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Question/Topic
How does UMP cover obstetric and newborn care?
Answer/Article

For information on adding a new dependent to your coverage, call PEBB Customer Service at 1-800-200-1004. You must enroll your new dependent within 60 days of birth or adoption.

UMP covers services for pregnancy and its complications when provided and billed by any one of the following providers:

  • A licensed physician
  • A nurse practitioner
  • A licensed midwife or certified nurse midwife
  • A hospital
  • A birthing center
  • Short-stay obstetric (childbirth) services (released within 24 hours of admission)

UMP covers only services performed by providers able to provide the full scope of obstetric services (prenatal, delivery, and postnatal care), except in geographic areas where provider access is limited. You pay the inpatient hospital copayment, enrollee coinsurance, and any medical deductible owed for the year.

Professional services covered include:

  • Prenatal and postnatal care
  • Amniocentesis and related genetic counseling and testing during pregnancy
  • Prenatal testing (following state regulations in Washington Administrative Code [WAC] 246-680-020)
  • Vaginal or cesarean delivery
  • Care of complications resulting from pregnancy

UMP covers routine newborn nursery care during hospitalization of the mother receiving maternity benefits under UMP, and you do not pay a separate copayment. UMP covers lactation services for medical conditions of the mother or infant.

UMP covers other hospitalization for a newborn for the first 21 days after birth, if UMP also covers the mother. You must first pay any deductible, copayment, and coinsurance requirements. After 21 days from birth, UMP will cover the child if you enroll him or her and pay your premium in full.

Note: See preventive care services for how UMP covers well-baby services.


Related Items
UMP definition: "hospital"
KBID 467
Date Modified 1/20/2009
Date Created 7/11/2006

The Certificate of Coverage (COC) is the source of coverage provisions offered under UMP. If information given here is inconsistent with the UMP COC, the rules in the COC will apply. Also, the COC may have additional information on this subject.

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