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Covered California and Obamacare related questions from consumers, employers and agents are answered by Phil Daigle with the best information available at the time. Archived entries may no longer be accurate as the Covered California and Obamacare knowledge-base is evolving quickly. TO REQUEST A PERSONAL RESPONSE INCLUDE EMAIL ADDRESS.


Mother and Newborn Insurance

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Question: I’m 9.5 months pregnant and currently covered under my husband’s group insurance policy. It’s very expensive, but we obviously needed the maternity coverage, so we opted for adding me to his rather than me getting individual insurance. We’d planned on just adding the baby to our plan, but just found out that the cost of this with our current plan is prohibitive and we can’t downgrade the plan for another 9 months (during open enrollment). I have done some research and think the best bet is for him to drop me from his plan 1 month after the baby is born (so my postnatal visits are covered) and for me and the baby to get individual insurance (which is still substantially cheaper than the family plan through his work) as soon as she’s born. My question is about the timeline with the birth and insurance. Since we wouldn’t be adding the baby to our existing plan and instead starting a new plan (which it looks like I can’t do till she’s born and we have her birth certificate), will we have trouble getting coverage? I know we have 30 days to add her to our group plan, but if we’re opening up a new plan, how does that work? I know it can take up to a few months to get new coverage and obviously can’t go without coverage for my child. We’re in Florida and I have no health concerns (other than currently being pregnant!). I’m nervous since we don’t have much time to sort this out. Thanks for your help!

Answer: I’m guessing at 9.5 months pregnant you don’t have much patience for a long-winded answer so I’ll get right to the point. You can apply for individual health insurance - both you and the child together - about 2 weeks after the baby is born. You will need a copy of the initial physical exam for the baby. If the baby has no health issues, you should be able to get coverage starting within 30 days of the baby’s birth. Your group health insurance will cover the baby for the first 30 days after birth. If you have the energy, click here to start shopping for a health plan now - just enter a birth date of a month ago for your child.

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