Birthday Rule for Newborn

[sangfroid]

Hi,

My baby was born in the month of May of 2014 and we put her under my wife's insurance in the month of June, 2014. There were bills of hospital and we submitted to my wife's insurance.


Now the insurance company is saying that, as my birthday comes earlier than that of my wife's and we both had insurance, the baby's insurance will be under mine for that time period.. No one told his and even insurance company didn't tell us.

Now, will I be able to submit those bills to my insurance company now ? Those bills are of previous year. And also which year's policy will apply , policy of 2014 or that of 2015 ?

 

[bluediamond]

Don't know what state or company you may be referring to, but I have never heard of that before, I thought either parent could add child to their policy upon birth, that's the way it's always been with the company I represent.

 

[unic.consulting]

I know that the general rule is that if the child has coverage through both parents, then the birthday rule comes into play. If she had coverage through you both, then you do need to submit the claims to your insurance first. They can't make you add the dependent to any specific plan as far as I'm aware though.

 

[kgmom219]

Hi,

My baby was born in the month of May of 2014 and we put her under my wife's insurance in the month of June, 2014. There were bills of hospital and we submitted to my wife's insurance.


Now the insurance company is saying that, as my birthday comes earlier than that of my wife's and we both had insurance, the baby's insurance will be under mine for that time period.. No one told his and even insurance company didn't tell us.

Now, will I be able to submit those bills to my insurance company now ? Those bills are of previous year. And also which year's policy will apply , policy of 2014 or that of 2015 ?

Take a deep breath. Its going to be OK.

1. Yes, you can file the claims. Sometimes there is a 12 month rule, but you should be OK. If they get rejected, go to HR. If that doesn't work, go to the state department of insurance. You are not responsible.
2. The claims will be filed with the 2014 carrier
3. Somewhere, in the fine print of your Summary Plan Description, is this information. They DID tell you. In a 500 page booklet, which is what they will fall back on.

I would start with the providers and ask them to re-file the claims with your 2014 policy. If they won't do it, then you will have do it manually.

Good Luck!

 

[kgmom219]

Its absolutely depends on the company, that's why it is mandatory to understand each and every feature before buying an insurance.

Since you are given so many options on an employer sponsered plan? The OP mentions company coverage for both him and his spouse

 

[taterpeeler]

Since you are given so many options on an employer sponsered plan? The OP mentions company coverage for both him and his spouse

Kgb... He's spaming to get to 20 post....probably from India or something

 

[FLM2]

Its absolutely depends on the company, that's why it is mandatory to understand each and every feature before buying an insurance.

He is really trying to get his 20 posts so he can spam about dental, isn't he?

 

[Northeast Agent]

Lawmakers float fix to health insurance 'birthday rule' | BenefitsPRO

The rule dictates that when a baby is born to parents with separate insurance plans, it's covered by the parent whose birthday comes first in the calendar year.