These data reflect the most commonly purchased benefits package for each of the health plans in
the year 2000. Coventry/Principal would not supply updated information.
HMO Prenatal Care and Obstetrical Services
Aetna US Healthcare Covers: Prenatal and other obstetrical services, including a minimum of 48 hours in the hospital after vaginal delivery or 96 hours after cesarean section. Member may elect to be discharged earlier when medically appropriate.

Cost Sharing: Copayment applies.
Blue Cross Blue Shield Covers: Prenatal and obstetrical services, including a minimum of 48 hours in the hospital after vaginal delivery or 96 hours after cesarean sections.
CIGNA / Healthsource Covers: Prenatal and obstetrical services, including a minimum of 48 hours in the hospital after vaginal delivery or 96 hours after cesarean sections.
Doctors Health Plan Covered.

Cost Sharing: Pregnant member pays a one-time office copay for prenatal care. Mother’s and newborn’s charges for hospital and physician services are considered separate and will be considered separately for benefits under the benefit plan.

Excludes: Genetic tests to determine paternity or sex of a child.
Generations Covers: Professional maternity services, including pre-natal care, physician services associated with delivery , and post-natal follow-up care.

Cost-Sharing: Covered 100% after a one time office visit copay made at first pre-natal physician office visit.
Optimum Choice Covers: Prenatal care, delivery, and prenatal and postnatal care arising from pregnancy or resulting in complications of childbirth and miscarriage. Coverage for deliveries includes a minimum of 48 hours in the hospital after vaginal delivery or 96 hours after cesarean sections. Also covers ordinary nursing care, childbirth education classes, and midwife services if at an accredited birthing center.

Cost Sharing: OCCI will reimburse $50 for childbirth education classes. Copayments may apply.

Excludes:

  • Maternity services provided outside the service area in the last trimester , unless authorized by the participating provider or OCCI.
PARTNERS Covers: Prenatal care and obstetrical services. Also covers complications of pregnancy for dependent children (miscarriages, tubal pregnancies and non-elective cesarean sections).

Excludes: Routine prenatal care for dependent children, including term and premature labor and delivery, elective cesarean sections, routine prenatal and post-natal services. Also excludes services provided at free standing birth centers.
Coventry/Principal Health Care of the Carolinas Covers: Pre- and post-natal care.

Excludes: Maternity services provided outside the service area within three weeks of the estimated date of delivery unless prior authorization is given in writing by Coventry/Principal.
QualChoice Covers: Prenatal visits, postnatal visits, complications of pregnancy and miscarriage. Coverage includes initial examination and medical care of a newborn child in a hospital, newborn foster child or child placed in a home while waiting for final adoption.
The Wellness Plan of North Carolina, Inc. Covers: Prenatal and obstetrical services, including a minimum of 48 hours in the hospital after vaginal delivery or 96 hours after cesarean sections.

Note: If the attending provider decides to discharge the mother and her newborn child before the expiration of the covered time, post delivery follow-up care is provided within 72 hours immediately following discharge. This follow-up care may be provided in the home, provider’s office, hospital, birthing center, or other appropriate setting.
United HealthCare Covers: Prenatal and obstetrical services, including a minimum of 48 hours in the hospital after vaginal delivery or 96 hours after cesarean sections.

Limits: No authorization is required for delivery services for the minimum of 48 hours in the hospital after vaginal delivery or 96 hours after cesarean section.

Cost Sharing: Members who require fewer than 10 visits will pay an office visit copayment for prenatal care, or $100, whichever is less.

Excludes: Non-medically necessary amniocentesis.
WellPath Covers: Prenatal and other obstetrical services, including a minimum of 48 hours in the hospital after vaginal delivery or 96 hours after cesarean section.

Cost Sharing: Copayment for the confirmation of pregnancy. For other visits to OB, there is no copayment.

Excludes: Charges for the normal delivery of a baby outside of the member’s service area, if the delivery is within 30 days of the due date specified by the participating physician.

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