simple and ensure your baby gets the right protection.

Four Key Facts About California Baby Health Insurance

  1. All of the delivery costs are covered under the mother’s health insurance plan, including any post-partum care for the mother or baby.  Any complications with the birthing process, or with the baby following birth will get the benefit of having the mothers plan deductible already being met.  So the cost of complications will be paid for by the maternity insurance company.  This is especially important if your baby was born prematurely and needs extra care.
  2. During the first 30 days of the baby’s life you can choose whether to put the baby on the health insurance plan of the mother or father.  The mother and father do not have to be married.  To put the baby onto a parent plan that is an individual health insurance plan, you can call the insurance company and simply request the change.  If the baby is being put onto a parent’s group health insurance plan, you should contact the employer’s HR department to get the necessary paperwork completed.
  3. During the first 30 days after birth the baby has a special enrollment period and is guaranteed to get coverage.  The insurance company must accept the baby into either parent’s plan regardless of the health of the baby.
  4. There are numerous pediatrician visits during the first 18 months of a baby’s life.  These office visits are called “Well Baby” visits, and are covered for free as preventive care.  Therefore, making sure to keep these scheduled visits is a great way to ensure your baby stays healthy.

Three Gotchas To Look Out For

There are a few surprises waiting that may come as a shock so you need to be prepared for these.  Unfortunately, two of the surprises are financial.

  1. Although the cost of any care the baby receives during the first 30 days is covered under the mother’s maternity insurance plan, the cost of the baby health insurance coverage is not.  Once you put the baby on a health insurance plan (either the mother or the father’s) you will have to pay for coverage during the first 30 days.  Many times this transition onto the baby’s own plan occurs such that you end up paying for both the first 30 days and the second month at the same time.  The shock is seeing that first California baby health insurance bill.
  2. A baby’s first year of life is the most costly insurance time of its life.  In some cases the baby’s cost of insurance can be two to three times the cost of the parent’s health insurance plan.  The reason for this is because of the risk an insurance company faces if the baby is premature or has any health problems.  The consolation to this is that in year two the child’s cost of health insurance can be cut by more than fifty percent.  In many cases the child’s cost of insurance will continue to drop for the first five to seven years, and then begin to slowly climb as the child gets older.
  3. Remember to switch the baby to a parent plan before the end of 30 days.  If you miss this window the baby may not be able to get health insurance coverage at the best rates.  In California children under the age of 19 are guaranteed to be able to get coverage, but if there are health issues the insurance cost can be increased.  If the child does not have continuous coverage for the 90 days prior to applying for health insurance, then an additional 20% cost penalty can be added to the plan during the first year

Check with your health broker or employer HR department ahead of time to prepare yourself for the cost of the baby health insurance, expect to pay for the first 30 days, and select a health plan for the baby within the first month.

How To Get The Best California Baby Health Insurance At The Right Price

The first step is to move the baby to a parent’s health insurance plan within the first 30 days.  The strategy for the plan selection is to choose the parent plan with the better benefits and cost.  Remember that the baby will start its own deductible after the first 30 days.

If one parent has a group health insurance plan, this may be the better option for the baby.  In many group plans, the cost to add a child to the plan is the same as the cost to add 2 children.  If you already have one child on a group plan with the parent, adding a second child might not add any cost.  You’ll need to check with your HR department to determine what the cost to add your baby will be.

If both parents have individual plans, then it’s a good option to choose the parent plan that offers more benefits.  That way the baby will get the best coverage if there are any health issues later on.  Sometimes it’s not obvious which plan is the better choice.  In those cases call us and we can help you weigh the benefits to determine which plan is the better option.

Once the baby is placed onto a parent health insurance plan, you should wait for about 90 days to get a better feel for your baby’s health care needs and then determine if a switch to another health plan makes sense.

 Find The Best Baby health insurance plans from all major insurance companies in California.

For healthy babies it may make sense to move to an insurance plan with less benefits or a higher deductible in order to reduce the high monthly premiums.  A great way to determine if this makes sense is to determine how many non Well Baby office visits the baby has had during the first three months.

If the baby has had none, then changing to a lower cost plan could make sense. See our baby and child health insurance plan recommendations page to determine which plans are best for your baby.  Making a change in health plans requires a complete application if the baby is also changing insurance companies at the same time.  For transfers within the same company, it might be possible to either request the change, or fill out a simple transfer form.  Call us to see what your insurance company needs.

If the baby has health conditions then it will be harder to make a change to a better plan.  This is the main reason why the initial plan choice during the 30 days after the baby is born is important.  Unhealthy babies will be required to stay on the initial plan choice until their first birthday.

Grinning Baby In PinkDuring the month of their birthday it will be possible to apply to move the baby to a plan with better benefits.  Each birthday, a child has a 30 day enrollment window in which they can switch plans without meeting underwriting requirements or having their premiums increased due to health conditions.  Review your baby’s expected health care needs and look for health plans that offer the best benefit versus cost for those needs.  Call us if you need any assistance with this.


Having a baby is a big change in lifestyle, and a big responsibility to stay on top of the baby’s health and health insurance.  The first 30 days of a baby’s life requires you to consider the baby’s needs and select the best health plan option for their care.  This is also a great time to set up the baby’s Well Baby doctor visits and get them on your schedule.

Where available, group health insurance may be the best option for your baby.  If both parents have individual health insurance, then you must be ready to pay for the baby to be covered during the first 30 days, even though the baby’s postpartum care is being covered by the mother’s health plan.

Most importantly, you have to decide which plan to put the baby on and notify the insurance company if it’s an individual plan, or notify the employer’s HR department if it’s a group health insurance plan.  This has to happen during the first 30 days, and should probably be done within the first couple weeks so you don’t forget.  Getting California baby health insurance should be a simple process as long as you follow the steps we’ve outlined above. Feel free to contact us if you would like any help with this process.

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