Having a baby? Congrats! It’s a…Silver PPO plan!

Did you know that having a baby qualifies you to buy health insurance off open enrollment? Even if you already have coverage, consider switching to a plan that fits your growing family. Doing so can help you afford your medical costs, avoid scary bills, and let you skip the government’s annual penalty for going uninsured (at least $325 or 2% of your household income in 2015, whichever is lower).

New Baby? Here’s what you need to know:

  • Trek Tip 1: You have 60 days to purchase. Having a baby is a “qualifying event,” which means you have 60 days after your child’s birth to purchase or switch insurance. This insurance will cover any of your child’s health needs during the first few critical years of their life when trips to the doctor are frequent.
  • Trek Tip 2: When you sign up for a new plan, make sure you have your child’s birth certificate or a letter from your medical center showing proof of birth. Many insurers require Qualifying Event Documentation to prove you really had a baby!
  • Trek tip 3: Adding someone to your plan makes your premiums (monthly payments) increase. It may be worthwhile to shop for a new policy for the whole family. Check your options so you can get the best deal.
  • Trek Tip 4: Cheaper isn’t always better. While health plans with low monthly payments may look like they save you more, they can leave you with big medical bills if you have a lot of health costs. If you anticipate many prescriptions and doctor visits in the next year, consider a plan with more expensive monthly payments (like a Gold tier plan). It can save you more by keeping the costs of doctor visits, medications, and treatments lower while offering more expansive access to different doctors and specialists.
  • Trek Tip 5: Pick a network with the doctors you want. Different plans provide different access to providers or doctors and hospitals. Ask your friends and family for pediatrician recommendations, then make sure one or two great doctors are included in your plan’s network. When talking with providers, use the word “contracted” not accept.
  • Trek Tip 6: Take advantage of your benefits. The Affordable Care Act mandated that all health insurance plans cover certain services. Some of the services that are especially useful to new parents include: – Breastfeeding support, supplies, and counseling: free! – Well-woman visits: free! – Prenatal and postpartum counseling: covered! Some limitations may apply.
  • Trek Tip 7: Consider your newborn’s special medical needs. If you know your child will require medical attention for a condition, focus on reducing the cost of specific treatments and doctors’ visits. If your child needs to see various specialists because of an illness they are born with, you might want to consider a “PPO” plan that allows more flexibility when visiting specialists and doctors, no refers needed or required.

Still confused?! Contact me…info@TrekInsuranceGroup.com

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