
Having a healthy pregnancy is a top priority for expectant mothers, and Blue Cross Blue Shield (BCBS) offers comprehensive coverage to support a smooth and successful journey. BCBS pregnancy coverage includes prenatal care, which typically begins around 8-12 weeks into pregnancy.
BCBS covers a range of prenatal services, including regular check-ups, ultrasounds, and blood tests to monitor fetal development and the mother's health. These check-ups are crucial in identifying any potential issues early on, allowing for timely interventions and a healthier outcome.
BCBS also covers childbirth education classes, which can help expectant mothers and their partners prepare for the birth process and new parenthood. These classes often cover topics such as labor, delivery, and postpartum care.
Benefits and Coverage
To understand what's covered under your Blue Cross NC plan, start by checking your Benefit Booklet on your Blue Connect℠ member portal. This is where you'll find the "Family Planning" section, which breaks down the benefits, services, and equipment that are covered and excluded for maternity care and infertility services.
You can also expect to find benefits that support your breastfeeding journey, such as insurance benefits to help with the costs associated with breastfeeding.
In addition to these benefits, Blue Cross NC plans typically include a range of standard benefits, including breast pumps, dental care, and prescription drugs. Here are some of the standard benefits you can expect to find in your plan:
- Breast pumps
- Dental care
- Doctor, hospital, and emergency services
- Family planning
- Home health services
- Laboratory and x-ray services
- Maternity and newborn care
- Mental health and substance abuse treatment
- Prescription drugs
- Rehabilitative services and supplies
- School-based services
- Speech therapy, audiology, and hearing aids
- Transportation to appointments
- Vision care
Plan Coverage
To understand what's covered under your health plan, start by checking your Benefit Booklet on your Blue Connect℠ member portal. Look for the “Family Planning” section to see which benefits, services, and equipment are covered and excluded in your plan for maternity care, and infertility services.
You can also check the Standard Benefits Include list, which includes family planning, maternity and newborn care, and other essential services. This list gives you a clear idea of what's covered under your plan.
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Here's a summary of the standard benefits included in your plan:
- Breast pumps
- Dental care
- Doctor, hospital, and emergency services
- Family planning
- Home health services
- Laboratory and x-ray services
- Maternity and newborn care
- Mental health and substance abuse treatment
- Prescription drugs
- Rehabilitative services and supplies
- School-based services
- Speech therapy, audiology, and hearing aids
- Transportation to appointments
- Vision care
Remember to also check your dental benefits, especially if you're pregnant. All Medicaid members ages 21 and older and Healthy Michigan Members ages 19 and older have dental coverage through Blue Cross Complete.
Fertility Treatment
Fertility treatment can be a complex and emotional journey, but it's essential to understand your options. Assisted Reproductive Technology (ART) is a type of fertility treatment that includes procedures like in vitro fertilization (IVF).
ART can increase the chances of getting pregnant, especially for couples with fertility issues. In fact, according to the relevant information, ART has been successful in helping many people build their families.
Fertility treatment can be expensive, but some employers offer fertility benefits as part of their employee benefits package. This can help offset the costs of fertility treatment, making it more accessible to those who need it.
IVF is a type of ART that involves fertilizing an egg with sperm outside the body. This can be a lengthy and invasive process, but it's been a game-changer for many couples.
Care and Support
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) members have benefits to help plan for a family, address fertility issues, and care for your reproductive health. Your family planning journey is unique, and Blue Cross NC wants to make sure you get everything you need, every step of the way.
Many family planning services are covered as preventive care, at 100% by your plan, such as breast pumps, dental care, and doctor services. These services are designed to support you throughout your pregnancy and after baby arrives.
You can take advantage of programs to help before, during, and after pregnancy, including specialized maternity benefits like lactation support and breast pumps. Most Blue Shield plans also offer these benefits, and you can check your Evidence of Coverage to see which ones are available on your plan.
Here are some of the standard benefits that Blue Shield members can expect:
- Breast pumps
- Dental care
- Doctor, hospital, and emergency services
- Family planning
- Home health services
- Laboratory and x-ray services
- Maternity and newborn care
- Mental health and substance abuse treatment
- Prescription drugs
- Rehabilitative services and supplies
- School-based services
- Speech therapy, audiology, and hearing aids
- Transportation to appointments
- Vision care
We Care for You
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) members have benefits to help plan for a family, address fertility issues, and care for your reproductive health. Many family planning services are covered as preventive care, meaning they're covered at 100% by your plan.
You can take advantage of programs to help before, during, and after pregnancy, including specialized maternity benefits such as breast pumps and lactation support. Most Blue Shield plans also offer these benefits.
Blue Shield Promise members can get help throughout pregnancy, whatever their needs may be, through the Maternity Program. This program offers personalized attention and resources, educational materials, and assessments at different stages to see if extra support is needed.
The Maternity Program also provides access to 24/7 Nurse Line to speak with a nurse anytime, nurse support after the baby is born, and confidential support at no extra cost.
Here are some of the services you can expect from the Maternity Program:
- Personalized attention and resources
- Educational materials
- Assessments at different stages
- 24/7 Nurse Line
- Nurse support after the baby is born
- Confidential support at no extra cost
Blue Shield Promise also offers doula services as part of their effort to improve access to pregnancy care and ensure healthy outcomes for every parent and baby. Doulas offer support during pregnancy, labor, and postpartum, and can connect members with community resources and help them create a birth plan.
The Maternal Infant Health Program (MIHP) is Michigan's largest home visiting program, and it provides services such as home visits, education and information on pregnancy and postpartum care, community resources and referrals, and rides to the doctor.
Equity
Equity is a crucial aspect of care and support. Blue Cross NC recognizes this by addressing racial disparities in pregnancy and childbirth through their national strategy for maternal health equity.
Racial disparities in pregnancy and childbirth are a significant concern. Understanding these disparities is essential for providing effective care and support.
Health care equity is a priority at Blue Cross NC. They have a specific strategy in place to address these disparities and promote equitable care.
By focusing on equity, Blue Cross NC aims to improve health outcomes for all individuals, regardless of their background or circumstances.
Financial Assistance
If you're expecting and have Blue Cross Blue Shield (BCBS) pregnancy coverage, you're in luck - you'll likely have access to financial assistance to help with medical expenses.
BCBS offers a variety of financial assistance programs to help pregnant women manage the cost of prenatal care, delivery, and postpartum care.
You may be eligible for a waiver of copays, coinsurance, and deductibles for certain services, such as prenatal visits and delivery.
BCBS also provides a maternity care coordination program that helps pregnant women navigate the healthcare system and get the care they need.
This program can help you find in-network providers, schedule appointments, and get support during pregnancy and postpartum.
BCBS will cover certain services, including ultrasounds, lab tests, and specialist visits, without requiring a copay or coinsurance.
Programs and Services
The Maternal Infant Health Program (MIHP) in Michigan offers home visiting services to pregnant individuals at no cost. These services are provided by healthcare professionals like nurses and social workers.
MIHP helps pregnant individuals access transportation, WIC, and childbirth education classes. They also receive home visits to discuss prenatal care, labor and delivery, and caring for their baby.
Healthcare professionals in MIHP can help with food and housing assistance, nutrition education, and managing health problems like diabetes and depression. They can also connect individuals with community services like childbirth education classes and baby pantries.
Some examples of services offered by MIHP include:
- Home visits from a healthcare professional
- Transportation to doctor's appointments and other services
- WIC and childbirth education classes
- Assistance with food and housing
- Support for managing health problems
- Connection to community resources
In addition to MIHP, some health plans offer their own maternity programs. These programs may include support and education for managing personal health needs during pregnancy, connection to community resources, and care management for high-risk pregnancies.
Some specific benefits of these maternity programs include:
- Personalized attention and resources
- Educational materials and assessments to identify additional support needs
- Access to 24/7 nurse support
- Nurse support after the baby is born
These programs are often available to health plan members at no extra cost and can be accessed by calling a dedicated phone number.
Frequently Asked Questions
How much does it cost to deliver a baby with Blue Cross insurance?
For Blue Cross members, the average cost of delivering a baby via vaginal delivery is around $13,325, while a cesarean delivery costs approximately $17,482. The cost difference between the two is around $4,157.
Is pregnancy a pre existing condition for BCBS?
No, pregnancy is not considered a pre-existing condition for BCBS, and coverage begins on the day your plan starts
What insurance should I get if I'm pregnant?
Consider reporting your pregnancy to see if you qualify for free or low-cost Medicaid or CHIP coverage, which may be a more affordable option than a Marketplace plan
Is a PPO plan better for pregnancy?
A PPO plan may be a safer choice for pregnancy due to its lower out-of-pocket costs for medical expenses, including potential complications like C-sections or NICU stays. However, the actual cost savings depend on individual circumstances and medical needs.
What pregnancy items can I get through insurance?
You may be eligible for insurance coverage of pregnancy-related items such as birth control pills, maternity compression garments, and testing for conditions like Down syndrome and gestational diabetes. Check your insurance plan for specific details on what is covered and how to access these benefits.
Sources
- https://www.bluecrossnc.com/members/maternal-health
- https://www.mibluecrosscomplete.com/member-benefits/pregnancy-care/
- https://dphhs.mt.gov/MontanaHealthcarePrograms/MemberServices
- https://www.blueshieldca.com/en/bsp/providers/programs/maternity-program
- https://www.blueshieldca.com/en/home/get-more/your-health-and-well-being/before-during-after-pregnancy
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