Coverage during pregnancy: what to expect
There’s nothing quite like seeing those two pink lines emerge on a pregnancy test. With nine months of gestation, the postpartum period, and beyond, it’s the beginning of many people’s biggest health journey to date. While the journey doesn’t look the same for everyone, the road is typically paved with tests, imaging, a hospital stay and more.
While this all can feel daunting, Comfort® members can have peace of mind knowing exactly what’s covered during pregnancy and postpartum care.
The average pregnancy requires 10 to 15 prenatal appointments. Attending these appointments is a proven way to achieve better health outcomes for both mom and baby. For in-network providers (both OB-GYNs and certified nurse-midwives), these appointments are always covered.
The first prenatal appointment often includes discussion about prenatal testing options, with standard, non-elective tests being covered under Comfort. Additional testing may also be recommended for high-risk pregnancies, including for members age 35 and older.
Later in a pregnancy, there are also tests for gestational diabetes, infections (group B strep, hepatitis B, HIV and others), as well as blood tests for anemia and Rh compatibility. These tests are always covered.
At the first prenatal appointment (usually around 8 weeks), most women will have their first ultrasound and get to see baby for the first time. That ultrasound, and any others ordered by an in-network provider, are fully covered.
Your provider will also recommend ensuring the following vaccinations are up to date:
- Flu vaccine
Any standard immunizations like these are always fully covered.
Sometimes providers will refer women to see a maternal fetal medicine specialist for a high-risk situation. In those situations, as well as any others that require a visit to a specialist, it’s covered.
Chiropractic Care and Physical Therapy
Pregnancy can take a toll on backs and introduce new aches and pains – from sciatica to round ligament pain – that a chiropractor can help address. With Comfort, acute chiropractic care is covered.
Similarly, physical therapy may help manage new issues that emerge during pregnancy, for things like pelvic floor concerns, and in-network physical therapists are covered under Comfort.
Prior to delivery, we recommend members contact Gravie Care™ to get a more detailed idea of what expenses from a hospital or birthing center would look like, as this is where members can expect to see some bills, regardless of their birth story. Assuming mothers used all in-network providers, Gravie members will only see hospitalization and delivery-related bills up to the out-of-pocket maximum that their employer set when choosing a plan. Remember that Gravie offers Gravie Pay® to help with big healthcare costs such as these. It’s an interest-free, pay-over-time option similar to retail versions like Klarna and Afterpay.
The delivery is over – now what’s covered? All postnatal care and appointments, as well as in-network lactation appointments. When 1 in 7 women can experience postpartum depression, as well as 1 in 10 men experiencing depression after the birth of a child, it’s worth noting that with Gravie, in-network therapy is always covered. Additionally, all generic birth control prescriptions (oral/injectable/implantable) are covered. The postnatal period can be quite an adjustment – for baby and family alike. We want members to feel comfortable reaching out and getting the help they need.
The pregnancy journey is like none other – and through it all, Gravie is a true partner.
For any questions on what’s covered for maternal health with Comfort, contact us.