There is a lot to do when in the process of adopting, and usually ensuring your child is added to your insurance isn’t at the top of your list. It likely doesn’t make the top ten or even the top twenty. There are some very important things to consider and keep in mind now, so that you don’t have any surprises (like a giant hospital bill) down the road.
When a Birth Mother is on Medicaid…
Generally speaking, most birth mothers are covered by Medicaid, insurance coverage provided jointly by the federal and state governments. If she is not currently enrolled, it is vital to help her get enrolled so that her labor and delivery, along with any prenatal care is covered. She can typically ask at the doctor’s office or her county’s social services department. Each state operates differently when it comes to enrollment, but typically all pregnant women are eligible for “emergency Medicaid” because they are pregnant. Typically everything is covered and there is no co-pay, however her choice of prenatal doctors or hospital may be limited.
After the baby is born, it is vital that the child immediately be enrolled in Medicaid for coverage. The baby will need to be enrolled as a child of the birth mother. This is important to ensure medical coverage from the beginning. Usually it cannot happen right away because a birth certificate has to be issued, and then sent on to the state Medicaid office. (Remember, this birth certificate will show the birth mother as the child’s mother.) This should be done by your attorney, the hospital social worker, or the agency that is working on your adoption. Typically there is a 60 day time frame for retroactive coverage. This coverage is very important, and can save you thousands of dollars.
While preparing for your adoption, call your own insurance provider and find out when coverage begins with them for an adopted child. Also ask for the forms or documentation required. Different companies have different coverage and requirements, which is why the initial Medicaid coverage is so vital.
When a Birth Mother has Insurance Coverage
If your birth mother works, she may already have insurance coverage through her employer or privately. This will give her more options of care providers as well as hospitals for her delivery. There is, however, typically a co-pay. Most states will allow adoptive parents to pay for medical expenses that are needed for the birth of the baby. (Be sure to ask your attorney to be sure.) Most birth mothers also expect it, as they should. They are trusting you with their child, it is only right that you are able to cover the medical costs that are engaged in the birth of the baby.
After the baby is born, you typically have a 30 day period to request a “special enrollment” to enroll your new child. Depending on your plan and the laws of the state of your adoption, it may be 30 days from birth or placement. If your insurance doesn’t cover until after the birth mother has relinquished her rights, she will need to enroll the baby on to her insurance to cover the window before your coverage begins.
Again, it is vital to learn what your provider covers and requires prior to the baby being born, or even prior to a match. The more prepared you are with answers, the fewer questions you will encounter along the way.
Babies require quite a few pediatrician visits in those first weeks and months. Being prepared now with the knowledge of what you need to do will empower you to ensure you are getting the best care possible for your new baby, as well as spending as much time as you can bonding with that little one, because you won’t be chasing down insurance agents looking for answers.
