Maternity Benefits
The Simplified Medical Plan will pay for most in-network maternity services through a global fee arrangement. Under such an arrangement, the copays that a member will be assessed are:
- $15 copay for an initial office visit with OB/GYN (i.e., to confirm pregnancy)
- Lab or standard radiology copays associated ultrasounds, amniocentesis, fetal stress tests and other related tests
- Inpatient hospital copay for delivery (per day in the hospital) Additional copays will apply for high risk or complex pregnancies.
If the obstetrician is out-of-network and/or does not have a global fee arrangement in place, the member will be charged for each visit and service based upon the copay for that service.