Pregnancy and Maternity Care Benefits Sample Clauses

Pregnancy and Maternity Care Benefits. Benefits are provided for maternity services, including the following: 1) prenatal care;

Pregnancy and Maternity Care Benefits. The following pregnancy and maternity care is covered sub- ject to the exclusions listed in the Principal Limitations, Ex- ceptions, Exclusions and Reductions section:

Pregnancy and Maternity Care Benefits. Benefits are provided for maternity services, including the following: 1) prenatal care; 2) prenatal diagnosis of genetic disorders of the fetus by means of diagnostic procedures in case of high-risk pregnancy; 3) outpatient maternity services; 4) involuntary complications of pregnancy (including puerperal infection, eclampsia, cesarean section delivery, ectopic pregnancy, and toxemia); 5) inpatient hospital maternity care including labor, delivery and post-delivery care; and 6) outpatient routine newborn circumcision within 18 months of birth. See the Outpatient X-ray, Imaging, Pathology and Laboratory Benefits section for information on coverage of other genetic testing and diagnostic procedures. The Newborns’ and Mothers’ Health Protection Act requires health plans to provide a minimum Hospital stay for the mother and newborn child of 48 hours after a normal, vaginal delivery and 96 hours after a C-section unless the attending Physician, in consultation with the mother, determines a shorter Hospital length of stay is adequate. If the Hospital stay is less than 48 hours after a normal, vaginal delivery or less than 96 hours after a C-section, a follow-up visit for the mother and newborn within 48 hours of discharge is covered when prescribed by the treating Physician. This visit shall be provided by a licensed health care provider whose scope of practice includes postpartum and newborn care. The treating Physician, in consultation with the mother, shall determine whether this visit shall occur at home, the contracted facility, or the Physician’s office. Preventive Health Services are only covered when rendered by a Participating Provider. These services include primary preventive medical screening and laboratory testing for early detection of disease as specifically listed below: 1) evidence-based items, drugs or services that have in effect a rating of “A” or “B” in the current recommendations of the United States Preventive Services Task Force; 2) immunizations that have in effect a recommendation from either the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention, or the most current version of the Recommended Childhood Immunization Schedule/United States, jointly adopted by the American Academy of Pediatrics, the Advisory Committee on Immunization Practices, and the American Academy of Family Physicians; 3) with respect to infants, children, and adolescents, evidence-informed preventive care and screenings p...

Pregnancy and Maternity Care Benefits. Prenatal and Postnatal Physician Office Visits (For inpatient hospital services, see "Hospitalization Services.") $30 per visit2 (Not subject to the Calendar-Year Deductible) 50%2 Counseling and consulting 20% Not covered Elective abortion11 20% Not covered Tubal ligation11 20% Not covered Vasectomy11 20% Not covered Devices, equipment, and non-testing supplies 20% 50%2 Diabetes self-management training (If billed by your provider, you will also be responsible for the office visit copayment) $30 per visit2 (Not subject to the Calendar-Year Deductible) 50%2 Hearing Aid (maximum combined benefit of $700 per person every 24 months for hearing aid and ancillary equipment) 20% 20% Care Outside of Plan Service Area Benefits provided through BlueCard® Program, for out-of-state emergency and non-emergency care, are provided at the preferred level of the local Blue Plan allowable amount when you use a Blue Cross/BlueShield provider. Within US: BlueCard Program See Applicable Benefit See Applicable Benefit Outside of US: BlueCard Worldwide See Applicable Benefit See Applicable Benefit 1 Member is responsible for copayment in addition to any charges above allowable amounts. The copayment percentage indicated is a percentage of allowable amounts. Preferred providers accept Blue Shield's allowable amount as full payment for covered services. Non-preferred providers can charge more than these amounts. When members use non-preferred providers, they must pay the applicable copayment plus any amount that exceeds Blue Shield's allowable amount. Charges above the allowable amount do not count toward the calendar-year deductible or copayment maximum.