Enrolling Your Newborn In The US Family Health Plan

It is VERY IMPORTANT that you understand how newborn coverage works and the steps you must take to ensure continuous coverage for your new baby from the day of his or her birth on. Please read the following information carefully and call a Martin’s Point US Family Health Plan representative at 1-888-241-4556 if you have any questions.

YOUR BABY’S FIRST 90 DAYS (Conditional Enrollment)

HOW COVERAGE WORKS
If at least one other member of the newborn’s immediate family is ALREADY enrolled in the Martin’s Point US Family Health Plan at the time of your baby’s birth, your baby will be CONDITIONALLY ENROLLED in the US Family Health Plan for the first 90 days of his/her life. The US Family Health Plan will pay claims for covered services your newborn receives from Day 1 through Day 90 under this Conditional Enrollment.

STEPS YOU MUST TAKE
STEP 1: Call the Martin’s Point US Family Health Plan as soon as possible after the baby’s birth to notify us of his or her date of birth. This will help ensure that your child will be conditionally enrolled so we can smoothly process any claims for services your baby receives in the first 90 days.

CONTINUED COVERAGE FROM DAY 91 ON (Official Enrollment)

HOW COVERAGE WORKS

To ensure continuous coverage for your newborn after the first 90 days of Conditional Coverage, you must officially enroll your newborn into the US Family Health Plan. You can officially enroll your newborn at any time during the first 90 days, but you MUST complete enrollment on or before Day 90 in order to guarantee continuous coverage by the Plan.

To officially enroll your newborn in the US Family Health Plan, the following conditions must be met:

  • At least one other member of the newborn’s immediate family must be enrolled in the US Family Health Plan at the time of your newborn’s official enrollment into the Plan
  • You must register your newborn in DEERS to establish TRICARE eligibility
  • You must submit a completed ENROLLMENT APPLICATION to the US Family Health Plan.

If you do not complete these actions on or before Day 90, your newborn’s conditional enrollment in the US Family Health Plan will end and claims filed for services received after Day 90 will not be paid by the US Family Health Plan.

STEPS YOU MUST TAKE
STEP 1: Register Your Newborn in DEERS to Establish TRICARE Eligibility
Parents and legal guardians must enroll their newborn child in DEERS as soon as possible after birth.
To establish a newborn’s TRICARE eligibility in DEERS, you must do the following three things:

  1. Submit a certificate of “Live Birth,” in person, to the nearest military ID card facility.
  2. Apply for your child’s Social Security number. Go to the Social Security Administration Web site: http://www.ssa.gov or call 1-800-772-1213 for an application.
  3. Once you receive your child’s Social Security number, go to your nearest military identification (ID) card-issuing facility to update your child’s information in DEERS.

Any changes that impact family status must be reported to DEERS. Family status changes include marriage, divorce, or new child. Because DEERS enrollment is directly tied to TRICARE eligibility, care may be denied if the sponsor and family members are not enrolled in DEERS.

STEP 2: Submit a completed Enrollment Application to the Martin’s Point US Family Health Plan 
There are several ways to enroll your newborn into the US Family Health Plan:

  • a) We strongly recommend that you fill out, print, and mail the Enrollment Application found in the “Enrollment” documents list above right or call a US Family Health Plan Representative at 888-241-4556 for assistance with enrolling your newborn.
  • b) You may enroll online through TRICARE at https://www.dmdc.osd.mil/appj/bwe/indexAction.do. IMPORTANT! The Beneficiary Web Enrollment (BWE) system, accessible through the TRICARE link above, does not recognize newborn status and, therefore, will not retroactively enroll your newborn back to his or her date of birth. Instead, the effective date will be based on the date the application is received.

SOME NOTES ABOUT NEWBORNS, DEERS, AND TRICARE ELIGIBILITY
Why Enrolling Your Newborn in DEERS is Important
By enrolling your newborn in DEERS, you establish TRICARE eligibility for the infant and avoid potential claims problems or other financial hardships for your family in the future. As a new parent, enrolling your baby in DEERS provides you the comfort of knowing your baby will remain TRICARE eligible and able to receive the essential well baby and pediatric health care he or she needs. 

Aren’t Newborns Already TRICARE Eligible?
A newborn infant is covered as a TRICARE Prime beneficiary in DEERS for the first 90 days after birth, as long as one additional family member is enrolled in the Martin’s Point US Family Health Plan, or a different TRICARE Prime or TRICARE Prime remote plan. After the first 90 days of life, claims will be denied unless enrolled in the Martin's Point US Family Health Plan, another TRICARE Prime or TRICARE Select coverage.

QUESTIONS? If you have questions about newborn eligibility and enrollment, please call a Martin’s Point US Family Health Plan representative at 1-888-241-4556.

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