Or find a chapter of La Leche League, a group led by moms who offer support and encouragement to women looking to breastfeed. Get up to $250 per year to help with living costs like utilities and more, Transition Assistance Nursing facility to community setting. NOTE: Services marked with an asterisk (*) are behavioral health in lieu of services. 1 Flu/Pandemic Prevention kit; 3 ply face masks 10 piece; oral digital thermometer; hand sanitizer. 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. Download the free version of Adobe Reader. One initial wheelchair evaluation per five years. Limited to members who live alone or who are alone for significant parts of the day who would otherwise require extensive supervision. Lightweight, portable pump with single and double pumping capability, quiet pump motor, and 100% anti-backflow design helps eliminate wasted milk. Services provided to pregnant women and newborns in hospitals that have special care centers to handle serious conditions. Pregnancy, postpartum and newborn care and assessment provided in your home by a doula. This can be a short-term or long- term rehabilitation stay. The Affordable Care Act requires most health insurance plans to cover breastfeeding services and supplies. Up to three screenings per calendar year. Please contact your health care provider to connect with additional resources. A doula is a professional assistant, but not a medical professional. Massage of soft body tissues to help injuries and reduce pain. One therapy re- evaluation per six months. Ordering a breast pump for your baby can be completely free, and Acelleron does all the work involved in making that happen. 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. Non-emergency transportation non-medical purposes. Services for families to have therapy sessions with a mental health professional. For children up to 21 there are no limits if medically necessary. You will work with a case manager who can help you with PDO. There are no appointments required and you can call as often as you need to. Help taking medications if you cant take medication by yourself. Some service limits may apply. That's pretty amazing! Services to help get medical and behavioral health care for people with mental illnesses. Talk to friends or family members. This means they are optional services you can choose over more traditional services based on your individual needs. Apple Health covers deliveries provided by a licensed midwife, nurse midwife or physician. Health care services provided in a county health department, federally qualified health center, or a rural health clinic. Additional coverage for items not covered under standard benefits, such as, wound supplies, hospital bed and mattresses, insulin pump and infusion pump. Emergency mental health services that are performed in a facility that is not a regular hospital. We will work with your insurance company to determine benefits for your insurance covered breast pump and file an insurance claim on your behalf. After 4 to 6 Weeks: 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. Even though the American Academy of Pediatrics recommends that all mothers breastfeed for at least six months, that's not always possible. Covered as medically necessary for children ages 0-20. There may be some services that we do not cover, but might still be covered by Medicaid. Services that include imaging such as x-rays, MRIs or CAT scans. We cover 365/366 days of services in nursing facilities as medically necessary. This contact information is for WIC Staff Use only. Surgery and other procedures that are performed in a facility that is not the hospital (outpatient). Durable Medical Equipment/ These are medical-grade garments designed by healthcare professionals that provide lots of health benefits for moms. Prior authorization is required for voluntary admissions. Standard assessment of mental health needs and progress. Substance Abuse Short-term Residential Treatment Services/ Residential Outpatient Services*. If patients request more information, please direct them to Member Services at 1-800-682-9090 (TTY 711). Services to treat conditions, illnesses, or diseases of the genitals or urinary system. Follow-up wheelchair evaluations, one at delivery and one six months later. The system must be able to be used by attachment to an electric breast pump or manually. Order now. If your insurance company does not cover a breast pump, MedSource will work with you to find an affordable option. Ambulance services are for when you need emergency care while being transported to the hospital or special support when being transported between facilities. Designed to be discreet, the Elvie Pump is a breastfeeding mom's best friend. In some cases, you can rent or buy an electric breast pump. * Limitations do not apply to SMI Specialty Plan. Sessions as needed Up to 26 hours per calendar year for adults ages 21 and over. Two hundred dollars ($200) per day up to one thousand dollars ($1,000) per year for trips greater than one hundred (100) miles. Short-term substance abuse treatment in a residential program. A review of all the prescription and over- the-counter medications you are taking. Services for children with severe mental illnesses that need treatment in a secured facility. *Some Medicaid members may not have all the benefits listed. Sessions as needed 2. Educational services for family members of children with severe emotional problems focused on child development and other family support. You'll also need breast milk storage bags, bottles and nipples, in addition to cleaning supplies. Your child must be receiving medical foster care services. Rent A Hospital-Grade Breast Pump Month-by-Month! Getting a Breast Pump Covered 100% Free with Your Insurance Home / Ambetter Breast Pump Ambetter Breast Pump When it comes to feeding a baby, every family needs to decide what is best for them. One initial evaluation per calendar year. They also include portable x- rays. Oh Baby! Home delivered meals post inpatient discharge. Standard electric or manual breast pumps. Nursing services provided in the home to members ages 0 to 20 who need constant care. Up to three screenings per calendar year. You have to hire, train and supervise the people who work for you (your direct service workers). There may be some services that we do not cover, but might still be covered by Medicaid. X-rays and other imaging for the foot, ankle and lower leg. Verify insurance HANDS-FREE WEARABLE CORD-FREE HANDS-FREE WEARABLE CORD-FREE HANDS-FREE WEARABLE CORD-FREE HANDS-FREE WEARABLE CORD-FREE get your motherhood essentials in 3 simple steps Provide your insurance information We verify your coverage and submit all required paperwork on your behalf Excessive bleeding, like bleeding through one pad/hour or passing blood clots the size of a golf ball or bigger An incision that is not healing A red or swollen leg that is painful or warm when you touch it A fever 100.4F or higher A headache that does not get better after taking medicine or causes vision changes Remember, services must bemedically necessary in order for us to pay for them. Individual therapy sessions for caregivers. Sunshine Health is a managed care plan with a Florida Medicaid contract. Two hundred dollars ($200) per day up to one thousand dollars ($1,000) per year for trips greater than one hundred (100) miles. Yes, for dental procedures not done in an office. Additional minutes for SafeLink phone or Connections Plus plan. Limitations, co-payments and restrictions may apply. All services limited to one every two calendar years, except for hearing aid monaural in ear, which is one per calendar year. Educational services for family members of children with severe emotional problems focused on child development and other family support. You can get these services and supplies from any Medicaid provider; they do not have to be a part of our Plan. Note: Pacify is only available to download in the App Store or Google Play Store. Support services are also available for family members or caregivers. This service helps you fix meals, do laundry and light housekeeping. Breast milk has certain proteins that help protect babies from common infections, food allergies, vomiting and diarrhea. FREE SHIPPING on orders over $75! Federal health officials are warning parents of newborns, Thursday, March 2, 2023, to sterilize equipment used for both bottle- and breast-feeding after a baby died last year from a rare. Medical equipment is used to help manage and treat a condition, illness, or injury. Services must be medically necessary and provided in a county health department, federally qualified health center, or a rural health clinic. We cover 365/366 days of services per calendar year, as medically necessary. Prior authorization may be required for some equipment or services. Talk to your doctor if you're having a lot of pain or feel like your baby isn't getting enough to eat. You'll want to buy or rent a breast pump if a partner or loved one is going to help at feeding time. Elvie Pump. Up to three follow-up evaluations per calendar year. A. Breast pumps are covered under your Sunshine Health Medicaid plan. One visit per month for people living in nursing facilities. Figuring out insurance coverage was never easy, and the affordable care act has changed the landscape for Services for people to have one-on-one therapy sessions with a mental health professional. Emergency substance abuse services that are performed in a facility that is not a regular hospital. Up to $5,000 per lifetime to assist member in moving out of a nursing facility. 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. Services for doctors visits to stay healthy and prevent or treat illness. One initial evaluation per calendar year. 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. 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). Limited to members who reside in adult family care homes. Women's Health - Breast Cancer Screening 77067, 77063, G0202, R403 Screening mammography Once a year ages 35 and up Mobile Crisis Assessment and Intervention Services*. Low-cost interventions including early initiation when not feeding at the breast, listening to relaxation music, massage and warming of the breasts, hand expression and lower cost pumps may be as effective, or more effective, than large electric pumps for some outcomes. Are You Pregnant? Other plans will only cover this benefit when a baby shows medical need. You do not need prior approval for these services. Expanded benefits are extra services we provide to you at no cost.