NEWSROOM

A Doula is someone trained to provide extra support throughout pregnancy, labor, delivery and after childbirth. They can also share non-medical information about pregnancy and the birthing process such as:

• Health education
• Guidance
• How to prepare for childbirth

Doulas are also available after birth to help with:

• Emotional and physical recovery
• New baby care

Below are the responses by carrier to frequently asked questions about newborn and doula services.

 

Aetna

How do premiums work for a newborn, and when does coverage start?

The newborn will be covered starting from the birth date, and the group has 31 days to request this from Aetna.

Is there an additional cost associated with covering the newborn for the first 30 days?

Yes, there is a premium for the additional dependent coverage.

Do you have additional resources on how to add newborns to insurance after birth?

This should be done via the usual enrollment process that the group uses (may submit online or by submitting to the enrollment team directly via normal channels).

Do you offer Doula services?

No, Doula services are currently not covered.

Resources

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Anthem Blue Cross

How do premiums work for a newborn, and when does coverage start?

Newborns are eligible for coverage from their date of birth. The premium will be prorated based on the birth date. For example, if a baby is born on the 15th of the month, Anthem will only charge for 15 days of coverage at the prorated rate.

Is there an additional cost associated with covering the newborn for the first 30 days?

Yes, newborns are covered under the subscriber’s plan for the first 31 days. It could be the mother’s or father’s or both plan(s).

Do you have additional resources on how to add newborns to insurance after birth?

The Employee does not pay any additional premium during the first 31 days if the newborn is never added as a dependent.

Do you offer Doula services?

Yes, see below:

The child will be covered for the first 31 days from the date of birth. Coverage will continue beyond the 31 days, provided that the employee submits an Employee Enrollment Application to the group within 60 days from the date of birth to add the child to the plan. If the employee submits an Employee ENrollment Application to the group within 60 days from the date of birth, coverage for the child under the plan will be effective beginning on the date of birh.

Resources

Doulas are not covered providers therefore services provided by Doulas are not covered.
 

Blue Shield of California

Is there an additional cost associated with covering the newborn for the first 30 days?

If the baby is not added to coverage, the first 30 days of coverage is only for delivery and the initial checkup.. For the baby to have any other services covered, the baby would need to be added as a dependent within 30 days of the date of birth. Premiums for the new dependent would be prorated to the date of birth.

Do you have additional resources on how to add newborns to insurance after birth?

The employee would need to complete a change request form to retro-actively add the baby as of the date of birth.

Do you offer Doula services?

Yes.

Resources

Maven Virtual Support for New and Expecting Parents
 

CaliforniaChoice

How do premiums work for a newborn, and when does coverage start?

If a newborn's date of birth (DOB) is on or before the 15th of the month, dependent coverage will be retroactive to the 1st of that month, and a full month's premium will be billed. If the DOB is after the 15th of the month, coverage will begin on the 1st of the following month.

 

Cigna

How do premiums work for a newborn, and when does coverage start?

Cigna uses a wash method for billing. Coverage starts on the date of birth (DOB). If a person is born in the first 15 days of the month, they will be charged the full premium. If born in the second 15 days, they won’t be billed until the following month. There is no proration of the premium.

Is there an additional cost associated with covering the newborn for the first 30 days?

On Cigna's fully insured plans, babies are usually covered under their mother's insurance for the first 30 days. For Level Funded plans, babies are covered from their date of birth (DOB). Cigna will process claims for 30 days starting from the DOB. If the baby is not added to the policy within that time, those claims will be denied, assuming the baby is covered by the father's insurance. Clients can choose to cover babies under the mother for 30 days on Level Funded plans, and this choice does not affect the rate.

Do you have additional resources on how to add newborns to insurance after birth?

N/A

Do you offer Doula services?

These are not standardly covered unless fully insured and required by a state mandate.
 

E.D.I.S.

 

Is there an additional cost associated with covering the newborn for the first 30 days?

For the HRA/MERP services, E.D.I.S. follows their carrier partner’s guidelines for coverages and benefits.

Do you have additional resources on how to add newborns to insurance after birth?

EDHP Stop Loss plans, there is no additional cost for the first 30 days after birth, however, newborns need to be added to the member’s plan within the 30 days to have them covered. This can be done via application submission.

Do you offer Doula services?

Doula services are not available with the EDHP Stop Loss plans.

Resources

N/A

Health Net

How do premiums work for a newborn, and when does coverage start?

Health Net will enroll newborns as of the date of birth, and the 1st month will be prorated.

Is there an additional cost associated with covering the newborn for the first 30 days?

Yes, Health Net could prorate the premium for the newborn based on the date of birth.

Do you have additional resources on how to add newborns to insurance after birth?

Yes, the Employer Guide is a resource and provides information on eligibility, the process, etc. I’m attaching our latest copy.

Do you offer Doula services?

Yes, available to members at $0 cost.

Resources

Employer Guide

Doula Program Flyer (English)

Doula Program Flyer (Spanish)

Individual Doula program

Mahmee Virtual Doula with Wrap-around services via their digital app

Start Smart for Your Baby®
 

Kaiser Permanente

How do premiums work for a newborn, and when does coverage start?

Newborns are covered by their parents' medical insurance (usually the mother's) for the first 30 days after birth. When the enrollment is submitted, Kaiser Permanente will process the newborn's enrollment effective from the first day of the month following the date of birth. Some contracts may allow for enrollment on any day, but this will need to be reviewed according to the specific group contracts.

Is there an additional cost associated with covering the newborn for the first 30 days?

All plans cover hospital inpatient newborn care during the newborn eligibility period*. During this period, the newborn is covered under the parent/guardian plan. Coverage includes but is not limited to:

• Normal nursery care services
• Newborn services and screenings such as Phenylketonuria (PKU) and gonorrhea eye medication
• Neonatal Intensive Care Unit (NICU) or Intermediate Care Nursery (ICN) services. Care in the NICU and ICN are higher levels of care and not considered normal nursery care (HOSPACUT)

*A KP members newborn is not automatically enrolled. If a subscriber does not enroll their newborn under their KP plan during the special enrollment period, the newborn will only be covered under the parent/guardian plan for 31 days (including date of birth), or until the newborn is enrolled in other coverage, whichever happens first.

Do you have additional resources on how to add newborns to insurance after birth?

Some plans include a deductible, copay, or coinsurance for hospital inpatient newborn care. For those plans where a deductible is applicable, the member is responsible for 100% of charges until the deductible is satisfied. Once the deductible is satisfied, the applicable cost share applies. This information can be found in the EOC, excerpt…Cost Share for Services received by newborn children of a Member: During the 31 days of automatic coverage for newborn children described under “If you have a baby” under “Who Is Eligible” in the “Premiums, Eligibility, and Enrollment” section, the parent or guardian of the newborn must pay the Cost Share indicated in the “Cost Share Summary” section of this EOC for any Services that the newborn receives, whether or not the newborn is enrolled. When the “Cost Share Summary” indicates the Services are subject to the Plan Deductible, the Cost Share for those Services will be Charges if the newborn has not met the Plan Deductible.

Resources

N/A
 

MediExcel Health Plan

How do premiums work for a newborn, and when does coverage start?

A newborn is automatically covered under the mother’s MediExcel Health Plan for the first 30 days after birth. To continue coverage beyond that period, MediExcel must receive a completed enrollment form within 60 days of birth. Once enrolled, coverage is retroactive to the date of birth, and premiums are also charged from that date, regardless of when the enrollment paperwork is processed. This ensures uninterrupted coverage from day one.

Is there an additional cost associated with covering the newborn for the first 30 days?

Yes. Although the newborn is automatically covered during the first 30 days, once enrollment is finalized, premiums are billed retroactively from the date of birth. This means the cost for the initial 30 days will be included in your billing once the newborn is officially added to the plan.

Do you have additional resources on how to add newborns to insurance after birth?

Yes. MediExcel Health Plan has detailed guidelines within the Evidence of Coverage (EOC) for both Small Group and Large Group plans. These outline timelines, enrollment procedures, and rules for adding newborns or adopted children 

Do you offer Doula services?

MediExcel does not cover Doula services.
 

Prominence Health Plan

Is there an additional cost associated with covering the newborn for the first 30 days?

Newborns are covered upon notification to Prominence that the baby was born. Mother has 30 days to enroll the newborn at which time, any claims for the newborn will be processed as a dependent.

Do you have additional resources on how to add newborns to insurance after birth?

Premium is waived for the first 30 days.

In the event the mother doesn’t enroll the infant as a dependent within the first 30 days, any claims with dates of service after the initial 30-day period will be denied.

Do you offer Doula services?

No, Doulas are not covered under our fully insured policies.

Resources

N/A
 

Sutter Health Plus

How do premiums work for a newborn, and when does coverage start?

Coverage for a newborn starts at birth. However, you must enroll the newborn within the timeframe set by your Group and allowed by law or regulation. If you don't, the child will only be covered for 30 days, including the date of birth, under the coverage of the mother or father.

Is there an additional cost associated with covering the newborn for the first 30 days?

If a child's birthday is on or before the 15th of the month, Sutter will charge the Premium for the whole month.

Do you have additional resources on how to add newborns to insurance after birth?

The enrollment must be submitted through the Employer.

If a child's birthday is on or before the 15th of the month, Sutter will charge the Premium for the whole month.

Do you offer Doula services?

Yes, Doula Services Program 


Resources

N/A
 

UnitedHealthcare

How do premiums work for a newborn, and when does coverage start?

For newborns on PPO, the rate is prorated. However, for HMO, the newborn will incur a charge for the entire month. If the newborn is added within the first 30 days from the date of birth, there will be no premium charges. If the newborn is enrolled in ongoing coverage, premiums will be charged starting from the 1st of the month following the birthdate.

Is there an additional cost associated with covering the newborn for the first 30 days?

All newborn claims are processed under the mother’s eligibility for the first 31 days from birth due to the newborn not being enrolled in the group plan yet.

Specific to CA state guidelines: The state has a “birthday gift” for newborns who are enrolled. This means that there is no premium increase for the first 31 days of coverage for a newborn.

** Please Note** UnitedHealthcare policy allows a minimum of 60 days for the group to provide official notification of a newborn’s enrollment (also known as positive enrollment).

Do you have additional resources on how to add newborns to insurance after birth?

Enrollment is submitted the same way as any other dependent would be added, with the enrollment change form or online via employer eServices or UHC eServices.

**Newborns can be added without the SSN – it can be added at a later time once it’s received.

Do you offer Doula services?

Not covered as there is no information available.


Resources

N/A