Infant health insurance

Infant health insurance is a category of medical coverage that pays for healthcare costs specifically for children aged 0–12 months. The Affordable Care Act mandates insurers cover infants under their parents’ plan, which includes preventive services like well-baby visits and immunizations with no copay.

Medicaid and the Children’s Health Insurance Program (CHIP) provide infant health coverage to families with qualifying incomes–for instance, over 39% of US infants were covered by Medicaid or CHIP in 2021 according to the Census Bureau. Most private health insurance policies require newborn enrollment within 30–60 days after birth–UnitedHealthcare and Aetna both enforce this window, as filed by the Insurance Information Database.

Covered services typically include pediatrician checkups, hearing screenings, and vaccinations like the Hepatitis B shot given at birth per CDC guidelines. Insurers often exclude elective procedures such as circumcision from standard infant policies, requiring additional payment.

Premiums for infant coverage vary: in 2024, Healthcare.Gov reports the average unsubsidized monthly premium for a child under age one is $278. Newborns are automatically covered under their mother’s plan for at least 30 days after birth; Blue Cross Blue Shield confirms this practice.

Families must submit proof of birth, such as a hospital record or birth certificate, when enrolling an infant on most plans. Deductibles for infant care can range widely–Kaiser Foundation data shows employer-based plans averaged $2,004 in annual deductible costs in 2023.

Out-of-network care or specialist visits usually carry higher out-of-pocket costs: Cigna lists typical specialist copays between $30–$75 per visit for infants.