Blue Cross and BCN’s newborn coverage policy changes

Blue Cross Blue Shield of Michigan and Blue Care Network’s newborn coverage policy has changed, retroactive to Jan. 1, 2017, for insured business.

Here’s how the new policy works:

Subscribers are still required to add newborns within the time frames allowed in their contracts to obtain coverage for new dependents. However, Blue Cross and BCN have changed our newborn coverage policy so that even if a newborn is not added to the subscriber’s contract within the required time frames, we’ll cover both facility and professional inpatient claims for the newborn during the first 48 hours for a vaginal delivery and the first 96 hours for a cesarean delivery, as an extension of the mother’s maternity benefit.

This coverage only applies if the mother has Blue Cross or BCN coverage on the newborn’s date of birth as a subscriber, spouse or dependent.

Blue Cross and BCN won’t pay a newborn claim if it’s determined that the newborn had other coverage on the date of birth or if the subscriber contacts customer service to indicate they don’t want us to pay the claim.

You’ll want to encourage subscribers to add newborns within the time frames allowed under their contracts to obtain coverage for their newborns beyond the 48 or 96 hours.

This change is being applied retroactively to Jan. 1, 2017. As a result, some newborn claims have been reprocessed to pay for facility and professional inpatient services within the 48-hour and 96-hour thresholds where the mother had our coverage on the newborn’s date of birth and the newborn didn’t have other coverage.