Can an insurance company add newborn to the mother's policy and cover the baby for the first 30 days no matter what?

  • by Z3r0
  • Jun 23,2018
  • 8 answers

My wife's insurance added our newborn to her policy automatically and state he is covered no matter what for the first 30 days even though I added him to my policy, and we never added our newborn to hers. This is causing many problems because for those 30 days her insurance is considered the primary due to a birthday rule (whoever's first), and causing me to still pay for bills despite reaching the max out of pocket on the policy to which I actually added him to.


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Insurance Answers (8)

Insurance Pickle.com 2 months ago

If it's still in the first 30 days, then drop the baby off her plan. Not sure how they'd add the baby automatically unless it was Medicaid.

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lucy 3 months ago

https://www.insure.com/health-insurance/...
To add/delete someone to health insurance (outside) open enrollment, you need a “life event”, and (must be done w/in 30 days, which having a baby is a life event.
When you have 2 policies it gets confusing, since then they apply who is primary and who is secondary, which in this case is your wife’s by the birthday rule, but you are upset since it appears you have a lower deductible and (expected) that your policy would pick up the difference of what her policy pays, but does not work that way, since they have a coordination of benefits which you found out, that your policy did not pick up those amounts.
But you made a mistake, since both of you have health insurance at your employer, thus only (1) of you should have added the baby, thus not to have this problem and (chose) which was cheaper or paid more vs the other policy.
Now that your wife’s employer added your baby and paid those bills, then even though she did not add the baby, she did (not) reject it, thus the baby will be on (both) you and your wife’s employer health insurance policy, (plus) they will most likely (deduct) the premiums from your wife’s paycheck till the next open enrollment where she can delete off the baby to be on (only) your policy.
Or put another way, they don’t just pay the bills for 30 days and then say, (ok) you can drop the baby off the policy, since IRS forbids this.

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curtisports2 3 months ago

What's the problem? If hers is the primary, hers pays first. What it doesn't pay goes to the secondary, yours, to pay whatever it will cover. It's a paperwork issue, maybe, but it shouldn't be costing you MORE money than what you would ordinarily have to pay. Get the two insurance companies to coordinate on this.

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mbrcatz 3 months ago

Yes, they can. The providers should also be billing your insurance, as secondary, which should pick up 100% after that max out of pocket has been reached. So no penalty to you, for having two insurances.

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Pascal the Gambler 3 months ago

Can they? Sure. Why are you paying for bills when the baby is covered under wife's insurance? Makes no sense.

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Casey Y 3 months ago

So, your wife's plan is primary...submit your bills to them.

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babyboomer1001 3 months ago

Of course they can - they did and if they did not, they would not be doing your wife and your child a very good service.

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STEVEN F 3 months ago

I bet the terms of her policy REQUIRE they cover the child.

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