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Newborn Baby Health Insurance in Texas

During a baby's first year, it is recommended that she visit the pediatrician for a check-up seven times and receive numerous screenings and immunizations. These preventive measures along with sick care can cost a small fortune without health insurance. Residents of the state of Texas can find health insurance for newborns from numerous sources, some of which are free or low cost and all of which provide free preventive care.

  1. Public Assistance

    • If you cannot afford health insurance for your newborn baby, you may qualify for public health assistance through the TexCare Medicaid or Texas CHIP programs. Eligibility for both programs depends on financial need, though Medicaid also provides benefits to the medically needy. Texas determines its own qualification guidelines, but it accepts newborn children under age 1 with higher household incomes than older children and adults. While Medicaid only accepts children ages 1 to 19 from households with incomes of 100 to 133 percent of the federal poverty limit, newborns can use Medicaid with household incomes of up to 185 percent of the federal poverty limit. CHIP, on the other hand, enrolls children with household incomes of up to 200 percent of the federal poverty limit. Both Medicaid and CHIP offer comprehensive benefits at either free or reduced premiums. To find out if you qualify for Texas public assistance, use a phone to dial 2-1-1 at anytime of the day to speak to a representative.

    Enrollment

    • If you have a private health insurance policy that you either purchased individually or through an employer's group health plan, your insurance company likely offers an open enrollment period each year as an opportunity to add or delete dependents from your policy. However, the law requires insurers to allow you to make changes to your insurance policy following a qualifying event, such as a birth, adoption or divorce. You have 30 days to add a newborn child to your health insurance or else wait until open enrollment.

    Coverage

    • Laws in the Affordable Care Act, enacted in 2010, require health insurance policies to accept children under age 19 for coverage regardless of the health of your child. For example, if your newborn is born with a birth defect or other health condition, your insurer cannot refuse coverage to your dependent because of health. Additionally, the law mandates that health insurance companies pay 100 percent of the cost of preventive care for your newborn, including immunizations, well-baby check ups and hearing screenings without charging you a deductible, co-insurance or co-pay.

    Considerations

    • If your newborn is without health insurance for any reason, it doesn't mean you cannot provide the care your baby needs at an affordable price. The Vaccines for Children, or VFC program, is a federally run program that supplies uninsured children with free childhood immunizations from participating providers, such as health departments, schools, hospitals and pediatricians. To find a VFC provider contact the Texas Dept of Health's Immunization Division. Additionally, many Texas cities are home to low-cost health clinics that ask patients to pay only what they can afford, as well as health providers and public hospitals, that feature cash payment discounts for uninsured patients.

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