sunshine health breast pump coverage sunshine health breast pump coverage

For more information contact the Managed Care Plan. 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. Remember, services must bemedically necessary in order for us to pay for them. Services for mental health or substance abuse needs. This program focuses on your health during your pregnancy and your babys first year. Up to three follow-up evaluations per calendar year. Services used to detect or diagnose mental illnesses and behavioral health disorders. A quick look at Healthline's picks for the best breast pumps Best all-around breast pump: Spectra S1 Plus Electric Breast Pump Best natural suction breast pump: Haakaa Silicone. Supervision, social programs and activities provided at an adult day care center during the day. This can be a short-term rehabilitation stay or long-term. There may be some services that we do not cover, but might still be covered by Medicaid. This can include any tests, medicines, therapies and treatments, visits from doctors and equipment that is used to treat you. Contact your care manager to determine eligibility. (Note: these items cannot be returned.) Intermittent and skilled nursing care services. Want to breastfeed your baby? Respiratory therapy includes treatments that help you breathe better. Because of the Affordable Care Act (ACA), health insurance providers are required to provide coverage for breastfeeding support, counseling, and equipment. One initial wheelchair evaluation per five years. Elvie Pump. SMI Specialty Plan members are eligible to receive $35 per household worth of OTC items each month. Doctor visits after delivery of your baby. 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. Treatments that help you do things in your daily life, like writing, feeding yourself and using items around the house. One frame every two years and two lenses every 365 days for adults ages 21 and older. Expanded benefits are extra services we provide to you at no cost. 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 As medically necessary, some service and age limits apply. Services provided to adults (ages 18 and older) that help with activities of daily living and taking medication. We cover the following medically necessary services when prescribed by your doctor: Services that test and treat conditions, illnesses and diseases of the eyes. Breast milk has certain proteins that help protect babies from common infections, food allergies, vomiting and diarrhea. We cover preventive services and tests, even when you are healthy. Assisted living facility or adult family care home. Mental health therapy in a group setting. You have to hire, train and supervise the people who work for you (your direct service workers). A manual, battery powered, or standard electric breast pump has been trialed and failed, and any . Maternal health benefits - Breastfeeding is linked to a lower risk of these health problems in women: type 2 diabetes; breast cancer; ovarian cancer; and. Services to help people who are in recovery from an addiction or mental illness. 5. Service provided in a hospital setting on an outpatient basis. Emergency mental health services that are performed in a facility that is not a regular hospital. Prior authorization may be required for some equipment or services. They also offer comfort through physical and emotional support. Breast pump, hospital grade rental; Sunshine Health is a managed care plan with a Florida Medicaid contract. One per day with no limits per calendar year. Unlimited hypoallergenic bedding and one (1) HEPA filter vacuum cleaner for members diagnosed with asthma. For information on obtaining doula services, read the Sunshine Health. These breast pumps are portable and lightweight, allowing for a comfortable pumping experience both at home and on the go. Here are some resources that can help. These are medical-grade garments designed by healthcare professionals that provide lots of health benefits for moms. Medical care and other treatments for the feet. 1 Flu/Pandemic Prevention kit; 3 ply face masks 10 piece; oral digital thermometer; hand sanitizer. If the member resides in a room other than a standard semi- private room, the facility may charge extra. The hospital grade breast pump will be covered upon the mother's discharge from the hospital HUSKY Health will not reimburse for a pump while the mother is inpatient. I was given an RX by my doctor for an electric pump, but I am curious as to which brands are available. Please contact your health care provider to connect with additional resources. Tell Us Right Away! We cover medically necessary blood or skin allergy testing and up to 156 doses per calendar year of allergy shots. Expert health content provided You don't necessarily need a professional to help your baby get the hang of breastfeeding. Transfers between hospitals or facilities. Please refer to Guidance for WIC Staff regarding HUSKY Health Coverage of Breast Pumps to determine who to contact. Services to diagnose or treat conditions, illnesses or diseases of the bones or joints. All services limited to one every two calendar years, except for hearing aid monaural in ear, which is one per calendar year. Services to treat conditions, illnesses, or diseases of the stomach or digestion system. This service delivers healthy meals to your home. If you have any questions about any of the covered services, please call your care manager or Member Services. The following are covered services: 1. Up to 26 hours per calendar year for adults ages 21 and over. Services for a group of people to have therapy sessions with a mental health professional. Support services are also available for family members or caregivers. Up to $5,000 per lifetime to assist member in moving out of a nursing facility. Visual aids are items such as glasses, contact lenses and prosthetic (fake) eyes. Services must be medically necessary (PDF)in order for us to pay for them. Except for emergency care, Sunshine Health must prior authorize any services provided by an out-of-network provider and any elective inpatient admissions. Or find a chapter of La Leche League, a group led by moms who offer support and encouragement to women looking to breastfeed. If there are changes in covered services or other changes that will affect you, we will notify you in writing at least 30 days before the effective date of the change. Provided to members with behavioral health conditions and involves activities with horses. Non-emergency transportation non-medical purposes. One initial assessment per calendar year. Occupational therapy includes treatments that help you do things in your daily life, like writing, feeding yourself and using items around the house. Doulas are trained non-medical companions that support pregnant people. Outpatient visits with a dietician for members. Durable medical equipment is used over and over again, and includes things like wheelchairs, braces, crutches and other items. Intensive outpatient treatment for alcohol or drug services and behavioral health treatment or services. Breast pumps that are hospital-grade are specifically designed for multiple users, with a special closed system that makes the pump safe for moms to share. Limitations, co-payments and restrictions may apply. Keep in mind, however, that your exact plan will specify the type of pump they will cover (electric or manual), the length of a rental, and whether the pump . Other moms may have additional ideas or offer the support you need. Including health focused clinical interview, behavioral observations, and health and behavioral interviews for individual, group and family (with or without the patient). Regional Perinatal Intensive Care Center Services. Durable Medical Equipment/ 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. But it's up to you and your doctor to decide what's right . Services to diagnose or treat conditions, illnesses or diseases of the brain, spinal cord or nervous system. Massage of soft body tissues to help injuries and reduce pain. Home visit by a clinical social worker to assess your needs and provide available options and education to address those needs. Services that help children with health problems who live in foster care homes. One therapy re- evaluation per six months. This means they are optional services you can choose over more traditional services based on your individual needs. This can be a short-term or long- term rehabilitation stay. Services that treat conditions, illnesses or diseases of the lungs or respiratory system. Doulas are trained non-medical companions that support pregnant people. Pump more and save more when you purchase your Willow pump with insurance. Available for long distance medical appointment day-trips. Pregnancy, postpartum and newborn care and assessment provided in your home by a doula. Services used to detect or diagnose mental illnesses and behavioral health disorders. Transportation to and from all of your LTC program services. Additional minutes for SafeLink phone or Connections Plus plan. It may reduce your risk of ovarian and breast cancer. Benefits, formulary, pharmacy network, premium and/or co-payments/co-insurance may change. Call 1-866-796-0530 (TTY: 1-800-955-8770) for more information. Services for women who are pregnant or want to become pregnant. As part of your Kansas Medicaid benefits and coverage, Sunflower Health Plan can help you find a provider, find local resources, plan an appointment and find transportation. According to Healthcare.gov, health insurance providers are required to cover the costs of a breast pump. They also include portable x- rays. If your insurance company does not cover a breast pump, MedSource will work with you to find an affordable option. Postpartum doulas may have additional ideas to help you become more comfortable or more confident in the process. Maximum 60 days per calendar year. Less work missed - Breastfeeding mothers miss fewer days from work, because their infants are sick less often. 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. Training and counseling for the people who help take care of you. Financial assistance to members residing in a nursing home who can transfer to independent living situations. Transfers between hospitals or facilities. A plan may cover 100% of the cost of a breast pump or may cover only a fraction of the cost. Detoxification or Addictions Receiving Facility Services*. You may be offered the Participant Direction Option (PDO). Massage of soft body tissues to help injuries and reduce pain. These services are free. One evaluation of oral pharyngeal swallowing per calendar year. Extra nursing help if you do not need nursing supervision all the time or need it at a regular time. Services to treat conditions such as sneezing or rashes that are not caused by an illness. It may help with brain development and learning. One per day and no limit per calendar year. Doctor visits after delivery of your baby. One initial wheelchair evaluation per 5 years, Follow-up wheelchair evaluations, one at delivery and one 6-months later. Services to help people understand and make the best choices for taking medication. Breast pumps will only be covered once per 3 years, and if the item is used for multiple pregnancies during the reasonable useful lifetime, only the kits will be covered. Up to three visits per day for all other members. It can lower your risk for osteoporosis, a disease that weakens your bones. Short term residential treatment program for pregnant women with substance use disorder. manual breast pumps along with supplies are considered medically necessary and are a Patient Protection and Affordable Care Act Women's Preventive Health Services mandate, effective August 1, 2012. Asthma Supplies. As medically necessary and recommended by us. Behavioral health services provided in a group home setting for children ages 021 who have experienced trauma and are in the child welfare system. A review of all the prescription and over- the-counter medications you are taking. With a range of breast pump brands and insurance-covered maternity compression garments, Pumps for Mom can help make new and expectant moms' lives easier. Comprehensive Behavioral Health Assessments. get your motherhood essentials in 3 simple steps Provide your insurance information We verify your coverage and submit all required paperwork on your behalf Or, let's be honest, just get a few more minutes of sleep. FREE SHIPPING on orders over $75! One new hearing aid per ear, once every three years. Services used to help people who are struggling with drug addiction. You can call 1-877-659-8420 to schedule a ride. Up to 26 hours per calendar year for adults ages 21 and over. It's easier to prepare than formula and is always at the correct temperature. X-rays and other imaging for the foot, ankle and lower leg. Services for people to have one-on-one therapy sessions with a mental health professional. Services for families to have therapy sessions with a mental health professional. One visit per month for people living in nursing facilities. Up to three follow-up evaluations per calendar year. Hospital-grade breast pumps are used by mothers of NICU babies or when medical issues may hinder mom & baby's ability to successfully breastfeed. Limitations, co-payments and restrictions may apply. sunshine health breast pump coverage sunshine health breast pump coverage on Jun 11, 2022 on Jun 11, 2022 It does not include major changes like new carpeting, roof repairs, plumbing systems, etc. Sunshine Health is a managed care plan with a Florida Medicaid contract. Breast pumps can be issued to both mothers and babies enrolled in Medicaid or CHIP. Provided to members with behavioral health conditions in an outpatient setting. Breast pump supplies . The American Academy of Pediatrics recommends that babies be given exclusively breast milk for their first six months of life or even longer. Educational services for family members of children with severe emotional problems focused on child development and other family support. Health care services provided in a county health department, federally qualified health center, or a rural health clinic. Asthma Supplies. Covered as medically necessary. Must be diagnosed with asthma to qualify. Services for doctors visits to stay healthy and prevent or treat illness. Find out what breast pump you qualify for through your insurance. Surgery and other procedures that are performed in a facility that is not the hospital (outpatient). They can answer questions about pregnancy, labor and caring for your baby after birth. Home delivered meals post inpatient discharge. Home Delivered Meals - Disaster Preparedness/ Relief. Up to 45 days for all other members (extra days are covered for emergencies). What you may not know is that thanks to the Affordable Care Act, breast pumps are covered under most health insurance policies for free. 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. Available for members aged 17 through 18.5. Home visit by a clinical social worker to assess your needs and provide available options and education to address those needs.