Pregnant Women And Infants
Healthy Connections provides coverage to pregnant women with low income. This coverage for the mother continues for 60 days after the baby’s birth. The infant is covered up to age one.
A woman who may qualify for this program must:
- Be pregnant
- Be a South Carolina resident
- Be a U.S. citizen or Lawful Permanent Resident Alien
- Have a Social Security number or verify an application for one
Individuals who are eligible will receive all Medicaid covered services.
Apply online or complete the following form and submit it electronically to , by mail to SCDHHS-Central Mail, P.O. Box 100101, Columbia, SC 29202-3101 or to your .
The Omnibus Budget Reconciliation Act of 1986 gave states the option to provide Medicaid coverage to pregnant women with low income.
Adding Your Newborn To Medicare
Enrolling your newborn in Medicare will allow them to receive free or lower cost healthcare and prescriptions. Your baby will also get free treatment in a public hospital as a public patient. Here is some information to help you enrol your newborn in Medicare.
As soon as you add your baby to your Medicare card, they will have access to subsidised or free healthcare.
If your baby is 52 weeks old or less, you can register them using a Newborn Child Declaration form. This form is provided in the Parent Pack you get from your midwife or hospital. The back page of the form will need to be filled out and signed by the midwife or doctor who attended your babys birth. Submitting this form will automatically enrol your baby in Medicare. The form has instructions on how to fill it out.
You can upload your Newborn Child Declaration form using your Medicare online account. You will be sent a Medicare card with your baby on it in 3 to 4 weeks. You can get a digital version of the card straight away in the Express Plus Medicare app.
You can also enrol your baby using your Centrelink online account when you claim any one of these payments:
- Family Tax Benefit including Newborn Upfront Payment and Newborn Supplement
- Parental Leave Pay
- Dad and Partner Pay
You should fill in the Newborn Child Declaration form from your Parent Pack and submit it through either:
- your Centrelink online account through myGov
- your Express Plus Centrelink mobile app
While You Wait For Baby
While preparing for your newborns arrival, research your maternity and newborn benefits. Check your plans Summary Plan Description and Summary of Benefits and Coverage documents, or call your insurer. If you and your spouse/partner each have coverage through your employer, compare plans to see which makes the most sense for your family.
You may also want to check your states maternity and newborn coverage rules, which you can find through the National Association of Insurance Commissioners.10
Reach out to your company contact or your health insurer to add your baby to your coverage, and notify them within 30 days of birth, adoption, or placement for adoption. If you have or switch to a Marketplace plan, youll have 60 days from the date of birth or adoption.
Then get all the sleep you can before the baby arrives.
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Medicaid And Your New Baby
If you have a baby while you are on Medicaid or ARKids First, your baby will most likely be able to get Medicaid too.
You need to fill out paperwork on your new baby as soon as you can.
- Go to the DHS office in your county, or
- Fill out an application on the Internet.
Youll need a birth certificate or some kind of proof of your babys age.
Make sure your baby sees the doctor for well-child check-ups and shots. If your baby has Medicaid or ARKids First, these services are paid for. Talk to your doctor about how often your baby needs well-child check-ups.
If You Dont Have Health Coverage
- Health coverage makes it easier to get the medical check-ups and screening tests to help keep both you and your baby healthy during pregnancy.
- If you qualify for a Special Enrollment Period due to a life event like moving or losing other coverage, you may be able to enroll in a Marketplace health plan right now. Being pregnant doesnt make you eligible, but the birth of a child does.
- Create an account now to apply for Marketplace coverage through the Open Enrollment Period or a Special Enrollment Period. If you select the option to get help paying for coverage on your application, youll be asked if youre pregnant. Reporting your pregnancy may help you and your family members get the most affordable coverage.
- If you dont qualify for a Special Enrollment Period right now, youll be eligible to apply within 60 days of your childs birth. You can also enroll in 2021 coverage during the next Open Enrollment Period this fall.
- If eligible for Medicaid or CHIP, your coverage can begin at any time.
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Pregnancy And Newborn Services
Prenatal care is an important way to keep you and your baby healthy during your pregnancy. These regular checkups allow doctors to find and treat health problems early, if needed. They also help make sure your baby is growing and developing properly.
Its important to see a doctor if you are planning on becoming pregnant, or as soon as you know you are pregnant. If you need help finding an OB-GYN, we can help. Use our Find a Provider tool or call Member Services at 1-855-463-4100.
Lead Screening Helps Keep Your Baby Safe From Lead Poisoning
Very young children are curious! They love to explore. But lead poisoning from lead paint, chips and dust, and lead in water, can interfere with growth, harm hearing, lower IQ scores and cause behavioral problems. There are usually no signs or symptoms until a child is seriously ill with lead poisoning. To check for lead poisoning, have a simple blood test for lead at regular appointments around your child’s first and second birthdays.
You can get an early start protecting your baby from lead by:
- Using cold tap water, not hot, to make infant formula. Let the cold water run for at least a minute to remove any lead picked up from the pipes.
- Using iron-fortified infant formula and cereals for toddlers, to help lower your baby’s lead risk.
- Washing your baby’s hands, pacifier and toys often.
- Being sure your toddler doesn’t put paint chips or plaster in his or her mouth, or chew on windowsills or stair rails.
- Damp mopping floors to remove lead dust.
- Keeping your toddler out of the house during any home renovations.
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Ways To Apply For Chip:
- Fill out an application through the Health Insurance Marketplace®. If it looks like anyone in your household qualifies for Medicaid or CHIP, well send your information to your state agency. Theyll contact you about enrollment. When you submit your Marketplace application, youll also find out if you qualify for an individual insurance plan with savings based on your income instead. Create an account or log in to an existing account to get started.
FYI: Apply any time
You can apply for and enroll in Medicaid or CHIP any time of year. Theres no limited enrollment period for either Medicaid or CHIP. If you qualify, your coverage can start immediately.
How To Enroll In Medicaid
You or members of your family may qualify for Medicaid through Maryland Health Connection to receive free or low-cost health care. Enrollment in Medicaid and the Maryland Childrens Health Program is available any time of year.
Are you eligible for Medicaid?
Look up your income and household size below to see if you may qualify. If youre pregnant or have children, you may earn more and still qualify.
|You may be eligible for Medicaid if your monthly income is up to approximately:|
|If your household size is this||Adults|
Effective February 1, 2021 *Premium cost is per family / household each month
What does Medicaid cover?
Your managed care organization covers doctor visits, pregnancy care, prescription drugs, hospital and emergency services, and more, at no cost.
How do you enroll in Medicaid or MCHP?
2. Check for available help
Get answers and advice on all of your health coverage options before you select your plan. Search for free, local help.
3. Send verification documents as needed
You will receive a notice if we need documents to complete your application.
4. Choose a doctor and a Managed Care Organization
Ask your doctors which MCOs they accept or use the MCO search tool.
5. Pay your bill
- What is Medicaid & How Do I Apply?
- Enrolling in Medicaid
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What Do You Need To Do Before Your Baby Is Born
While youre preparing for your baby to arrive, review the costs and benefits of your current health insurance and compare them to other plans and options . If you find a better option, reach out to the new insurer to make the switch after your baby is born.
If you have other children, it may not cost you more to add the newborn.
Maternity and newborn care are part of the essential health benefits required by the Affordable Care Act.
Will Your Health Insurance Cover Your Newborn
Yes, regardless of whether you have an individual or family health insurance plan, your newborn will be covered for the first 30 days of life. At this time, nothing about your policy or deductible will change as checkups and other care for your baby are included within the mothers coverage.
After that, securing ongoing health insurance coverage for your newborn will require that you speak to your insurance company and update your insurance policy to a family plan. Unfortunately, ongoing care after day 31 of your childs life isnt deemed essential.
As for eligibility, note that having a child is considered a qualifying life event in the same category as marriage, divorce, and citizenship changes. That means you can take advantage of a 60-day special enrollment period to update your health insurance plan to include your infant.
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What To Do If Confirmatory Testing Or Treatment Is Needed
If a client is found to screen positive for any genetic disorders, confirmatory testing and treatment may be needed. If confirmatory testing or immediate treatment is needed, DSHS case management staff will contact the provider about next steps. Typically, confirmatory testing and treatment are recommended by metabolic specialists. The confirmatory laboratory tests are conducted by private laboratories, and are later billed to the health plans. Contracted CHIP or CHIP perinatal providers should contact the CHIP health plan for more information.
How To Add A Baby To Health Insurance
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As you welcome a new baby into your family, you may be considering how you can ensure your new addition has health insurance coverage. If you have health insurance already through your employer or through a family health care plan, you can add your new baby to your existing health plan by following several steps.
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Newborn’s Effect On The Eligibility Of Other Household Members’ Mo Healthnet
Determine the effect of the child’s birth on the family’s eligibility for other MO HealthNet coverage. When the child is determined eligible under the Newborn program, use the date of birth as the application date to add the newborn as a member of an active Family MO HealthNet or MO HealthNet for Kids case.
NOTE: If the birth of a newborn is reported timely, the effective date of any coverage changes for the household is the newborn’s birthdate. If birth of a newborn is not reported timely, the effective date of any coverage changes for the household is the date the birth was reported.
If You Have Medicaid Or Chip
- If found eligible during your pregnancy, youll be covered for 60 days after you give birth. After 60 days, you may no longer qualify. Your state Medicaid or CHIP agency will notify you if your coverage is ending. You can enroll in a Marketplace plan during this time to avoid a break in coverage.
- If you have Medicaid when you give birth, your newborn is automatically enrolled in Medicaid coverage, and theyll remain eligible for at least a year.
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Is A Woman Who Has Access To A Family Members Employer
Possibly. If the employer-sponsored insurance is unaffordable or not MEC, the woman is eligible for APTCs. Affordability is determined by the IRS standards for the percentage of income a person is expected to spend on insurance. This calculation applies to the cost of the employees insurance, not the cost of the family plan. That means that if the premiums for the employees insurance are affordable, no member of the family is eligible for an APTC. If the individuals premium is unaffordable, the family will be eligible for APTCs in an amount determined by their income and the premium cost.
Will A Marketplace Health Plan Also Cover A Newborn
Yes. The ACAs EHB requirement mandates coverage of maternity and newborn care. Newborn care covers childbirth and immediate care for the baby after birth. The specifics of this coverage will vary by state and by each individual plan, but all women in Marketplace coverage must also enroll their baby in coverage soon after birth.
If the newborn is eligible for Marketplace coverage, then the parents can choose to add the baby to the familys existing Marketplace plan or choose a new Marketplace plan for the baby. If they opt for the latter, they can enroll the baby into a new Marketplace plan at any metal tier. However, when enrolling a newborn into Marketplace coverage, other members of the household are generally not permitted to change their existing Marketplace coverage.
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