Non-emergency transportation non-medical purposes. You will need Adobe Reader to open PDFs on this site. Child Health Services Targeted Case Management, Services provided to children (ages 0- 3) to help them get health care and other services. Services that test blood, urine, saliva or other items from the body for conditions, illnesses or diseases. Medical equipment is used to help manage and treat a condition, illness, or injury. The benefit information provided is a brief summary, not a complete description of benefits. Services for families to have therapy sessions with a mental health professional. One initial evaluation per lifetime, completed by a team. Member is responsible for paying ALF room and board. Prior authorization may be required for some equipment or services. Breast Pumps Date of Origin: 09/2019 Last Review Date: 07/27/2022 Effective Date: 08/01/2022 . The, Talk to a postpartum doula. Purchase it from a brick-and-mortar medical supply store. Services that treat conditions, illnesses or diseases of the lungs or respiratory system. For children under the age of 21, we cover medically necessary: Services that include tests and treatments to help you talk or swallow better. These expenses cover a wide range of healthcare needs, including breastfeeding products like breast pumps, nursing accessories, and breast pump spare parts pre-tax. Family Training and Counseling for Child Development*. 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. If you have questions about any of the covered medical services, please call Member Services. Nutritional Assessment/ Risk Reduction Services. Personal toiletries and household items such as detergent, bleach and paper towels are covered as medically necessary. We cover the following as prescribed by your doctor, when medically necessary: Services to children ages 0-3 who have developmental delays and other conditions. One evaluation of oral pharyngeal swallowing per calendar year. A plan may cover a hospital-grade breast pump for any mom. Services for members ages 0-20 to help you breathe better while being treated for a respiratory condition, illness or disease. A. Outpatient visits with a dietician for members. To learn about breast pump coverage under your Independence plan, contact Customer Service at 1-800-ASK-BLUE (1-800-275-2583) (TTY:711). For more information contact the Managed Care Plan. 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. Emergency services are covered as medically necessary. Less work missed - Breastfeeding mothers miss fewer days from work, because their infants are sick less often. Apple Health covers one manual breast pump per lifetime. Medical care, treatment and emotional support services for people with terminal illnesses or who are at the end of their lives to help keep them comfortable and pain free. Respiratory therapy in an office setting. NOTE: Services marked with an asterisk (*) are behavioral health in lieu of services. * Limitations do not apply to SMI Specialty Plan. You can rent one from the hospital, or buy one from an in-network durable medical equipment (DME) vendor. Emergency substance abuse services that are performed in a facility that is not a regular hospital. You can use this service in your home, an Assisted Living Facility or a Nursing Facility. Order Your Insurance-Covered Breast Pump Today! They can answer questions about pregnancy, labor and caring for your baby after birth. Postpartum doulas may have additional ideas to help you become more comfortable or more confident in the process. Tell Us Right Away! Remember, services must be medically necessary in order for us to pay for them. These breast pumps are portable and lightweight, allowing for a comfortable pumping experience both at home and on the go. Limitations, co-payments and restrictions may apply. Services to help people who are in recovery from an addiction or mental illness. Speech therapy includes tests and treatments that help you talk or swallow. As medically necessary, some service and age limits apply. Services to help get medical and behavioral health care for people with mental illnesses. Oh Baby! Excludes those adaptations or improvements to the home that are of general use and are not of direct medical or remedial benefit to the member. Structured mental health treatment services provided in a hospital four- six hours each day for five days per week. We cover medically necessary family planning services. You can get these services and supplies from any Medicaid provider; they do not have to be a part of our Plan. Hospital-grade breast pumps are used by mothers of NICU babies or when medical issues may hinder mom & baby's ability to successfully breastfeed. Large LCD screen designed to increase control by displaying suction level, mode, timing, an more. Medical care that you get while you are in the hospital. Storkpump is AdaptHealth's insurance covered breast pump program. 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, Information about pregnancy and newborn care, Community help with housing, food, clothing and cribs, Experienced and licensed medical staff to work with you and your doctor if any issues occur during your pregnancy, Text and email health tips for you and your newborn, In-person labor support at birthing location, Text, email and phone support between visits, 24/7 on-call support at 37 weeks until birth, Practice movement, positions and breathing for labor. Hearing tests, treatments and supplies that help diagnose or treat problems with your hearing. You can hire family members, neighbors or friends. One breast pump is covered per pregnancy. Transfers between hospitals or facilities. Services for people to have one-on-one therapy sessions with a mental health professional. Determined through multi- disciplinary assessment. Substance Abuse Short-term Residential Treatment Services/ Residential Outpatient Services*. Medical supplies are used to treat and manage conditions, illnesses or injury. These services are voluntary and confidential, even if you are under 18 years old. You will need Adobe Reader to open PDFs on this site. One evaluation of oral pharyngeal swallowing per calendar year. If your insurance company does not cover a breast pump, MedSource will work with you to find an affordable option. A health and wellness program for birth, baby and beyond. Services used to detect or diagnose mental illnesses and behavioral health disorders. As stated earlier, you may not see major results at first, however, the body will acclimate to the suction of the pump. Most of the United Healthcare benefit plans include coverage for the purchase of a personal-use, double-electric breast pump at no cost. Services provided to children (ages 020) who use medical foster care services. Services to treat conditions, illnesses, or diseases of the genitals or urinary system. This is available to members who are in a SNF or PDN setting and parent is obtaining guardianship to protect those who are unable to care for their own well-being. Services that include imaging such as x-rays, MRIs or CAT scans. Please let us know when you are pregnant by logging in to our secure member portal and filling out a Notice of Pregnancy form. Up to seven therapy treatment units per week. Home Children under age 21 can receive swimming lessons. Services that treat conditions, illnesses or diseases of the lungs or respiratory system. Services to treat conditions, illnesses, or diseases of the stomach or digestion system. *Some Medicaid members may not have all the benefits listed. Asthma Supplies. Services to help people who are in recovery from an addiction or mental illness. Breast pump, hospital grade rental; Sunshine Health is a managed care plan with a Florida Medicaid contract. Health care services provided in a county health department, federally qualified health center, or a rural health clinic. Speech and language therapy services in the office setting. This service helps you with general household activities, like meal preparation and routine home chores. Specialized Therapeutic Foster Care Services. Pumping Bras Pumping Essentials Pump Accessories You've got coverage. Additional minutes for SafeLink phone or Connections Plus plan. Priority Health has also partnered with Ovia for participants to have access to a free pregnancy tracker and Byram for covered breast pumps. Physical therapy includes exercises, stretching and other treatments to help your body get stronger and feel better after an injury, illness or because of a medical condition. The benefit information provided is a brief summary, not a complete description of benefits. Sunshine Health is a managed care plan with a Florida Medicaid contract. Must be diagnosed with asthma to qualify. per provider recommendation. Eligible for the first 1,000 members who have received their flu vaccine. Transportation provided by ambulances or air ambulances (helicopter or airplane) to get you to a hospital because of an emergency. One initial assessment per calendar year. That's pretty amazing! We cover the following inpatient hospital services based on age and situation, when medically necessary: Services to diagnose or treat skin conditions, illnesses or diseases. For information on obtaining doula services, read the Sunshine Health. Services provided to adults (ages 18 and older) that help with activities of daily living and taking medication. Up to three follow-up evaluations per calendar year. Intensive outpatient treatment for alcohol or drug services and behavioral health treatment or services. Visual aids are items such as glasses, contact lenses and prosthetic (fake) eyes. Services that test blood, urine, saliva or other items from the body for conditions, illnesses or diseases. Maximum of five hundred dollars ($500) per eligible enrollee per lifetime. This contact information is for WIC Staff Use only. Emergency substance abuse services that are performed in a facility that is not a regular hospital. Including health focused clinical interview, behavioral observations, and health and behavioral interviews for individual, group and family (with or without the patient). This service also includes dialysis supplies and other supplies that help treat the kidneys. Diagnosis and manipulative treatment of misalignments of the joints, especially the spinal column, which may cause other disorders by affecting the nerves, muscles and organs. One frame every two years and two lenses every 365 days for adults ages 21 and older. Medical care or skilled nursing care that you get while you are in a nursing facility. Sessions as needed Short term residential treatment program for pregnant women with substance use disorder. Family Training and Counseling for Child Development*. One evaluation/re- evaluation per calendar year. One initial evaluation per calendar year. Download the free version of Adobe Reader. Nursing services provided in the home to members ages 0 to 20 who need constant care. This program focuses on your health during your pregnancy and your babys first year. sunshine health breast pump coverage sunshine health breast pump coverage on Jun 11, 2022 on Jun 11, 2022 Two of the most popular breast pumps that may be covered by your Medicaid plan are the Smartpump 2.0 Starter Set and the Signature Pro Double Electric Breast Pump. Provided to members with behavioral health conditions and involves activities with horses. 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. Transfers between hospitals or facilities. Services to diagnose or treat conditions, illnesses or diseases of the bones or joints. Up to a 34-day supply of drugs, per prescription. One standard electric or manual breast pump per pregnancy; 2. Services must be medically necessary (PDF)in order for us to pay for them. One communication evaluation per five calendar years. Can be provided in a hospital, office or outpatient setting. You can get these services and supplies from any Medicaid provider; they do not have to be a part of our Plan. Except for emergency care, Sunshine Health must prior authorize any services provided by an out-of-network provider and any elective inpatient admissions. Please copy the WIC State agency Medical supplies are items meant for one-time use and then thrown away. One initial evaluation and re-evaluation per calendar year. They can answer questions about pregnancy, labor and caring for your baby after birth. We're here to help! Tap to START SAVING in 2023! Prenatal care is an important way to keep you and your baby healthy during your pregnancy. NOTE: Services marked with an asterisk (*) are behavioral health in lieu of services. Durable medical equipment is used over and over again, and includes things like wheelchairs, braces, crutches and other items. Up to two training or support sessions per week. Services provided to children ages 0- 20 with mental illnesses or substance use disorders. All services limited to one every two calendar years, except for hearing aid monaural in ear, which is one per calendar year. All services must be medically necessary. One per day and no limit per calendar year. Transportation provided by ambulances or air ambulances (helicopter or airplane) to get you to a hospital because of an emergency. They also help make sure your baby is growing and developing properly.