Newborn care

Your baby is covered under the mother’s plan for their first 31 days unless you request a change ahead of time. To continue coverage after this 31-day period, you’ll need to add your child as a dependent.

Giving birth or adopting a child allows you to get your child health insurance outside of open enrollment, known as a special enrollment period.

• If you gave birth to your child, their first 31 days of coverage begins on the day they were born.
• If you adopted your child, their first 31 days of coverage begins on their adoption date.
• In most cases, newborns are assigned to the mother’s plan medical group (PMG) for the first 31 days, unless changed by a parent (or discharge from the hospital, whichever is later).
  • Be sure to review your child’s PMG and choose a pediatrician in their PMG before their first appointment. Your child’s PMG may be different from their mother’s PMG for the first 31 days.
  • If your newborn is sick, they will be covered under the mother’s PMG until discharged from the hospital.
  • If your newborn is well, you may choose a new primary care physician (PCP) or plan medical group.

To continue coverage after the first 31 days, please complete an Enrollment Application. A birth or adoption certificate may be needed to confirm that your child is a dependent.

You may choose a different PCP or PMG following your child’s birth month by calling Customer Care. Simply select your network, medical group and any other preferences, then click “Search.”

If an unexpected change to your coverage, provider or network happens, you may have questions about how to continue care for you or your newborn. Learn how to keep your current health care provider and continue receiving health care services.

Wellness exams are covered. During your child’s exam, you’ll learn more about their immunization schedule, and measure their growth, nourishment and development.

Children typically receive wellness exams following this schedule:

• Directly after birth
• 1 week old
• 1 month old
• 2 months old
• 4 months old
• Every 3 months from age 6 months to 18 months old

Many preventive care services are available at no extra cost. Be sure to schedule preventive care appointments with an in-network provider and keep them separate from appointments for other care or treatment. Take this checklist to your newborn’s next appointment to discuss your options.

If you’ve felt overwhelmed or anxious after bringing your newborn home, you’re not alone. “Baby blues” and postpartum depression can affect any parent, whether they’ve given birth or adopted a child. Our behavioral health providers can offer extra support when you need it most. You can make an appointment without a referral from your PCP.

Most new parents are covered for a breast pump with no copay. No prescription is needed, but you should request one within the first year after delivery of your new baby.

Breast pumps are not covered before delivery. If you buy your breast pump from a non-contracted supplier, it won’t be covered.

Contact Customer Care for information about ordering your breast pump by email or by calling 1-800-359-2002 on weekdays, 8 am – 6 pm.