Maternity Services. Your benefits for maternity services are the same as your benefits for any other condition and are available whether you have Individual Coverage or Family Coverage. Benefits will be provided for delivery charges and for any of the pre viously described Covered Services when rendered in connection with pregnancy. Benefits will be provided for any treatment of an illness, injury, congenital defect, birth abnormality or a premature birth from the moment of the birth up to the first 31 days, thereafter, you must add the newborn child to your Family Coverage. Premiums will be adjusted accordingly. Coverage will be provided for the mother and the newborn for a minimum of:
Maternity Services. Your benefits for services rendered in connection with pregnancy are the same as your benefits for any other condition and are available whether you have In dividual Coverage or Family Coverage. In addition to all of the previously described Covered Services, routine Inpatient nursery charges for the newborn child are covered, even under Individual Coverage. (If the newborn child needs treatment for an illness, injury, congenital defect, birth abnormality or a prema ture birth, that care will be covered from the moment of birth up to the first 31 days, thereafter, you must add the newborn child to your Family Coverage. Pre miums will be adjusted accordingly. Coverage will be provided for the mother and the newborn for a minimum of:
Maternity Services. Under the Newborns and Mothers Health Protection Act, the MCO may not: • Limit benefits for postpartum hospital stays to less than forty-eight (48) hours following a normal vaginal delivery or ninety-six (96) hours following a cesarean section unless the attending provider, in consultation with the mother, makes the decision to discharge the mother or the newborn before that time; or • Require that a provider obtain authorization from the plan before prescribing this length of stay. This requirement must not preclude the MCO from requiring prior authorization or denying coverage for elective inductions and elective C-sections.
Maternity Services. The following maternity services are provided for all female members.
Maternity Services. Maternity care benefits and services include prenatal, delivery, postpartum services and nursery charges for a normal pregnancy or complications related to the pregnancy. The CONTRACTOR shall:
Maternity Services. Hospital Services and medical/surgical services rendered by a Facility Provider or Professional Provider for:
Maternity Services. We cover obstetrical Services for routine global maternity care; care for conditions that existed prior to pregnancy; care for high-risk conditions that develop during pregnancy; and non-routine obstetrical care.
Maternity Services. We cover for pre-and post-natal Services, which includes routine and non-routine office visits, telemedicine visits, x-ray, lab and specialty tests. The Health Plan covers birthing classes and breastfeeding support, supplies, and counseling from trained providers during pregnancy and/or in the postpartum period. Services for pre-existing conditions care related to the development of a high-risk condition(s) during pregnancy, and non-routine obstetrical care are covered subject to applicable Cost Share for specialty, diagnostic, and/or treatment Services. We cover inpatient hospitalization Services for you and your enrolled newborn child for a minimum stay of at least forty-eight (48) hours following an uncomplicated vaginal delivery; and at least ninety-six (96) hours following an uncomplicated cesarean section. We also cover postpartum home care visits upon release, when prescribed by the attending provider. In consultation with your physician, you may request a shorter length of stay. In such cases, we will cover one home health visit scheduled to occur within twenty-four (24) hours after discharge, and an additional home visit if prescribed by the attending provider. Up to four (4) days of additional hospitalization for the newborn is covered if you are required to remain hospitalized after childbirth for medical reasons. Comprehensive lactation (breastfeeding) education and counseling, by trained clinicians during pregnancy and/or postpartum period in conjunction with each birth, Breastfeeding equipment is issued, per pregnancy. The breast-feeding pump (including any equipment that is required for pump functionality) is covered for six (6) months at no cost sharing to the member. See the benefit-specific exclusion immediately below for additional information Benefit-Specific Exclusion: 1. Personal and convenience supplies associated with breastfeeding equipment such as pads, bottles, and carrier cases. 2. Services for newborn deliveries performed at home Medical Foods We cover medical foods and low protein modified food products for the treatment of inherited metabolic diseases caused by an inherited abnormality of body chemistry including a disease for which the State screens newborn babies. Coverage is provided if the medical foods and low protein food products are prescribed as Medically Necessary for the therapeutic treatment of inherited metabolic diseases and are administered under the direction of a Plan Provider. Medical foods are intended for ...
Maternity Services. Copayment applies to first prenatal visit (per pregnancy). All other maternity physician covered services are paid the same as Medical / Surgical Services. $25 Copay 80% after deductible Medical / Surgical Services Coverage for surgical procedures, inpatient visits therapies, allergy injections or treatments, and certain diagnostic procedures as well as other physician services 100% after deductible 80% after deductible Hosp ita l S e rv ic es Inpatient Hospital Services Coverage includes services received in a hospital, skilled nursing facility, coordinated home care and hospice, including mental health and substance abuse services. Room allowances based on the hospital’s most common semi-private room rates. 100% after deductible 80% after deductible Outpatient Hospital Services Coverage for services includes, but is not limited to outpatient or ambulatory surgical procedures, x-ray, lab tests, chemotherapy, radiation therapy, renal dialysis, and mammograms performed in a hospital or ambulatory surgical center, including mental health and substance abuse services. Routine mammograms performed in an in-network outpatient hospital setting are payable at 100%, no deductible will apply. 100% after deductible 80% after deductible
Maternity Services. Maternity Services include Inpatient Services, Outpatient Services and Physician Home Visits and Office Services. Maternity Services are used for normal or complicated pregnancy and ordinary routine nursery care for a healthy newborn. In order to aid in facilitating a pregnant Enrollee's prenatal care, she is required to notify Us of her pregnancy within 7 days of the date that she becomes aware that she is pregnant. If the Enrollee is pregnant on her Effective Date and is in the first trimester of the pregnancy, she must change to a Participating Provider to have Covered Maternity Services paid at the Delivery System level. If the Enrollee is pregnant on her Effective Date, benefits for obstetrical care will be paid at the Delivery System level if the Enrollee is in her second or third trimester of pregnancy (13 weeks or later) as of the Effective Date. Covered Maternity Services will include the obstetrical care provided by that Provider through the end of the pregnancy and the immediate post-partum period. If a newborn child is required to stay as an Inpatient past the mother’s discharge date, the Health Services for the newborn child will then be considered a separate admission from the Maternity and an ordinary routine nursery admission, and will be subject to a separate Inpatient Coinsurance/Copay. Coverage for the Inpatient postpartum stay for You and Your newborn child in a Hospital will be, at a minimum, 48 hours for a vaginal delivery and 96 hours for a cesarean section. Coverage will be for the length of stay recommended by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists in their Guidelines for Prenatal Care and Postnatal Care. Covered Maternity Services include post-delivery care visits at Your residence by a Physician or Nurse performed no later than 48 hours following You and Your newborn child’s discharge from the Hospital. Coverage for this visit includes all of the following listed below.
