有读者问:「我正在考虑买 BCBS 的 PPO,newborn 的 NICU 是包括在妈妈的保险里吧?新生儿的前 30 天的保险是不是也都包括在妈妈的保险里?是不是生产的所有费用都可以算在 maximum out of pocket 里?」
根据 1996 年通过的《健康保险便利和责任法案》(Health Insurance Portability and Accountability Act)和《新生儿和母亲的健康保护法案》(The Newborns’ and Mothers’ Health Protection Act),孩子出生后 30 天内可加入父母的保险计划,生效日期追溯到出生之日,参见劳工部官网说明:
As long as you enroll your newborn within 30 days of birth, coverage should be effective as of your baby’s birth date, and your baby cannot be subject to a preexisting condition exclusion.
美国每个州的法律不同、各个保险公司的政策也不同,究竟「哪项服务找妈妈付账、哪项服务找新生儿付账」,甚至连从业人员也未必能搞清楚,有些公司干脆「接生后 30 天内所有账单一律找妈妈」,甚至有把新生小男孩割包皮的钱也算在妈妈的账户下。
不过,更常见的做法是把生产的费用算在妈妈账下,包括接生、麻醉、妈妈住院等,而孩子出生、成为另一个「人」)之后,他自己用到的服务,比如早产住 NICU 、或有先天疾病需要治疗,这些费用可能会记在新生儿自己的账户下 —— 因而也可能会影响 deductible 、 out of pocket 等的计算。
参考:
- Pregnancy Expenses: 4 Types of Bills & 4 Pieces of Advice
- This Dad Says His Baby Was Charged $3,500 For His Own Delivery—How Common is That?
- Will My Baby Get Billed for Birth?
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