Common use of Postpartum Care Clause in Contracts

Postpartum Care. Maternity Care includes postpartum visits. Postpartum care in the home is covered in accordance with accepted maternal and neonatal Physician assessments, by a person with appropriate licensure, training and experience to provide postpartum care. Services provided by such person shall include, but not be limited to, parent education, assistance and training in breast and bottle feeding, and the performance of any necessary and appropriate clinical tests. Coverage for postpartum care in the home includes a minimum of three home visits, unless one or two home visits are determined to be sufficient by the attending Physician or person with appropriate licensure, training and experience to provide postpartum care, and the mother. The home visits shall be conducted within the time period ordered by the attending Physician or person with appropriate licensure, training and experience to provide postpartum care. The following benefits and services are covered at no cost to the Member when received from a Participating Provider:  Member must have a prescription for a manual breast pump, supplies, and counseling to prove that the Member gave birth.  Member will be provided with one (1) manual breast pump. One (1) replacement manual breast pump is allowed for each following birth. A replacement set of associated supplies is allowed per Member per year. Supplies include such items as breast pump, tubing and pads.  If it is deemed Medically Necessary for the Member to use an electric breast pump, the Member’s Durable Medical Equipment benefit would apply and may include a cost share.  Breastfeeding counseling services are limited to a duration of one year. The alpha-fetoprotein IV screening test for pregnant women. The test screens for certain genetic abnormalities in the fetus. This test generally occurs between the sixteenth (16th) and twentieth (20th) week of pregnancy.