So I (30f) didn’t enroll my newborn in my health insurance believing he was covered for 30 days automatically. Turns out that applies only if I had added him for future coverage. I had him on his father’s plan, but it seems they didn’t add him until January 1st… now I’ve got a 67k bill! What should I do? I’m in Ohio.
So just to make sure, did dad not add the baby using the birth qualifying event? Did he only add the baby during the Open Enrollment period?
Val said:
So just to make sure, did dad not add the baby using the birth qualifying event? Did he only add the baby during the Open Enrollment period?
He told me he filled out something as a qualifying event.
@Bao
If he filled that out, the baby should have been added effective the date of birth. It seems they processed it for open enrollment instead. He needs to check with HR to find out what he completed.
@Fintan
Or he claims he filled something out when he really didn’t.
Val said:
So just to make sure, did dad not add the baby using the birth qualifying event? Did he only add the baby during the Open Enrollment period?
I don’t know; I’m trying to figure it out. The intention was to do the qualifying event, but he was born during enrollment, so I’m not sure if there was confusion.
@Bao
He should definitely work with HR, explain he was trying to use the Qualifying Event and Open Enrollment and got mixed up. Hopefully, they can help him work it out and communicate with the insurance company to get retroactive coverage to the birth date.
@Val
I’d start by saying, “I used the qualifying event to add my child and also used the enrollment period to make sure my child is covered for the new year.”… the problem might be in how HR processed the addition, rather than admitting confusion.
Chances are that the system is confusing, and the employee shouldn’t be left to deal with a bad system.
@Hollis
I was a group health insurance broker. This is common and can usually be backdated if the initial forms are available, even if the father made a mistake.
@Hollis
I’ve had the same issue where Open Enrollment happened right before a birth, so I couldn’t include the baby as part of my choices, then added them during the qualifying event and had to reach out to HR to say, ‘this should apply to my coverage during Open Enrollment.’
@Hadley
Yep, that makes total sense. My main point is the system should be more user-friendly and prompt users for answers.
@Hollis
I completely relate! I had to really push that I was using the qualifying event to add my child. HR managed to get it corrected.
@Hollis
^That’s crucial—always assume the mistake is on their end!
@Bao
I’ve had a similar situation—these November and December birthdays can be tricky! I made my selections during open enrollment, then added the baby as a qualifying event afterward, but didn’t realize I needed to redo open enrollment with the baby included. So he temporarily lost coverage on January 1st. I panicked, but my HR sorted it out in less than an hour!
You will need to get in touch with the hospital.
First, apply for charity care or financial assistance.
While doing this, clarify with your husband if he added the baby within the 30 days after birth, or if he waited until open enrollment. If he didn’t use the birth as a Qualifying Life Event, unfortunately, you both missed the mark.
Once you know whether dad added the baby during open enrollment or as a qualifying event, you’ll know how to proceed.
If he added the baby during open enrollment, you’ll need to fill out the charity care application and set up a payment plan. There’s likely nothing to be done about getting HR to cover the baby at birth. Researching state and federal laws around employer coverage for birth might be a long shot and may not help much.
If he added the baby as a qualifying event, he should contact HR ASAP to ask why they didn’t backdate coverage to the baby’s birth. They need to have a conversation about the hospital bill and what insurance claims are saying.
Usually, depending on your plan, you generally only have about 30 to 60 days to add a dependent after they are born. If that didn’t happen… well, that could be a problem.
Reach out to your HR and benefits coordinator. It’s hard to give meaningful advice without knowing specific dates and plan details.
Your next move should be to negotiate with the hospital. That bill of 67K for just the baby seems really high unless there were complications.
@Phoenix
This is crazy. I’m a nurse midwife. At our free-standing birth center, we charge less than $500 total for the care of a healthy newborn.
Lennox said:
@Phoenix
This is crazy. I’m a nurse midwife. At our free-standing birth center, we charge less than $500 total for the care of a healthy newborn.
Our bill was about $300k but that included minor surgery and some ICU nights. But honestly, they didn’t even have the good flavors of jello for my wife, lol.
@Sage
Haha, I love that you’re focused on this! I’m like 23k for one night in the hospital and just one kind of Italian ice? What a joke!
Lennox said:
@Phoenix
This is crazy. I’m a nurse midwife. At our free-standing birth center, we charge less than $500 total for the care of a healthy newborn.
Yeah, sounds really high for just the baby. My newborn’s bill sent to insurance was 20k, but we had multiple visits from the pediatrician because he was born with a birth defect.