If a married couple have separate insurance plans, do they get to decide under which plan a child is covered? I have heard that the child must be covered underneath the mother’s plan for thirty days before the couple can switch the child to the father’s plan, if they want. Is this true? Are the rules different in different states?
And does this differ for unmarried couples? I heard that the child cannot be put on the father’s policy unless the mother has no coverage of her own. Is this true?
I suspect it depends on what country and what state or province you are in. I think where I am the court pretty standardly orders the medical insurance to be payed by the non-custodial parent. I have never heard any of the rules you site, although i suppose it is possible.
Oh, yes, this would be in the U.S. Theoretically in Pennsylvania. And no court would be involved in either case.
Most health plans cover a new born under the mother’s ID number for the 1st 30 days. Then you have to add the child to to the plan for coverage beyond the 1st 30 days.
Regarding the unmarried couple aspect. The only documentation I ask for when an employee wants to add a baby to coverage (I’m a benefits admin) is a birth certificate. The health plans don’t seem to care whether the couple is actually married or not. At least it’s never come up in the 13 years I’ve been in benefits. And I’m talking about situations where an employee walks into my office and says “my “wife” just had a baby and I want to add him/her to my coverage”. To my knowledge you can’t just move in with someone and start adding their kids to your coverage without the benefit of marriage. Unless, perhaps, the company offers domestic partner benefits. Our company doesn’t offer domestic partner benefits, and I don’t know if companies that do offer domestic partner benefits allow coverage for the domestic partner’s children. I would think so, but I’ve never researched the issue.
In divorce situations, or situations where unmarried parents are separated, the plan of the parent with primary custody is the primary plan, and pays benefits first. Unless there is a Qualified Domestic Medical Child Support Order (QDMCSO). In that case the parent’s plan who is under the QDMCSO would be primary.
And I’ve never heard of a rule that would require the mother to not have coverage in order for the child to be added to the father’s coverage.
I’ve worked in benefits, too.
In the case of a married couple, with both people working, it’s fairly common for them to check out both employers plans, and choose to have the child covered under whichever plan costs the least, or provides the best coverage. In most cases, there are no restrictions preventing them from choosing whichever plan they prefer.
I live in Mass. and am not a benefits expert, but here, if parents are married and both have coverage, the birthdates of the parents and child form some sort of rule that determines which insurance is primray. I forget what the rule is, but there is one.
My son was covered by both our insurance plans when he was born.