New baby and health insurance

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New baby and health insurance

To an expectant couple, few experiences match the power and wonder of pregnancy and childbirth. As you prepare for your baby's arrival, you'll undoubtedly be thinking of his or her health care.
 
The first year of your baby's life will be full of visits to the pediatrician for weigh-ins, vaccinations and the occasional prescription, and you will feel better knowing that you have a comprehensive health care plan in place, ready to absorb the many healthcare costs to come.
 
Working With An Individual Plan
The good news is that it's usually not difficult to add your baby to the health plan you have at work or to your personal plan.
 
If you opt for an individual health insurance plan, you can work with a health insurance company, an agent or broker in person, or you can buy a plan from an online agent or broker. Depending on the online agent, buying insurance online can be fast, save you time and may allow you to check the status of your application electronically and review your policy. Whichever method you choose, make sure the company or agent you are dealing with is licensed to sell health insurance in your state.
 
Also, use a rating service like A.M. Best Company, Fitch Ratings, Moody's Investor Services, Standard and Poor's Insurance Rating Service, or Weiss Ratings to check a company's financial strength.
 
Choose a plan with the services you need - like well-baby care - at a price you can afford. Health plans usually charge additional premiums and out-of-pocket costs once you add your baby. Still, there are many kinds of plans to consider. For example, fee-for-service plans offer the freedom to choose from a wide array of doctors and hospitals, but are generally more expensive than managed care plans, which limit your choice of doctors, but generally provide regular checkups - for you and your baby - for a minimal or no co-payment. Compare health plans from different insurance companies, since levels of coverage and prices can vary dramatically. Go for policies that pay large medical costs, and avoid those that offer protection for only one disease.
 
Make sure you are comfortable with what your policy will and will not cover. Also, note that most policies offer a "free look" period of 10 to 30 days after purchase, which gives you time to change your mind. Remember that some policies impose waiting periods before they begin paying benefits.
 
What is HIPPA's role?
The U.S. government's Health Insurance Portability and Accountability Act of 1996, or HIPAA, a Federal law established to prevent employer-sponsored group health plans, insurance companies and HMOs from discriminating in the provision of healthcare benefits.
 
Among HIPAA's many requirements is one that prohibits group health plans from treating pregnancy as a pre-existing condition. Additionally, HIPAA prohibits group plans that already offer maternity coverage from refusing to cover prenatal care or childbirth. This applies whether you are the health insurance policyholder or a dependent spouse and despite your employment or health insurance history. Plus, health plans can't deny you coverage when you change jobs and switch from one employer-sponsored group health plan to another.
 
It is important to understand that HIPAA's protections apply mainly to group health plans. This means that if you replace an individual health plan with another, or switch from a group to an individual plan, you might sacrifice pregnancy coverage. You also might have to wait several weeks before the coverage kicks in.
 
SOURCES: "Life Changes Require Health Choices: Know Your Benefit Options," U.S. Department of Labor, Employee Benefits Security Administration, Washington, D.C., http://www.dol.gov/ebsa/publications/life_changes.html; Elaws, Health Benefits Advisor, "Questions and Answers: Recent Changes in Health Care Law," U.S. Department of Labor, Washington, D.C., http://www.dol.gov/ebsa/pdf/hippa.pdf; The U.S. Equal Employment Opportunity Commission, Pregnancy Discrimination, http://www.eeoc.gov/types/pregnancy.html; 360 Degrees of Financial Literacy, The American Institute of Certified Public Accountants, New York, N.Y., http://www.360financialliteracy.org/Life+Stages/Parenthood/Articles/Budgeting+Basics/And+baby+makes+three.htm
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