Pregnancy and maternity care. Benefits are available for maternity care services. Benefits include: Prenatal care; Postnatal care; Involuntary complications of pregnancy; Inpatient Hospital services including labor, delivery, and postpartum care; Elective newborn circumcision within 18 months of birth; and Pregnancy termination services. See the Diagnostic X-ray, imaging, pathology, and laboratory services and Preventive Health Services sections for information about coverage of genetic testing and diagnostic procedures related to pregnancy and maternity care. The Newborns’ and Mothers’ Health Protection Act requires health plans to provide a minimum Hospital stay for the mother and newborn child of 48 hours after a normal, vaginal delivery and 96 hours after a C-section. The attending Physician, in consultation with the mother, may determine that a shorter length of stay is adequate. If your Hospital stay is shorter than the minimum stay, you can receive a follow-up visit with a Health Care Provider whose scope of practice includes postpartum and newborn care. This follow-up visit may occur at home or as an outpatient, as necessary. This visit will include parent education, assistance and training in breast or bottle feeding, and any necessary physical assessments for the mother and child. Prior authorization is not required for this follow-up visit.
Pregnancy and maternity care. (Please refer to the Benefit Schedule for other benefit provisions which may apply.) Your Participating Provider Plan provides pregnancy and post delivery care benefits for You and Your Family Members All comprehensive benefits described in this Plan are available for maternity services. Comprehensive Hospital benefits for routine nursery care of a newborn child are available so long as the child qualifies as an Eligible Dependent as defined in ‘Conditions of Eligibility’ in the section of this Plan titled “Who is Eligible for Coverage?”. The mother and her newborn child shall be entitled to inpatient Hospital coverage for a period of 48 hours following an uncomplicated vaginal delivery; and 96 hours following an uncomplicated delivery by cesarean section. If a decision is made between a mother and doctor to discharge a mother or newborn child from inpatient care before the 48 or 96 hour time period, coverage for timely post delivery care is available. This Policy provides benefits for complications of pregnancy. Benefits are available for other pregnancy and maternity care as indicated above under “Pregnancy and Maternity Care”. We will not restrict benefits for any Hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section; or require that a provider obtain authorization for prescribing a length of stay that does not exceed the above periods. However, We may provide benefits for a shorter stay if the attending provider (e.g., the Physician, nurse midwife), after consultation with the mother, discharges the mother or newborn earlier.
Pregnancy and maternity care. (Including Any Non-Surgical Outpatient Facility Costs Associated With These Services) Services and benefits including prenatal care for any condition arising from pregnancy or resulting childbirth and any complications thereof, including therapeutic abortion, miscarriage, delivery, antepartum and postpartum care, and pediatric care of the newborn infant and such other newborn care as medically necessary. This includes the services provided by a nurse midwife.
