My (M) insurance when it comes to baby with my Fiancée (F)

[levit7]

My boy beat me to the proposal by a surprisingly narrow window, but so it goes.

Here’s the short end of it:

1. She’ll be giving birth before we’re married,
2. My health insurance has better coverage for most things than hers
3. Our son will be filed under my insurance
4. (Potentially related) I have a decently large FSA ($2500 in case that’s useful to inform things) that ends ~2 months after our baby’s due date

My main questions for this revolve around:

What can I cover with my insurance vs her’s?​

I’m just using my FSA without worrying about it for the periodic appointments, and my FSA messed up bad, so I’m not too concerned about them covering XYZ so much as I am with the insurance

For example:

Suppose my insurance plan would cover a lactation consultant if I was a mother. Would it then cover a lactation consultant for my son, or is the technicality that it would be for the mother, and thus her insurance would need to handle it?

I just mean that as an example, the real meat of the question here is if you guys have any resources or tips on figuring out what parts of pregnancy, delivery, and post-birth care will my insurance cover (given that I am the father)?

Bonus question: Are there any tips on things you guys found you could buy through your FSA that you might not expect? (The stroller and car seat alone opens up more options, etc.)

 

[shellfish]

@levit7 A suggestion/question: is it at all possible to get legally married before the baby is born, so that you can move your fiancé to your insurance? I realize that isn’t the way either of you envisioned getting married, but you can just do a simple civil ceremony, and then have a wedding with family and friends (if that is what you’re planning) later.

Some good friends of mine did exactly that when their wedding got postponed due to covid. They now have 2 kids and are finally having their wedding this summer, after being married for almost 3 years.

 

[falafelraptor]

@shellfish I know no less than about 3 couples who did this. Married in secret quite literally just for the insurance, then had their big weddings like they originally planned. I don’t think they really told people that’s what they did either, they just use their big wedding date as their actual wedding date. It’s really sad that that’s what it comes to for some people, private health insurance sucks

 

[levit7]

@shellfish That’s a good point - it’s something I’ve kept in the back of my head, and if we were in a financial situation where that was really needed, I’d have no problem doing it

For this though, I don’t think it’s worth it

 

[mr_mcbride]

@levit7 My husband and I were on our own individual insurance plans during pregnancy. Mine was a bit more expensive but also had better coverage (so probably all equaled out to the same but oh well).

I gave birth in May and I stayed on my own insurance for the rest of the year while my baby was added to my husbands. This way all my postpartum care was almost all covered since I hit my deductible and most of my co insurance with pregnancy appointments and delivery bills.

This year we are all on my husbands family plan.

Edit: I hit save before finishing! If you aren’t too far along in your deductible I would switch to the better plan. Even if that meant getting legally married. Pregnancy and delivery and postpartum care is expensive.

 

[brendafox]

@levit7 If you add your baby to your plan, any services rendered for him will be billed to your insurance, and any services rendered to mom will be billed to her insurance. I’m not 100% sure on the lactation specialist but I imagine that would be billed under mom.

Depending on her insurance carrier and the hospital, they may start sending claims for baby to mom’s insurance so I’d recommend double checking the EOBs before you start paying your bills, since you may receive hospital bills before the claims are processed through insurance.

For FSA, I recommend checking fsastore.com to see eligible items for baby.

Lastly, if she’s thinking of pumping, have her check with her insurance or broker to see what pumps may be available under the durable medical equipment benefit.

 

[believing2015]

@levit7 I am not a tax expert or even an accountant. However my understanding is that you can only spend your FSA/HSA money on yourself or your legal dependents. Until the baby is born, I don't think he can be considered a dependent.

I would find it VERY weird if your insurance would cover your fiancée. Unless you have some specialized pre-natal procedure, all treatment will be to HER, not to the baby.

Have you considered getting legally married now and not telling anybody? Then you can have the ceremony/party later. That would be a "qualifying event" which would allow you to change your insurance and add her to your plan.

I would be happy to be told I'm wrong... it might actually come in useful this year for me too. For right now, I am just splitting costs with my partner by sending her payments from my checking account (post-taxes of course). It is a little less complicated for us because we are on the same insurance plan so coverage is the same (both work for same employer)