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The plan covers services performed by approved provider types.
Services for pregnancy and its complications are covered. Professional services covered include:
- Prenatal and postnatal care.
- Amniocentesis and related genetic counseling and testing during pregnancy
- Prenatal testing (follows state regulations in Washington Administrative Code 246-680-020)
- Vaginal or cesarean delivery
- Care of complications resulting from pregnancy
- Lactation services for medical conditions of the mother or infant (see durable medical equipment benefit for coverage of breast pumps)
For inpatient hospital charges related to a routine childbirth, you pay:
For non-routine hospitalization of the newborn, you will also pay the inpatient hospital copay for the newborn.
A newborn dependent of an enrollee is covered from birth to at least 21 days following birth. See ”Adding a New Dependent to Your Coverage" for what you need to do for continued coverage.
If your obstetric care began while covered under another health plan, and the providers are not part of the plan network, call Customer Service at 1-800-762-6004.
Note: See preventive care services for coverage of well-baby care.
TIP: Prenatal vitamins prescribed during pregnancy must be preauthorized. Have your provider call 1-888-361-1611.
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