Human Resources

Q:

I’m having a baby. Do I need to notify my health plan before receiving maternity services?



A:

Regular prenatal care can help keep you and your baby healthy. All of PEBA Insurance Benefits’ health plans offer coverage for maternity care for subscribers and their spouses.

The State Health Plan requires that all expectant mothers participate in the Maternity Management Program and preauthorize maternity benefits with Medi-Call during the first trimester (three months) of the pregnancy. If you do not preauthorize, there will be a $200 penalty for failing to call, as well as a $200 penalty for each maternity-related inpatient admission and a coinsurance penalty.

BlueChoice participants do not require preauthorization for maternity benefits.

Newborns are not automatically enrolled. Once the baby is born, contact your benefits office within 31 days to add the child to your coverage.

Note: Covered children of subscribers are not eligible for maternity benefits.




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