Hellobee Boards

I think this really depends on your plan - I’ve had some insurance through work we’re irs basically paid ahead - so June payments are for July coverage. And also where it’s in real time so June payment is for June - I would direct hr to contact your insurance for a final answer

I think if she's born on Aug 15th you don't owe a premium for her until the next payment is due. So for my plan that would be Sept 1 because I don't think our plan does any prorating.

@math.nerd: it is the worst ours would also be reversed if we didn't sign baby up within 30 days, thankfully at least we're already on a family premium. I think that's pretty common but so crappy. I feel like we pretty much just pay premiums for disaster insurance or to get the negotiated rates . . . I am expecting to pay our full OOP max this year, the only thing insurance has paid is mandated stuff like immunizations. so I'm with you in being angry!!

@math.nerd: under Obama care the rule was newborns are covered under the mothers plan for the 1st 30 days of life. It is only on the 31st day that the baby needs their own insurance. I dont think that has been changed yet. This is a legal requirement

@math.nerd: oh I see... with my last two births we added thr baby closer to the 4th week after birth and didn't get any extra premium during that period. I always thought thr baby was covered under the mother's insurance premium. But maybe it depends on the state and type of insurance?

The word "covered" is the problem. Individuals and insurance companies don't use this word in the same way. To the insurance industry, "covered" doesn't mean paid for, it just means carrying health insurance.

For what it's worth, I was told I MUST enroll my baby in the first 30 days, or else any payments on her behalf would be reversed. My first payment post-enrollment was a larger one because it included a partial month premium for the month she was born.

Another word that makes people feel screwed is when medical offices say they "accept" your insurance. You assume it means they are in-network, but it only means they will send bills to your insurance; they could actually be out-of network! I've been screwed by this one before.

I think there is some confusion here. I'm not in the insurance industry, nor do I live in CA, but I do have an HMO plan in a different state.

To my knowledge, covered does not mean free coverage. It just means your coverage (within the terms of your plan/premiums) is extended to the baby on the mother's plan within 30 days of birth to allow time to get them added to the plan as an independent being. In my case, there was an additional premium charge taken from my paycheck to pay for that 30 days of coverage, the month after my children were born.

here are the actual numbers from my paystub:
August - pre-kid, individual premium $128
September - kid born, charged new individual + child premium ($246) + additional pro-rated premium for coverage of baby happening after birth, before added to policy ($118) for total charge that month of $364
October - charged new individual + child premium of $246

So long as your company has previously paid premiums surrounding a birth while using this insurance plan, I'd assume HR's answer is the more reliable one.

Anyway, it's mentally more comfortable to assume you're going to pay it (and potentially be pleasantly surprised), then the other way around.