Being pregnant often comes with a flood of emotions, from happiness and excitement to anxiety and worry. The State Health Plan has you covered every step of the way. Maternity benefits are provided to subscribers and their covered spouses. Benefits include necessary prenatal and postpartum care, such as childbirth, miscarriage and pregnancy-related complications. Additional services include breastfeeding support and helping you find services to support your mental health. Coming Attractions, a maternity management program, and MOMS, a maternal behavioral health program, are available to members at no cost.
Finding a provider
To find a network provider specializing in obstetrics and gynecology, search for a provider online. Your OB-GYN will care for you during the initial postpartum period; however, you should select a primary care provider afterward. You should also find a pediatrician for your child during your second or third trimester.
The Coming Attractions maternity management program helps pregnant members understand the changes of pregnancy and prepare for parenthood. You’ll receive one-on-one support from an obstetrically trained nurse care manager, trimester specific information, information on breastfeeding and assistance with obtaining a breast pump. Your maternity nurse care manager will also help provide you with education and community resources, as well as help you navigate your State Health Plan benefits so you can make the most of what is available to you. Coming Attractions, available at no cost to members, helps members make healthier lifestyle choices and lower their risks for pregnancy-related complications.
The program is primarily offered through My Health Planner, an app that supports digital member interactions with the clinical team. This personalized channel connects members to the clinical team with real-time progress, clinical alerts for care managers and two-way communication. Pregnant members can also get information, facts and reminders through the app. Care managers are also available by phone for members with greater needs.
Members who are pregnant will receive a welcome mailer to introduce them to Coming Attractions and provide instructions on how to enroll. Members can also enroll by logging in to their My Health Toolkit account to complete their initial maternity screening in the Personal Health Record or by calling BlueCross at 855.838.5897, Option 4.
Hello Heart, a program focused on managing hypertension, is available to State Health Plan primary members, ages 18 through 79, at no cost. Eligible members include those with a self-reported high blood pressure of 130/80 or higher, who have a hypertension diagnosis, including pregnancy-induced hypertension, or who currently take medication for hypertension. A member enrolled in Coming Attractions may be referred to Hello Heart’s maternity program or a member currently enrolled in Hello Heart can turn on the maternity program feature. Learn more on our Hello Heart webpage.
MOMS Support Program
The MOMS Support Program is a coaching program that assists mothers across the child-bearing spectrum by developing a personalized plan for strategies to better manage their depression and anxiety at any stage—pre- or post-pregnancy. The program assesses, empowers and educates members, allowing them to identify and self-monitor their symptoms. MOMS is available at no cost to women diagnosed with behavioral health needs during pregnancy through those who are two years’ postpartum, as well as women who lost a pregnancy. To enroll, go to the Companion Benefit Alternatives website, select Members, then Request a Health Coach. You can also call 800.868.1032, Ext. 25835, to enroll.
Screening, Brief Intervention and Referral to Treatment
The SBIRT is a screening tool for providers to assess pregnant women who might have been or can be at risk for substance use, domestic violence, depression and anxiety. Providers are trained to use this tool in many settings including, but not limited to, primary care, psychiatric clinics, inpatient and urgent care settings, as well as behavioral health clinics. It offers a means of identifying at-risk patients in advance of worsening substance-related problems.
Centering Pregnancy
Centering Pregnancy is an evidence-based group model for prenatal care that targets low-risk mothers and has demonstrated reductions in preterm deliveries. Learn more from the Centering Healthcare Institute and find a centering site online.
Vaccinations
According to the CDC, getting certain vaccines while you’re pregnant helps your body create protective antibodies. You can pass those antibodies to your baby and help protect them from those diseases during the first few months of life.
- Your OB-GYN might recommend you get a flu shot if you are pregnant during flu season. The flu vaccine is safe during pregnancy and can be given during any trimester.
- Tdap helps protect against whooping cough, which can be life-threatening for newborns. The Tdap vaccine should be given between the 27th and 36th weeks of each pregnancy, preferably during the earlier part of this period.
- RSV is a common cause of severe respiratory illness in infants. You can choose to get an RSV vaccine during the 32nd and 36th weeks of your pregnancy or September to January. Alternatively, your baby 8 months or younger can get the RSV immunization during their first RSV season.
- The COVID-19 vaccination is recommended for everyone ages 6 months and older, including women who are pregnant, breastfeeding, trying to get pregnant or who might become pregnant in the future.
The State Health Plan covers vaccinations as recommended by the CDC. Talk to your OB-GYN care provider to see what vaccinations might be recommended for you.
Baby-Friendly hospitals
A Baby-Friendly designated hospital gives mothers the information, confidence and skills necessary to successfully initiate and continue breastfeeding their babies. The hospital must adhere to the Ten Steps to Successful Breastfeeding. There are 16 Baby-Friendly designated hospitals in South Carolina. Learn more by visiting Baby-Friendly USA and Find a Baby-Friendly Facility.
Breast pumps
Members can receive certain electric or manual breast pumps at no member cost. They can learn how to get a breast pump by enrolling in the maternity management program, Coming Attractions.
Lactation consultation
State Health Plan members can access lactation consultations post-delivery in the hospital, during postpartum appointments with their OB-GYN and at well-child visits with a pediatrician. While most lactation consultants are in network through a facility, OB-GYN office or pediatrician, the Plan will also cover consultations if billed separately by a network provider. Lactation support is also available through the maternity management program, Coming Attractions, and participating breast pump vendors also offer lactation services for additional support.
NICU case management
The NICU case management program is available to infants who have certain conditions. Conditions include, but are not limited to, complications associated with premature birth, congenital birth defects, hydrocephalus, seizures, cystic fibrosis and genetic disorders. Clinically experienced certified nurse case managers work closely with the caregiver and the member’s providers to ensure ongoing communication and coordination of care throughout the first year of life.
Well child care visits
The State Health Plan covers doctor visits based on recommendations from the American Academy of Pediatrics and immunizations based on recommendations from the CDC at network providers. The Plan pays 100% of the allowed amount for approved exams and immunizations for up to six visits for children younger than 1. Covered children are eligible for well child care exams until age 19. More details are available in the Insurance Benefits Guide.
Postpartum checkups
Postpartum checkups with an OB-GYN are a key opportunity to make sure new mothers stay healthy. Postpartum checkups give providers and mothers the chance to address problems early and can help prevent future medical problems. The first checkup should be within three weeks of birth. If you had high blood pressure during pregnancy, you should have a checkup sooner. Additional visits should be scheduled as needed, and the American College of Obstetricians and Gynecologists recommends you have a comprehensive postpartum visit no later than 12 weeks after birth.