October 18, 2023

Understanding Medicaid: Coverage Basics for New and Expecting Moms

Medicaid covers more than 40% of births in the United States. But Medicaid is a complex program, and understanding coverage for the benefits you need can be confusing.

Fortunately, Lucina’s care service providers can help. In conjunction with information gleaned from our AI-enabled maternity analytics, our care service providers are available to quickly connect moms and babies with the Medicaid-covered resources that are most helpful for each family’s personal circumstances.

Moms are often surprised to learn that Medicaid coverage extends beyond medical visits to include many types of support for new and expecting parents. Maternal health Medicaid benefits include:

  • Prenatal visits
  • Maternal-fetal medicine visits, if needed
  • Birth of the baby
  • Hospital stay after giving birth
  • Pharmacy
  • Ultrasounds
  • On some plans, non-emergent transportation
  • 24/7 nurse line
  • A maternity-focused program with high-risk case management
  • Postpartum visits
  • Assessments, counseling, and medication for postpartum depression
  • Family planning coverage for contraceptive care

After giving birth, mom will continue to have Medicaid coverage.

Until baby is enrolled in Medicaid, the newborn is usually on mom’s insurance. The length of time Medicaid covers baby for pediatric services under mom’s plan varies by state. Some states require newborns to have their own Medicaid ID for pediatric billing.

Some managed care organizations offer value-added benefits, which are additional benefits covered by Medicaid. Sometimes called expanded benefits, common examples your plan may include are:

  • Transportation to social services appointments, such as the WIC nutrition program
  • High school equivalency (GED) assistance
  • Free cell phones
  • Car seats and car seat checks
  • Pregnancy substance abuse programs
  • Smoking cessation programs
  • In-home obstetric support, for those who are eligible
  • Housing resources
  • Incentive programs for attending regularly scheduled prenatal and postpartum visits
  • Lactation support
  • Allowance for non-prescription medications and medical supplies
  • Dental care
  • Virtual baby showers with gifts and information about what to expect postpartum
  • Community events and resource fairs
  • Free breast pumps
  • Boys and Girls Club memberships
  • Health education classes on topics such as childbirth, infant care, poison prevention, water safety, gun safety and parenting
  • Doula services

Your managed care organization can provide more information on their value-added benefits and a complete list of services your plan offers.

These programs can make a huge difference in the start of mom and baby’s life together. For example, when a mom with a high-risk pregnancy was not attending prenatal and maternal-fetal medicine appointments, one of our care service providers learned that the mom was struggling with financial challenges. Her phone was often cut off and she did not have a way to get from home to appointments.

Upon learning about these problems, our care service provider was able to connect the mom to free phone and transportation programs. That same day, the mom was set up with a phone and arrangements for rides to her next three appointments. In the end, this mom was able to make it to all her other appointments and delivered a healthy baby.

For more information about Lucina’s AI-enabled predictive analytic tool and care service providers, contact us here. And don’t forget to follow us on LinkedIn and Twitter.