Common use of Maternity Services Clause in Contracts

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.