You can add your baby to your insurance at placement, and once placement papers are signed in a private adoption, you are responsible for the medical needs of the child placed. Talk to your agency, attorney, case worker, etc. to see if the baby may be eligible for Medicaid coverage. In our twins’ case, the birth mother was on Medicaid at the time of birth and didn’t sign relinquishment for five days. In the meantime, she filled out paperwork to cover the twins’ medical costs postpartum. They were covered by Medicaid for six months without us needing to qualify for coverage. Medicaid paid secondary to our own insurance, which helped us cover the costs of deductibles, co-payments, and coinsurance.