Coverage for a Newborn Child. All health coverage applicable for children under this contract will be provided for a newborn child of a member or to a member’s covered family member from the moment of birth if the newborn is enrolled timely as specified in the Special Enrollment provision. The coverage, benefits or services for newborns shall consist of coverage for injury or sickness, including the necessary care or treatment of medically diagnosed congenital defects, birth abnormalities or pre- maturity and up to $1,000 transportation costs of the newborn to and from the nearest appropriate facility staffed and equipped to treat the newborn’s condition when such transportation is certified by the treating provider as necessary to protect the health and safety of the newborn child. Additional premium will be required to continue coverage beyond the 31st day after the date of birth of the child. The required premium will be calculated from the child's date of birth. If notice of the newborn is given to us by the Marketplace within the 31 days from birth, an additional premium for coverage of the newborn child will be charged for 31 days from the birth of the child. If notice is not given with the 31 days from birth, we will charge an additional premium from the date of birth. If notice is given by the Marketplace within 60 days of the birth of the child, the contract may not deny coverage of the child due to failure to notify us of the birth of the child or to pre-enroll the child Coverage for An Adopted Child Coverage for children under this contract will be provided for the adopted child of a member who has family coverage in force. Coverage is provided to a child the member proposes to adopt who is placed in the member’s residence in compliance with chapter 63, from the moment of placement. A newborn infant who is adopted by the member is covered from the moment of birth if a written agreement to adopt such child has been entered into prior to the birth of the child, whether or not such agreement is enforceable. However, coverage will not be provided in the event the child is not ultimately placed in the member’s residence in compliance with chapter 63, Florida Statutes. The member’s adopted child is covered from the moment of placement in the residence, or if a newborn, from the moment of birth, if the child is enrolled timely as specified in the Special Enrollment Period provision. Additional premium will be required to continue coverage beyond the 31st day following placement of the child and where the issuer is notified by the Marketplace. The required premium will be calculated from the date of placement for adoption. Coverage of the child will terminate on the 31st day following placement, unless we have received both: (A) Notification of the addition of the child from the Marketplace within 60 days of the birth or placement and (B) any additional premium required for the addition of the child within 90 days of the date of placement
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Samples: ambetter.sunshinehealth.com, ambetter.sunshinehealth.com
Coverage for a Newborn Child. All health coverage applicable for children under this contract will be provided for a newborn child of a member or to a member’s covered family member from the moment of birth if the newborn is enrolled timely as specified in the Special Enrollment provision. The coverage, benefits or services for newborns shall consist of coverage for injury or sickness, including the necessary care or treatment of medically diagnosed congenital defects, birth abnormalities or pre- maturity and up to $1,000 transportation costs of the newborn to and from the nearest appropriate facility staffed and equipped to treat the newborn’s condition when such transportation is certified by the treating provider as necessary to protect the health and safety of the newborn child. Additional premium will be required to continue coverage beyond the 31st day after the date of birth of the child. The required premium will be calculated from the child's date of birth. If notice of the newborn is given to us by the Marketplace within the 31 days from birth, an additional premium for coverage of the newborn child will be charged for 31 days from the birth of the child. If notice is not given with the 31 days from birth, we will charge an additional premium from the date of birth. If notice is given by the Marketplace to us within 60 days of the birth of the child, the contract may not deny coverage of the child due to failure to notify us of the birth of the child or to pre-enroll the child Coverage for An Adopted Child Coverage for children under this contract will be provided for the adopted child of a member who has family coverage in force. Coverage is provided to a child the member proposes to adopt who is placed in the member’s residence in compliance with chapter 63, from the moment of placement. A newborn infant who is adopted by the member is covered from the moment of birth if a written agreement to adopt such child has been entered into prior to the birth of the child, whether or not such agreement is enforceable. However, coverage will not be provided in the event the child is not ultimately placed in the member’s residence in compliance with chapter 63, Florida Statutes. The member’s adopted child is covered from the moment of placement in the residence, or if a newborn, from the moment of birth, if the child is enrolled timely as specified in the Special Enrollment Period provision. Additional premium will be required to continue coverage beyond the 31st day following placement of the child and where the issuer is notified by the Marketplacechild. The required premium will be calculated from the date of placement for adoption. Coverage of the child will terminate on the 31st day following placement, unless we have received both: (A) Notification of the addition of the child from the Marketplace you within 60 days of the birth or placement and (B) any additional premium required for the addition of the child within 90 days of the date of placement
Appears in 1 contract
Samples: ambetter.sunshinehealth.com
Coverage for a Newborn Child. All health coverage applicable for children under this contract An eligible child born to you or your covered family member(s) will be provided for a newborn child of a member or to a member’s covered family member from the moment time of birth if the newborn is enrolled timely as specified in the Special Enrollment provision. The coverage, benefits or services for newborns shall consist of coverage for injury or sickness, including the necessary care or treatment of medically diagnosed congenital defects, birth abnormalities or pre- maturity and up to $1,000 transportation costs of the newborn to and from the nearest appropriate facility staffed and equipped to treat the newborn’s condition when such transportation is certified by the treating provider as necessary to protect the health and safety of the newborn child. Additional premium will be required to continue coverage beyond the 31st day after the date of birth of the childbirth. The required premium will be calculated from the child's date of birth. If notice of the newborn is given to us by the Health Insurance Marketplace within the 31 days from birth, an additional premium for coverage of the newborn child will be charged for not less than 31 days from after the birth of the child. If notice is not given with the 31 days from birth, we will charge an additional premium from the date of birth. If notice is given by the Health Insurance Marketplace within 60 days of the birth of the child, the contract may not deny coverage of the child due to failure to notify us of the birth of the child or to pre-enroll the child Coverage for An an Adopted Child Coverage for children under this contract will be provided for the adopted child of a member who has family coverage in force. Coverage is provided from the moment of placement to a child the member proposes to adopt who is placed in the member’s residence in compliance with chapter Chapter 63, from the moment of placementFlorida Statutes. A newborn infant who is adopted by the member is covered from the moment of birth if a written agreement to adopt such child has been entered into prior to the birth of the child, whether or not such agreement is enforceable. However, coverage will not be provided in the event the child is not ultimately placed in the member’s residence in compliance with chapter 63, Florida Statutes. The member’s adopted child is covered from the moment of placement in the residence, or if a newborn, from the moment of birth, if the child is enrolled timely as specified in the Special and Limited Enrollment Period provision. Additional premium will be required to continue coverage beyond the 31st day following placement of the child and where the issuer is notified by we have received notification from the Marketplace. The required premium will be calculated from the date of placement for adoption. Coverage of the child will terminate on the 31st day following placement, unless we have received both: (A) Notification of the addition of the child from the Marketplace within 60 days of the birth or placement and (B) any additional premium required for the addition of the child within 90 days of the date of placement
Appears in 1 contract
Samples: ambetter.sunshinehealth.com