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Up to 365/366 days for members ages 0-20. Surgery and other procedures that are performed in a facility that is not the hospital (outpatient). This program focuses on your health during your pregnancy and your babys first year. Unlimited units for group therapy and unlimited units for brief group medical therapy. If you have questions about any of the covered medical services, please call Member Services. Order Your Pump. We cover the following inpatient hospital services based on age and situation, when medically necessary: Services to diagnose or treat skin conditions, illnesses or diseases. Transportation to and from all of your medical appointments. 24 patient visits per calendar year, per member. Yes, for dental procedures not done in an office. One initial wheelchair evaluation per five years. A. Behavioral Health Day Services/Day Treatment, Day treatment and adult day care services, Behavioral Health Medical Services (Medication Management, Drug Screening). One initial wheelchair evaluation per 5 years, Follow-up wheelchair evaluations, one at delivery and one 6-months later. One initial assessment per calendar year. One standard electric or manual breast pump per pregnancy; 2. These are medical-grade garments designed by healthcare professionals that provide lots of health benefits for moms. The Affordable Care Act requires most health insurance plans to cover breastfeeding services and supplies. Services must be medically necessary and provided in a county health department, federally qualified health center, or a rural health clinic. Family supplementation is allowed to pay the difference in cost between a shared and private room directly to the facility. Doulas are trained non-medical companions that support pregnant people. Up to 26 hours per calendar year for adults ages 21 and over. Because of the Affordable Care Act (ACA), health insurance providers are required to provide coverage for breastfeeding support, counseling, and equipment. You can use this service in your home, an Assisted Living Facility or a Nursing Facility. 2. Complete our quick online form, and we will do the rest of the work from verifying your coverage and determining your breast pump selection to handling all paperwork and shipping your insurance-covered breast pump to your home! Transportation provided by ambulances or air ambulances (helicopter or airplane) to get you to a hospital because of an emergency. It may help with brain development and learning. . Please contact your health care provider to connect with additional resources. Comprehensive Behavioral Health Assessments. Services to help people understand and make the best choices for taking medication. Download the free version of Adobe Reader. They also offer comfort through physical and emotional support. Participants may be directed to call Member Services at 1-800-859-9889. One initial wheelchair evaluation per five years. Diagnosis and manipulative treatment of misalignments of the joints, especially the spinal column, which may cause other disorders by affecting the nerves, muscles and organs. Limitations, co-payments and restrictions may apply. This can include any tests, medicines, therapies and treatments, visits from doctors and equipment that is used to treat you. Low-cost interventions including early initiation when not feeding at the breast, listening to relaxation music, massage and warming of the breasts, hand expression and lower cost pumps may be as effective, or more effective, than large electric pumps for some outcomes. This means you get to choose your service provider and how and when you get your service. This service is for drugs that are prescribed to you by a doctor or other health care provider. Download the free version of Adobe Reader. Sessions as needed Breast milk can be stored at room temperature for 10 hours, in the refrigerator for up to eight days, and in a freezer for three months. Two pairs of eyeglasses for children ages 0-20. Treatments that help you do things in your daily life, like writing, feeding yourself and using items around the house. Services that include all surgery and pre- and post- surgical care. Excludes those adaptations or improvements to the home that are of general use and are not of direct medical or remedial benefit to the member. As a reminder, we also provide the following: A 24-hour nurse advice line Breastfeeding support and resources Help obtaining a breast pump overwhelmed, "down" or thinking about harming yourself or others) Methods to help you quit smoking, alcohol or drugs Ask your doctor or call us for more information. Breast milk is easier for babies to digest than formula. Up to three visits per day for all other members. Speech and language therapy services in the office setting. This can be a short-term or long- term rehabilitation stay. One initial wheelchair evaluation per 5 years, Follow-up wheelchair evaluations, one at delivery and one 6-months later. Family Training and Counseling for Child Development*. Eligible participants will receive items like prenatal vitamins, a convertible toddler car seat, a breast pump (including related replacement parts), breast milk storage bags, a home safety kit, a . Services for women who are pregnant or want to become pregnant. You can call 1-877-659-8420 to schedule a ride. Additional coverage for items not covered under standard benefits, such as, wound supplies, hospital bed and mattresses, insulin pump and infusion pump. We cover the following inpatient hospital services based on age and situation, when medically necessary: Services to diagnose or treat skin conditions, illnesses or diseases. Services provided to children ages 0- 20 with mental illnesses or substance use disorders. Diagnosis and manipulative treatment of misalignments of the joints, especially the spinal column, which may cause other disorders by affecting the nerves, muscles and organs. Contact lens types: spherical, PMMA, toric or prism ballast, gas permeable, extended wear, hydrophilic, spherical, toric or prism ballast; and hydrophilic extended wear, other types. Emergency mental health services provided in the home, community or school by a team of health care professionals. One-on-one individual mental health therapy. Services that help children with health problems who live in foster care homes. Individual therapy sessions for caregivers. Services that include imaging such as x-rays, MRIs or CAT scans. Physical therapy includes exercises, stretching and other treatments to help your body get stronger and feel better after an injury, illness, or because of a medical condition. Services to diagnose or treat conditions, illnesses or diseases of the bones or joints. Up to seven therapy treatment units per week. Services to keep you from feeling pain during surgery or other medical procedures. Home delivered meals post inpatient discharge. Covered as medically necessary. One initial evaluation and re-evaluation per calendar year. These are services that are usually provided in an assisted living facility (ALF). FILE - A mother holds a bottle of baby formula as she feeds her infant son, Friday, May 13, 2022, in San Antonio. Limited to members who live alone or who are alone for significant parts of the day who would otherwise require extensive supervision. Services for children with severe mental illnesses that need treatment in a secured facility. Ambulance services are for when you need emergency care while being transported to the hospital or special support when being transported between facilities. Its important to see a doctor if you are planning on becoming pregnant, or as soon as you know you are pregnant. It is what nature intended for mothers and babies. Have your insurance card ready! Services to assist people re-enter everyday life. These tables list the services covered by our Plan. Types of pumps covered for rental, pending prior authorization: Hospital-grade heavy duty electric breast pump (CPT code E0604): A piston electric pump with pulsatile vacuum suction and release cycles. Substance Abuse Intensive Outpatient Program*. Medical care and other treatments for the feet. This means they are optional services you can choose over more traditional services based on your individual needs. Once the newborn is discharged, the breast pump will no longer be covered; or A breast pump will be covered for babies who have congenital anomalies that interfere with feeding. The benefit information provided is a brief summary, not a complete description of benefits. Rent A Hospital-Grade Breast Pump Month-by-Month! Health care providers and DME vendors must review the specifications and determine if the pumps they prescribe/issue to postpartum women qualify to be reimbursed. Physical therapy includes exercises, stretching and other treatments to help your body get stronger and feel better after an injury, illness or because of a medical condition. The hospital grade breast pump will be covered upon the mother's discharge from the hospital HUSKY Health will not reimburse for a pump while the mother is inpatient. Babies who are breastfed have reduced risk for numerous health conditions, including asthma, ear and respiratory infections, and allergies. Infant Mental Health Pre- and Post- Testing Services*. electric or manual breast pumps along with supplies are considered medically necessary and are a Patient Protection and Affordable Care Act Women's Preventive Health Services mandate, effective August 1, 2012. Covered as medically necessary. Call 1-866-796-0530 (TTY: 1-800-955-8770) for more information. Just call 1-855-232-3596 (TTY: 711) to get your pump. Home Delivered Meals - Disaster Preparedness/ Relief. One per day and no limit per calendar year. The First Four Weeks: Aim for 8 to 10 pumping sessions every 24 hours following birth, expressing (expelling milk) for at least 15 minutes each session. Nursing facility services include medical supervision, 24-hour nursing care, help with day-to-day activities, physical therapy, occupational therapy and speech- language pathology. Contact your care manager to determine eligibility. is a health and wellness program available at no additional cost to eligible members who are either expecting or adopting a child. Additional minutes for SafeLink phone or Connections Plus plan. That means you could receive a high-quality, name brand pump at no cost to you. Transfers between hospitals or facilities. We cover medically necessary family planning services. Mental health therapy in a group setting. One communication evaluation per five calendar years. This can be a short-term rehabilitation stay or long-term. For more information contact the Managed Care Plan. Insertion of thin needles through skin to treat pain, stress and other conditions. You'll want to buy or rent a breast pump if a partner or loved one is going to help at feeding time. Well Child Visits are provided based on age and developmental needs. Maximum of five hundred dollars ($500) per eligible enrollee per lifetime. They can answer questions about pregnancy, labor and caring for your baby after birth. They also include family planning services that provide birth control drugs and supplies to help you plan the size of your family. *Some Medicaid members may not have all the benefits listed. Babylist Health was created to help cut through the paperwork and make it easier for you to get your breast pump. Medical care and other treatments for the feet. One per day and no limit per calendar year. The Affordable Care Act requires most health insurance plans to cover the cost of a breast pump as part of women's preventive health services. Help taking medications if you cant take medication by yourself. Visual aids are items such as glasses, contact lenses and prosthetic (fake) eyes. Services to diagnose or treat conditions, illnesses or diseases of the bones or joints. Unlimited units for verbal interaction, medication management and drug screening, Behavioral Health Psychosocial Rehabilitation, Services to help people re-enter everyday life (cooking, managing money and performing household chores), Computerized Cognitive Behavioral Analysis. You can either: Order it online from a medical supply company. We cover 365/366 days of medically necessary services per calendar year. These expenses cover a wide range of healthcare needs, including breastfeeding products like breast pumps, nursing accessories, and breast pump spare parts pre-tax. Postpartum doulas may have additional ideas to help you become more comfortable or more confident in the process. Children under age 21 can receive swimming lessons. Durable Medical Equipment and Medical Supplies Services. In some cases, you can rent or buy an electric breast pump. One evaluation/re- evaluation per calendar year. Maximum of five hundred dollars ($500) per eligible enrollee per lifetime. Medical care, tests and other treatments for the kidneys. These services are free. Visual aids are items such as glasses, contact lenses and prosthetic (fake) eyes. This service makes changes to your home to help you live and move in your home safely and more easily. This can include any tests, medicines, therapies and treatments, visits from doctors and equipment that is used to treat you. Health care services provided in a county health department, federally qualified health center, or a rural health clinic. Medical equipment is used to help manage and treat a condition, illness, or injury. You'll be able to choose from popular brands like Ameda Finesse, Evenflo Advanced, Lansinoh Signature Pro, Spectra S2 Plus and Medela Pump in Style. Emergency mental health services that are performed in a facility that is not a regular hospital. It may reduce your risk of ovarian and breast cancer. It's a good idea to try it if you can, because breast milk has all the nutrition a baby needs during the first six months. Here are some activities to do with your doula: Contact The Doula Network team at 1-877-436-8527 and select extension 0 to learn more. You will need Adobe Reader to open PDFs on this site. Services include evaluation of the need for medication; clinical effectiveness and side effects of medication; medication education; and prescribing, dispensing, and administering of psychiatric medications. We cover for children ages 0-20 and for adults under the $1,500 outpatient services cap, as medically necessary: We cover for people of all ages, as medically necessary: Services that provide teeth extractions (removals) and to treat other conditions, illnesses or diseases of the mouth and oral cavity. You can get these services and supplies from any Medicaid provider; they do not have to be a part of our Plan. This could be on the bus, a van that can transport people with disabilities, a taxi, or other kinds of vehicles. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change. You will need Adobe Reader to open PDFs on this site. They offer high-quality choices that can help you have a successful breastfeeding experience. * Limitations do not apply to SMI Specialty Plan. To learn about breast pump coverage under your Independence plan, contact Customer Service at 1-800-ASK-BLUE (1-800-275-2583) (TTY:711). Children's Medical Services Health Plan (KidCare), Complaints, Grievances and Appeals (Medicaid), Medicaid Supplemental Preferred Drug List, Pediatric Therapy Provider Access Contact, ROPA Provider Enrollment Application Now Available, Derrick Brooks and Sunshine Health encourage COVID-19 vaccinations, How to Create Positive New Habits in our New World. Including health focused clinical interview, behavioral observations, and health and behavioral interviews for individual, group and family (with or without the patient). If you are a new or expecting mother, be sure to take advantage of the breast pump coverage your insurance provider offers you. Standard assessment of mental health needs and progress. A. Large LCD screen designed to increase control by displaying suction level, mode, timing, an more. Up to $5,000 per lifetime to assist member in moving out of a nursing facility. Most of the United Healthcare benefit plans include coverage for the purchase of a personal-use, double-electric breast pump at no cost. Up to two training or support sessions per week. Treatments for long-lasting pain that does not get better after other services have been provided. Find out what breast pump you qualify for through your insurance. See information on Patient Responsibility for room & board.