get your motherhood essentials in 3 simple steps Provide your insurance information We verify your coverage and submit all required paperwork on your behalf Transportation provided by ambulances or air ambulances (helicopter or airplane) to get you to a hospital because of an emergency. The following are covered services: 1. Digital blood pressure cuff and weight scale, One (1) digital blood pressure cuff every three (3) years; One (1) weight scale every three (3) years. Sunshine Health is a managed care plan with a Florida Medicaid contract. A. Speech and language therapy services in the office setting. Emergency substance abuse services that are performed in a facility that is not a regular hospital. Services to diagnose or treat conditions, illnesses or diseases of the brain, spinal cord or nervous system. Order Your Pump. Services provided to children ages 0- 20 with mental illnesses or substance use disorders. Beds can be held for 14 days if the member has resided in facility for a minimum of 30 days between episodes. Women's Health - Breast Cancer Screening 77067, 77063, G0202, R403 Screening mammography Once a year ages 35 and up Regional Perinatal Intensive Care Center Services. Services for children with severe mental illnesses that need treatment in a secured facility. Services for members ages 0-20 to help you breathe better while being treated for a respiratory condition, illness or disease. Breastfeeding can help your uterus return to its normal size more quickly after delivery. This is available to members who are in a SNF or PDN setting and parent is obtaining guardianship to protect those who are unable to care for their own well-being. Family Training and Counseling for Child Development*. Home delivered meals post inpatient discharge. Storkpump is AdaptHealth's insurance covered breast pump program. Up to a 34-day supply of drugs, per prescription. Services to assist people re-enter everyday life. As a Sunshine Health member, you get these doula benefits at no-cost: 3 visits while pregnant is a health and wellness program available at no additional cost to eligible members who are either expecting or adopting a child. Up to three follow-up evaluations per calendar year. Want to breastfeed your baby? If you need a ride to any of these services, we can help you. Adapt to your breast shape for personalized comfort and 11.8% more milk faster compared to a traditional breast shield Safe & simple parts All parts that touch breast milk are made without BPA, and most parts are dishwasher safe for easy cleaning Get the #1 breast pump brand in America through insurance Email Baby's Birth / Due Date Call Customer Service at 1-877-644-4623 . But if you hear insurance and think red tape, you are not alone. Apple Health covers one manual breast pump per lifetime. We cover medically necessary blood or skin allergy testing and up to 156 doses per calendar year of allergy shots. Short term residential treatment program for pregnant women with substance use disorder. That's pretty amazing! Medical equipment is used to manage and treat a condition, illness, or injury. Here are some activities to do with your doula: Contact The Doula Network team at 1-877-436-8527 and select extension 0 to learn more. Breast milk can be stored at room temperature for 10 hours, in the refrigerator for up to eight days, and in a freezer for three months. Sessions as needed Services that include imaging such as x-rays, MRIs or CAT scans. If you need a ride to any of these services, we can help you. Your child must be enrolled in the DOH Early Steps program. Rent A Hospital-Grade Breast Pump Month-by-Month! postpartum depression. For children under the age of 21, we cover medically necessary: Services that include tests and treatments to help you talk or swallow better. Services that treat conditions, illnesses or diseases of the lungs or respiratory system. Services used to help people who are struggling with drug addiction. And sometimes that's all you need. Testing services by a mental health professional with special training in infants and young children. This can be a short-term rehabilitation stay or long-term. A health and wellness program for birth, baby and beyond. United Health Care Breast Pump Through Insurance - 100% Free. Therapy services, behavior management, and therapeutic support are coordinated through individualized treatment teams to help members with complex needs from requiring placement in a more intensive, restrictive behavioral health setting. To find out about these benefits, call the Agency Medicaid Help Line at 1-877-254-1055. Pregnancy, postpartum and newborn care and assessment provided in your home by a doula. "As both an insurance provider and part of a healthcare system, we have the ability to collaboratively look at our current maternity management programs, and identify opportunities within both education . Provided to members with behavioral health conditions and involves activities with trained animals. (Note: these items cannot be returned.) Child Health Services Targeted Case Management, Services provided to children (ages 0- 3) to help them get health care and other services. One visit per month for people living in nursing facilities. We cover for children ages 0-20 and for adults under the $1,500 outpatient services cap, as medically necessary: We cover for people of all ages, as medically necessary: Services that provide teeth extractions (removals) and to treat other conditions, illnesses or diseases of the mouth and oral cavity. One per day and no limit per calendar year. Service provided in a hospital setting on an outpatient basis. Breast Pumps Covered By Insurance I apologize in advance if this has already been asked, but is there anyone here that has Sunshine Health (in FL) that has had their breast pump supplied by Univita? Coverage for cold, cough, allergy, vitamins, supplements, ophthalmic/otic preparations, pain relievers, gastrointestinal products, first aid care, hygiene products, insect repellant, oral hygiene products and skin care. You'll be able to choose from popular brands like Ameda Finesse, Evenflo Advanced, Lansinoh Signature Pro, Spectra S2 Plus and Medela Pump in Style. They also include family planning services that provide birth control drugs and supplies to help you plan the size of your family. For more information contact the Managed Care Plan. Diagnosis and manipulative treatment of misalignments of the joints, especially the spinal column, which may cause other disorders by affecting the nerves, muscles and organs. 1-800-342-3556 Fax 850-922-3936 Mailing Address Bureau of WIC Program Services 4052 Bald Cypress Way, Bin A16 Tallahassee FL 32399 Breastfeeding is a normal part of mothers and babies being together. Behavioral Health Day Services/Day Treatment, Day treatment and adult day care services, Behavioral Health Medical Services (Medication Management, Drug Screening). You just pump breast milk when it works for you. The following are included in the rental payment for a hospital-grade breast pump: Set-up and education on the proper use and care of the pump; Child Health Services Targeted Case Management, Services provided to children (ages 0- 3) to help them get health care and other services. Treatment Breastfeeding guide Sunshine Health Health (9 days ago) WebFor more information on obtaining a breast pump, call Member Services at 1-866-796-0530, or TTY at 1-800-955-8770, Monday through Friday, 8 a.m. to 8 p.m. other than holidays. A. Moda Health will consider coverage for rental of hospital grade breast pump medically necessary when ALL of the following criteria are met; a. Start your membership today its easy! Yes, for dental procedures not done in an office. Breast pump, hospital grade rental; Sunshine Health is a managed care plan with a Florida Medicaid contract. Lactation services: If you need help with breastfeeding positions, milk supply and soreness, lactation support may . Breast pumps are covered under your Sunshine Health Medicaid plan. Financial assistance to members residing in a nursing home who can transfer to independent living situations. Transportation for non-medical trips, such as shopping or social events. One breast pump is covered per pregnancy. Please contact customer service at 888-510-5100 or Click Here to verify insurance. The benefit information provided is a brief summary, not a complete description of benefits. Talk to your doctor if you're having a lot of pain or feel like your baby isn't getting enough to eat. Meals delivered to your home after discharge from hospital or nursing facility. Tell Us Right Away! Educational services for family members of children with severe emotional problems focused on child development and other family support. E0602 Breast pump, manual Women's Health - Contraceptive Management* (with Diagnosis) . Our Start Smart for Your Baby program provides customized support and care for pregnant women and new moms. Limited to members who live alone or who are alone for significant parts of the day who would otherwise require extensive supervision. Children's Medical Services Health Plan (KidCare), Complaints, Grievances and Appeals (Medicaid), Medicaid Supplemental Preferred Drug List, Pediatric Therapy Provider Access Contact, ROPA Provider Enrollment Application Now Available, Derrick Brooks and Sunshine Health encourage COVID-19 vaccinations, How to Create Positive New Habits in our New World, Services must be medically necessary (PDF). Contact lens types: spherical, PMMA, toric or prism ballast, gas permeable, extended wear, hydrophilic, spherical, toric or prism ballast; and hydrophilic extended wear, other types. Sunshine Health is a managed care plan with a Florida Medicaid contract. We cover medically necessary blood or skin allergy testing and up to 156 doses per calendar year of allergy shots. Infant Mental Health Pre- and Post- Testing Services*. Hand-operated pumps are available through your over-the-counter benefit call 1-866-577-9010 for more information. We cover the following medically necessary services for children ages 0-20: We cover the following medically necessary services for adults: Statewide Inpatient Psychiatric Program Services. Substance Abuse Short-term Residential Treatment Services/ Residential Outpatient Services*. Including health focused clinical interview, behavioral observations, and health and behavioral interviews for individual, group and family (with or without the patient). Ambulance services are for when you need emergency care while being transported to the hospital or special support when being transported between facilities. Children under age 21 can receive swimming lessons. Emergency mental health services provided in the home, community or school by a team of health care professionals. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change. This prevents your breasts from becoming full and painful. Up to $5,000 per lifetime to assist member in moving out of a nursing facility. There may be some services that we do not cover, but might still be covered by Medicaid. Infant Mental Health Pre- and Post- Testing Services*. Outpatient visits with a dietician for members. Remember, services must be medically necessary in order for us to pay for them. Therapy services, behavior management, and therapeutic support are coordinated through individualized treatment teams to help members with complex needs from requiring placement in a more intensive, restrictive behavioral health setting. One initial evaluation and re-evaluation per calendar year. It is what nature intended for mothers and babies. One adult health screening (check-up) per calendar year. This means you get to choose your service provider and how and when you get your service. Asthma Supplies. If you need help finding an OB-GYN, we can help. Breast pump supplies . It's a good idea to try it if you can, because breast milk has all the nutrition a baby needs during the first six months. They also include family planning services that provide birth control drugs and supplies to help you plan the size of your family. Home visit by a clinical social worker to assess your needs and provide available options and education to address those needs. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change. Medical care and other treatments for the feet. Visual aids are items such as glasses, contact lenses and prosthetic (fake) eyes. Up to 45 days for all other members (extra days are covered for emergencies). Services for mental health or substance abuse needs. As medically necessary and recommended by us. This can include any tests, medicines, therapies and treatments, visits from doctors and equipment that is used to treat you. Short-term substance abuse treatment in a residential program. This can include any tests, medicines, therapies and treatments, visits from doctors and equipment that is used to treat you. Ambulance services are for when you need emergency care while being transported to the hospital or special support when being transported between facilities. Pregnancy, postpartum and newborn care and assessment provided in your home by a doula. This can be a short-term rehabilitation stay or long-term. Medical care or skilled nursing care that you get while you are in a nursing facility. A plan may only cover breast pumps during the first 60 days postpartum. This hands-free, wearable breast pump fits inside nursing bras so you can pump on the gowithout the hassle of external cords or tubes to get in your way. Types of pumps covered for rental, pending prior authorization: Hospital-grade heavy duty electric breast pump (CPT code E0604): A piston electric pump with pulsatile vacuum suction and release cycles. SMI Specialty Plan members are eligible to receive $35 per household worth of OTC items each month. Please let us know when you are pregnant by logging in to our secure member portal and filling out a Notice of Pregnancy form. Detoxification or Addictions Receiving Facility Services*. Services that include imaging such as x-rays, MRIs or CAT scans. Covered as medically necessary for children ages 0-20. Babies who are breastfed have reduced risk for numerous health conditions, including asthma, ear and respiratory infections, and allergies. Note: Pacify is only available to download in the App Store or Google Play Store. Unlimited units for verbal interaction, medication management and drug screening, Behavioral Health Psychosocial Rehabilitation, Services to help people re-enter everyday life (cooking, managing money and performing household chores), Computerized Cognitive Behavioral Analysis. Transportation to and from all of your medical appointments. An electronic device that you can wear or keep near you that lets you call for emergency help anytime. Services provided to pregnant women and newborns in hospitals that have special care centers to handle serious conditions. One communication evaluation per five calendar years. Even though the American Academy of Pediatrics recommends that all mothers breastfeed for at least six months, that's not always possible. It can include changes like installing grab bars in your bathroom or a special toilet seat. Services for families to have therapy sessions with a mental health professional. Download the free version of Adobe Reader. Breastfeeding offers a huge array of benefits for both . Pump more and save more when you purchase your Willow pump with insurance. One initial evaluation per lifetime, completed by a team. Durable Medical Equipment and Medical Supplies Services. Services must be medically necessary and provided in a county health department, federally qualified health center, or a rural health clinic. Respiratory therapy in an office setting. A doula is a professional assistant, but not a medical professional. Most UMR insurance plans provide coverage for maternity support bands (also known as belly bands) and postpartum recovery garments through insurance but are subject to deductible and coinsurance. Services for doctors visits to stay healthy and prevent or treat illness. Babies who are breastfed also have lower lifetime risk for health conditions such as obesity and cardiovascular disease. Postpartum doulas may have additional ideas to help you become more comfortable or more confident in the process. This can include any tests, medicines, therapies and treatments, visits from doctors and equipment that is used to treat you. Transfers between hospitals or facilities. Comprehensive Long Term Care members receive Medicaid benefits and Long Term Care benefits. Transportation to and from all of your medical appointments. Unlimited units for group therapy and unlimited units for brief group medical therapy. From breast pumps to maternity support and postpartum recovery, discover the motherhood essentials covered by your insurance. Services provided to adults (ages 18 and older) that help with activities of daily living and taking medication. To find out about these benefits, call the state Medicaid Help Line at 1-877-254-1055. Additional coverage for items not covered under standard benefits, such as, wound supplies, hospital bed and mattresses, insulin pump and infusion pump. Services for people to have one-on-one therapy sessions with a mental health professional. These tables list the services covered by our Plan. Medical supplies are items meant for one-time use and then thrown away. Once the newborn is discharged, the breast pump will no longer be covered; or A breast pump will be covered for babies who have congenital anomalies that interfere with feeding. Transfers between hospitals or facilities. We cover 365/366 days of services per calendar year, as medically necessary. Hearing services include: assessment, hearing evaluation, hearing aid fitting, hearing aid monaural in ear, behind ear hearing aid, hearing aid dispensing fee, in ear binaural hearing aid, behind ear binaural hearing aid, behind ear cors hearing aid and behind ear bicros hearing aid. Testing services by a mental health professional with special training in infants and young children. Health care services provided in a county health department, federally qualified health center, or a rural health clinic. Emergency mental health services provided in the home, community or school by a team of health care professionals. Are You Pregnant? Available for long distance medical appointment day-trips. Covered as medically necessary for children ages 0-20. Electric Breast Pump (E0603)/ Standard/Manual Breast Pump (E0602)Hospital Grade Pumps (E0604) Hospital Grade Pumps (E0604) Effective for dates of service on or after April 12, 2019: One electric or manual breast pump is covered per birth event (birth or adoption) beginning at the 27th week of pregnancy (third trimester) or birth of a child should the birth occur earlier than 27 weeks. We cover preventive services and tests, even when you are healthy. Services must be medically necessary and provided in a county health department, federally qualified health center, or a rural health clinic. Substance Abuse Intensive Outpatient Program*. See information on Patient Responsibility for room & board. AAC fitting, adjustment and training; up to four 30-minute sessions per calendar year. Home Delivered Meals - Disaster Preparedness/ Relief. We cover hearing tests and the following as prescribed by your doctor, when medically necessary: Nursing services and medical assistance provided in your home to help you manage or recover from a medical condition, illness or injury. Nutritional Assessment/ Risk Reduction Services. Check Your Eligibility In 3 easy steps! Hearing tests, treatments and supplies that help diagnose or treat problems with your hearing. Medical care, treatment and emotional support services for people with terminal illnesses or who are at the end of their lives to help keep them comfortable and pain free. Talk to a lactation consultant or breastfeeding counselor for practical help and tips to get started. Up to 480 hours per calendar year, as medically necessary. Apple Health covers deliveries provided by a licensed midwife, nurse midwife or physician. Surgery and other procedures that are performed in a facility that is not the hospital (outpatient). One initial assessment per calendar year. We cover the following as prescribed by your doctor, when medically necessary: Services to children ages 0-3 who have developmental delays and other conditions. Up to two training or support sessions per week. Substance abuse treatment of detoxification services provided in an outpatient setting. Up to 150 minutes of brief behavioral health status assessments (no more than 30 minutes in a single day). Expanded benefits are extra goods or services we provide to you, free of charge. Provided to members with behavioral health conditions and involves activities with trained animals. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change. Provided to members with behavioral health conditions and involves activities with horses. It does not include major changes like new carpeting, roof repairs, plumbing systems, etc. We cover medically necessary family planning services. Provided to members with behavioral health conditions and involves activities with horses. Health care services provided in a county health department, federally qualified health center, or a rural health clinic. Assisted living facility or adult family care home. Visual aids are items such as glasses, contact lenses and prosthetic (fake) eyes. The benefit information provided is a brief summary, not a complete description of benefits. Breast pumps are covered through all health plans including Medicaid, CHIP, and Tricare. If you have questions about any of the covered medical services, please call Member Services. Must be in the custody of the Department of Children and Families. They also offer comfort through physical and emotional support. Breast Pump Death. Two hundred dollars ($200) per day up to one thousand dollars ($1,000) per year for trips greater than one hundred (100) miles. As a Sunshine Health member, you get these doula benefits at no-cost: Doula visits can be at your home, doctors office or in a public place. Transportation provided by ambulances or air ambulances (helicopter or airplane) to get you to a hospital because of an emergency. After 4 to 6 Weeks: You can call 1-877-659-8420 to schedule a ride. Follow-up wheelchair evaluations, one at delivery and one six months later. Services that treat conditions, illnesses or diseases of the lungs or respiratory system. Services for women who are pregnant or want to become pregnant. Limitations, co-payments and restrictions may apply. This means they are optional services you can choose over more traditional services based on your individual needs. Or, let's be honest, just get a few more minutes of sleep.