What New Parents Should Consider When Choosing a Health Plan
Welcoming a newborn into your family is an exciting time in your life. In addition to choosing a nursery color and buying all the necessary – and maybe some not so necessary, but really adorable – baby equipment, you will no doubt start thinking about the future with your little one as a part of your daily life.
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And a key part of this new journey is making sure your child is immune from illness immediately. Sure, deciphering health insurance plans isn’t as fun as, say, guessing what your child’s personality will be, but it’s an important step.
Here’s how to navigate your company’s health plans to find the right one for your growing family.
1. Evaluate coverage options for both parents.
Above all, it is important to take stock of your and your partner’s respective health plans, especially if you are both covered for work. “Pay close attention to the different levels of coverage available with your plans,” said Kim Bucky, vice president of customer service at DirectPath, an employee engagement and healthcare compliance company. For example, some plans only allow you to cover yourself and one dependent, child, or spouse; others may need coverage for the entire family.
In some cases, it can be helpful to have two separate policies. “If both parents have the same policy, then adding a child can sometimes turn the policy into a family policy at a much higher cost,” says insurance agent Greg Sanders, a father of three. He notes that, for example, the small company he works with offers an employee / child policy that costs almost $ 600 a month less than a family plan that also includes a spouse.
In such cases, it might be worth including your spouse in his or her own corporate plan, rather than putting everyone on the same policy. In addition, adding a spouse to your own plan can result in a spousal allowance, Bucky says, whereby your plan may charge an additional fee to cover a spouse who is offered coverage through another employer and has refused to use it.
Bottom line: be sure to read the fine print.
You can also check to see if your preferred pediatrician and a nearby hospital are covered by a particular company.
2. Look at the total cost of the plan, not just the monthly premium.
When weighing the pros and cons of a plan, be sure to add co-payments, deductibles, and any other medical fees you are likely to have with a particular plan. A low premium plan is ineffective if you can’t actually afford the associated cash costs, Bucky said.
While you may have heard that the Affordable Care Act requires coverage for certain check-ups, it is important to speak with your pediatrician, insurance company, and benefits expert in your office to get a complete picture of your situation.
And be sure to factor in any potential emergency room or emergency room visits, as well as lab tests and prescriptions, says Raffi Terzian, M.D., senior vice president of clinical operations and senior medical director for Health Advocate, a health and safety company. help. … “If available, a plan with a lower deductible and higher monthly premiums may be more cost effective for a family with a newborn or young children, but it’s worth taking the time to evaluate all the options available to determine which is best for you,” he adds.
Finally, when it comes to out-of-pocket expenses, you should consider if there is a pediatrician you want to use and the closest online hospital in case of an emergency.
3. Understand the paperwork you need to add your newborn to your plan.
“The birth or adoption of a child is a qualifying life event , meaning you have a certain amount of time to choose coverage for your child, even if it’s not enrollment season yet,” Bucky says. New parents usually have about 30 days after birth or adoption to register with an employer plan, or 60 days to register with an insurance company in the market. If you are eligible for premium assistance through your Medicaid health insurance program or for children, you have 60 days from the date you were eligible to apply to your employer’s plan. In these cases, insurance coverage is retroactive until the date of birth or adoption.
You, of course, may not know in advance when this life event will happen – after all, women rarely give birth on time. And since some plans require documentation for a period of time after the birth or adoption of a child, to retroactively cover the initial medical costs, it’s worth getting as much paperwork as possible in advance.
Your HR department or insurance company can provide registration or application forms in advance, Terzian said. “Since getting a birth certificate or social security number can take time, check to see if you can use a letter from the hospital or other birth records in the meantime.”
4. Consider including your dependents care company flexible costs in your plan.
If you know you will need child care, consider using the FSA to save on costs. “The FSA’s 2016 dependents service limit is $ 5,000 for individuals or couples applying together,” says John F. Nolle, CFP®, Financial Planner at Saranap Wealth Advisors, LLC and father of 18 month old … “For the $ 5,000 you spend, you are actually buying services for about $ 7,140 because you are not paying taxes, which is essentially like getting a 30% discount.”
Also think about timing: As Nolle points out, the FSA’s Dependent Care are “use it or lose it” plans. If you are having a baby later in a tax year, you may want to consider paying less than if you had a baby in January or February.
If you have a high deductible health plan, your employer may also offer a Health Savings Account (HSA) , an account that you can deposit up to $ 6,750 of your 2016/2017 pre-tax dollars if you have family. This money can be withdrawn without paying taxes if it goes towards medical expenses . While it includes various medical services, keep in mind that everyday expenses like childcare or diapers do not count as medical expenses, so it is important to know what is covered before deciding if HSA is right for you.
A Quick Guide for New Parents on Choosing Health Benefits | LearnVest