New babies are little bundles of joy – extremely expensive little bundles of joy. Health insurance is supposed to help with the cost. However, if it’s not purchased correctly or used correctly, it won’t work. This could leave new parents with unbelievable expenses. It can be difficult to find the best Nevada health insurance for newborns.
In this article, I’ll review the best way to purchase the best Nevada health insurance for newborns. Below I review how to analyze the different plan options. I also recommend a few that cover doctors in Northern Nevada, but this analysis can be done with any plan anywhere. Some common mistakes, and how to avoid them, are included at the end.
1. Purchase only health insurance plans certified by the Nevada Division of Insurance.
Here in Nevada, it’s called the Nevada Division of Insurance. Using this site you can see all Qualified Major Medical Plans.
Why is it important to buy a Qualified Major Medical plan? –
Many people have a bad opinion about health insurance because they purchased a cheap policy, (think the one with the duck). Those are not Qualified Major Medical insurance plans. With that type of policy, the carrier only reimburses you a small amount.
Qualified Major Medical plans COVER the expense. You still may be responsible for deductibles and copayments (more details further on) but otherwise, this is dramatically different than a small reimbursement.
Don’t just go to this site, sort by the cheapest plan, and buy it. That’s not a good strategy – read on.
2. Make sure your plan includes the 10 essential health benefits.
The 10 essential health benefits are required to be covered by all Qualified Major Medical Plans. If the plan is listed on the state insurance website, it includes these. You’ll notice pregnancy is specifically listed. Other related services that may have to do with pregnancy are also listed – lab services, hospitalization, ER services, prescriptions, ambulatory patient services (diagnostic imaging)…
Don’t fall into the trap of thinking all plans include these 10 essential services, they don’t.
3. Pick the right insurance company.
Out of the insurance companies listed on the state website, which one is the best Nevada health insurance for newborns? Is the cheapest one the best? Why do the plan names look like they’re all in some code?
Start small – first pick the insurance company. The first step is to find out if the doctor you need (or at least a good list of doctors) accepts the insurance.
If you dive into the details of each plan, you will be able to find the “Provider and Rx Links”.
Find the doctor you need on this list. Don’t fall into the trap “The doctor takes my Anthem plan through my work – This is Anthem too” No, your company plan through work reimburses the doctor a lot more. That means your doctor can say, yes, he accepts that Anthem plan but no, he doesn’t take this one. Check your doctor.
4. Evaluate which plan is the best for newborns.
Plans are not all treated the same. Even though all of them cover the 10 essential health benefits, it doesn’t mean they cover it for no cost to you. Bronze plans are the least expensive per month, but most expensive to see the doctor. Gold and Platinum plans are just the opposite.
Many plans have a side-by-side comparison they’ll show you through their website.
This can be an easy way to compare which plan is going to work for you. You can usually find this by going to the insurance company’s website and digging around. A health insurance broker can also send you this information for free. Brokers will also be able to provide quotes from multiple companies. This is not available by going directly to the insurance company’s website.
Usually, buying up to a more expensive plan is almost always worth it. Especially if you know you’ll be using it. If you’re buying health insurance to cover a new baby, you’ll likely be using it. Don’t think that only sick children use the health insurance plan. Even the healthiest children will still use medical services.
What do you look at when you’re comparing the best Nevada health insurance for newborns?
Each plan will include a Summary of Benefits and Coverage (SBC). It will show examples of costs for common medical services. One of these medical services is having a baby. These are standard. Every insurance company has to include one, and it has to be in this exact same format.
This can give you an idea of the cost of the service, but please keep in mind this only gives you a rough idea.
Common Mistakes & Suggestions from Insurance Companies
I’ve contacted 3 of the largest insurance companies in Northern Nevada and asked them tough questions about their health plans. The clients are frustrated. The health plan may not cover a medical service they’re expecting it to cover. I’ve asked each insurance company about these issues, and their responses are summarized below.
Q: If my client goes into labor she’ll need to immediately go into the hospital. She has no control over which doctor is working that day. How can she make sure the doctor takes the insurance plan?
A: It’s a good idea to check with the insurance plan ahead of time to find out which hospital is “in-network”. This means they accept your insurance plan. Occasionally there will be a doctor, such as an Anesthesiologist, who will not accept the insurance. If the member didn’t have a choice they should file an appeal. The insurance will make an exception to cover this doctor.
Q: What are the main issues new mothers and fathers have regarding health insurance for newborns?
A: Make sure the new baby is added to the insurance plan as a separate person within 31 days of their birthday. Newborns are covered under their parent’s insurance for the first 31 days. During this same 31 day period, the parents need to submit an enrollment form to add the new child to the insurance plan. If the parents miss this window, the child will be uninsured beginning on day 32. The next opportunity to add the child to the plan will be during the next annual Open Enrollment period.
Q: Some OB’s bill all prenatal and baby well-check visits at the time of birth. Is this typical?
A: Yes – This is something that’s specific to the provider’s office, but it’s common. It’s also known as a Global Bill. Not all providers utilize it in the same way. Typically the doctor’s office will pre-authorize the entire cost of the birth through the insurance plan. They’ll then divide that by the number of months left in the pregnancy. This allows the doctor to bill the patient incrementally. In theory, by the time the birthday comes around the patient will have paid for the pregnancy in full.