Under the Newborns Mothers Health Protection Act the Plan may - PDF document

1 Under the Newborn’s & Mothers’ Healt
Under the Newborn’s & Mothers’ Health Protection Act, the Plan may not restrict benefits for a hospital stay in connection with childbirth to less than 48 hours following a vaginal delivery or less than 96 hours following a cesarean delivery. Plans may not require providers to obtain authorization from the plan for prescribing the stay. In addition, plans may not deny a stay within the 48 - hour (or 96 - hour) period because the plan’s utilization reviewer does not think such a stay is medically necessary. The plan must eliminate this preauthorization requirement with respect to hospital stays following vaginal delivery for the first 48 hours (or 96 hours in the case of a cesarean section). The plan may impose such an authorization requirement for hospital stays beyond this period. In addition, the plan may impose a requirement on the mother to give notice of a pregnancy in order to obtain a certain level of cost - sharing or to use certain medical facilities. However, the type of preauthorization required by this plan (within the 48/96 hour period and based on medical necessity) must be eliminated. There have been no changes to our Privacy Practices. If you would like a copy, you can find on our website at www.siho.org under Privacy Policy at the bottom of the web page or you can contact Member Services at (812)378 - 7070 or (800)443 - 2980. In accordance with the Women’s Health and Cancer Rights Act of 1998, SIHO Insurance Services’ covered members who undergo a mastectomy, and who elect breast reconstruction in connection with the mastectomy, are entitled to coverage for: • Reconstruction of the breast on which the mastectomy was performed. • Surgery and reconstruction of the other breast to produce a symmetric appearance. • Prosthesis and treatment of physical complications at all stages of the mastectomy, including lymphedemas, in a manner determined in consultation with the attending physician and the patient. The coverage may be subject to coinsurance and deductibles consistent with those established for other benefits. There have been no changes to our Privacy Practices. If you would like a copy, you can find on our website at www.siho.org under Privacy Policy at the bottom of the web page or you can contact Member Services at (812)378 - 7070 or (800)443 - 2980. For more information call SIHO at (812) 378 - 7070 or (800) 443 - 2980 . There have been no changes to our Privacy Practices. If you would like a copy, you can find on our website at www.siho.org under Privac

2 y Policy at the bottom of the web page o
y Policy at the bottom of the web page or you can contact Member Services at (812)378 - 7070 or (800)443 - 2980. If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov. If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1 - 877 - KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer - sponsored plan. If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1 - 866 - 444 - EBSA (3272). For questions contact the Department of Labor at www.askebsa.dol.gov or call 1 - 866 - 444 - 3272. If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of July 31st, 2018. Contact your State for more information on eligibility – A L A B A M A – M e d i c aid F L OR I D A – M e d i c a i d W e b s it e : h t t p m y h i p p c o m/ Ph o n e : - 8 55 - 6 9 2 - 5 447 W e b s it e : h t t p f m e di c a id t p r e c o ve r y c o m / h i p p Ph o n e : - 8 7 7 - 3 5 7 - 3 2 68 A L A S K A – M e d i c aid G E ORG I A – M e d i c aid T h e A K Hea l t h I n sur a nc e P r e m i um P ay m e n t P r o g r m W e b s

3 it e : h t t p m y kh i p p c o m/
it e : h t t p m y kh i p p c o m/ Ph o n e : - 8 6 6 - 2 5 - 4 8 6 Em a il : C us t o m e r S e r v i c e @ M y A K HI PP . c o m M e di c i d E i g i b i l it y h tt p d h s s k g o v d p P a g e s m e di c a i d d e f a u t p x W e b s it e : h t t p d ch g e o r g i g o v m e di c i d - C li c k o n Hea lt h I n sur a nc e P r e m i um P ay m e n t ( H PP) Ph o n e : 4 0 4 - 6 5 6 - 4 5 0 7 AR K AN S AS – M e d i c aid I ND I ANA – M e d i c aid W e b s it e : h t t p m y r h i p p c o m/ Ph o n e : 1 - 8 55 - M y A R HI P P ( 8 55 - 6 9 2 - 7447) Hea lt h y I n di a n a P l a n f o r l ow - i nc o m e a d u lt s 9 - 64 W e b s it e : h t t p w w w .i n g o v fss h i p Ph o n e : - 8 7 7 - 4 3 8 - 4479 A l l ot h e r M e di c i d W e b s it e : h t t p w w w .i n di n m e di c a i d c o m Ph o n e - 8 00 - 4 0 3 - 0 8 64 CO L ORADO – H e a l t h F i r s t C o l o r a d o ( Co l o r a d o ’ s M e d i c aid P r o g r a m ) & C h i l d H e a l t h P l an P l u s ( CH P + ) I OWA – M e d i c aid Hea lt h F i rst C o l o r a d o W e b s it e h tt p s w w w. h e t h f i rs t c o o r d o. c o m Hea lt h F i rst C o l o r a d o M e mb e r C o n t a c t C e n t e r 1 - 8 0 0 - 22 1 - 3 9 43 / S t a t e R e l a y 7 C H P + : C o o r d o g o v H C P F Ch i d - H e t h - P n - P us C H P + C us to m e r S e r v i c e : - 8 00 - 3 5 9 - 99 S t a t e R e l a y 7 W e b s it e: h tt p d h s .i o w a o v h w k - i Ph o n e : - 80 0 - 2 5 7 - 8 5 6 3 K AN S AS – M e d i c aid N E W HA M P S H I RE – M e d i c aid W e b s it e : h t t p w w w k d h e k s g o v hc f Ph o n e : - 7 8 5 - 2 9 6 - 3 5 12 W e b s it e : h t t p s w w w d hh s nh g o v o m b p nhhp p Ph o n e : 6 0 3 - 27 - 5 2 1 8 H otli n e : N H M e di c a i d S e r v i c e C e n t e r a t - 8 88 - 9 0 - 4 999 K E N T UC K Y – M e d i c aid N E W J E R S E Y – M e d i c aid a n d CH I P W e b s it e : h t t p s ch fs . k y o v Ph o n e : - 80 0 - 6 3 5 - 2 5 70 M e di c a i d W e b s i t e: h tt p // w w w s t t e n j u s / h u m n s e r v i c e s d m a h s c li e n t s m e di c a id M e di c a i d Ph o n e : 6 0 9 - 6 3 - 2 3 92 C HI P W e b s it e: h tt p w w w . n j f m i y c r e . o r g i n d ex h t m C HI P Ph o n e : - 80 0 - 7 0 - 0 71 0 L OU I S I ANA – M e d i c aid N E W YORK – M e d i c aid W e b s it e: h tt p /

4 / d hh o u i s i n g o v i n d ex c f m
/ d hh o u i s i n g o v i n d ex c f m u bh o m e / n / 33 Ph o n e : - 88 8 - 6 9 5 - 2 447 W e b s it e h tt p s w w w h e t h n y g o v h e t h _ c r e m e d i c i d/ Ph o n e : - 80 0 - 5 - 2 8 3 M A I NE – M e d i c aid NOR T H CARO LI NA – M e d i c aid W e b s it e : h t t p // w w w m i n e g o v d hh s/ o f i / p u b i c - s i s t a nc e i n d ex . h t m Ph o n e : - 80 0 - 44 2 - 6 0 0 3 TT Y : M a i n e r e l a y 7 W e b s it e : h t t p s d m nc d hh s g o v Ph o n e : 9 9 - 8 55 - 4 00 M A SS ACHU S ETT S – M e d i c aid a n d CH I P NOR T H DA K O T A – M e d i c aid W e b s it e: h tt p // w w w m ss g o v / e o hh s/ g o v / d e p r t m e n t s / m ss h e t h Ph o n e : - 80 0 - 8 6 2 - 4 8 40 W e b s it e: h tt p w w w . n d g o v d h s s e r v i c e s m e di c a s e r v m e di c a i d Ph o n e : - 8 44 - 8 5 4 - 4 8 2 5 M I NN E S O T A – M e d i c aid O K L AH O M A – M e d i c aid a n d CH I P W e b s it e: h tt p s mn g o v d h s p e o p e - w e - s e r ve /s e n i o rs h ea t h - c a r e h e t h - c a re - p r o g r m s p r o g r m s - n d - s e r v i c e s ot h e r - i n s ur nc e j sp Ph o n e : - 80 0 - 6 5 7 - 373 9 W e b s it e : h t t p w w w .i n sur e o k h o m . o rg Ph o n e : - 88 8 - 3 6 5 - 3742 U.S. Department of Labor Employee Benefits Security Administration www.dol.gov/agencies/ebsa 1 - 866 - 444 - EBSA (3272) U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services www.cms.hhs.gov 1 - 877 - 267 - 2323, Menu Option 4, Ext. 61565 M I SS OURI – M e d i c aid OR E GON – M e d i c aid W e b s it e: h tt p / w w w d s s m o g o v / mh d p r ti c i p n t s / p g e s/ h i p p h t m Ph o n e : 5 73 - 7 5 - 2 0 0 5 W e b s it e: h tt p h e t hc r e o r e g o n g o v P g e s i n d e x s p x h tt p w w w .o r e g o nh ea t hc r e . g o v i n d ex - e s h t ml Ph o n e : - 80 0 - 6 9 9 - 9 0 75 M ON T ANA – M e d i c aid P E NN S Y L V AN I A – M e d i c aid W e b s it e: h tt p d p hh s m t g o v M o n t n He t hc r e P r o g r m s H P P Ph o n e : - 80 0 - 6 9 4 - 3 08 4 W e b si t e: h tt p w w w d h s p g o v p r o v i d e r m e d i c ss i s t a nc e h e t h i n sur- nc e p r e m i u m p y m e n t h i p pp r o g r m / i n d ex h t m Ph o n e : - 80 0 - 6 9 2 - 74 6 2 N E B RA S K A – M e d i c aid RHODE I S L AND – M e d i c aid W e b s it e : h t t p w w w. ACC

5 ESSN e b r s k . n e o v Ph o n e :
ESSN e b r s k . n e o v Ph o n e : ( 8 55) 6 3 2 - 7 6 3 3 L i nc ol n : ( 4 0 2 ) 473 - 7 0 0 0 O m a h a : ( 4 0 2 ) 5 95 - 17 8 W e b s it e : h t t p w w w . e o h h s . r i o v Ph o n e : 8 55 - 6 9 7 - 4347 N E VADA – M e d i c aid S OU T H CARO LI NA – M e d i c aid Medicai d W ebsite : http://dhcfp.nv.gov M e di c a i d Ph o n e : - 8 0 0 - 99 2 - 0 9 0 0 W e b s it e : h t t p s w w w c d hh s o v Ph o n e : - 88 8 - 5 4 9 - 08 20 S OU T H DAKO T A - M e d i c aid WA S H I NG T ON – M e d i c a i d W e b s it e : h t t p d s s s d g o v Ph o n e : - 88 8 - 8 2 8 - 0 0 59 W e b s it e : h t t p w w w . hc .w a o v fr ee - o r - l ow - c o s t - h e t h - c a r e p r o g r a m - d m i n i s t r tio n p r e m i u m - p y m e n t - p r o g r a m Ph o n e : 1 - 8 00 - 5 6 2 - 3 0 2 2 e x t . 5 473 TE XAS – M e d i c aid W E S T V I RG I N I A – M e d i c aid W e b s it e : h t t p g e t h i p p t exa s c o m Ph o n e : - 80 0 - 44 0 - 0 4 93 W e b s it e : h t t p m y w v h i p p . c o m To l l - fr e e p h o n e : 1 - 8 55 - M y W VHI P P ( - 8 5 5 - 6 9 9 - 8 447) U T AH – M e d i c aid a n d CH I P W I S CON S I N – M e d i c aid a n d CH I P M e di c a i d W e b s i t e : h t t p s m e d i c i d. u t a h g o v C HI P W e b s it e : h t t p h e t h u t h g o v ch i p Ph o n e : - 8 7 7 - 5 43 - 7 669 W e b s it e: h tt p s w w w.d h s .wi s c o n si n g o v / p u b i c tio n s / p / p 00 9 5 p df Ph o n e : - 80 0 - 3 6 2 - 3 0 0 2 V E R M ON T – M e d i c aid WYO M I NG – M e d i c aid W e b s it e : h t t p w w w . g r ee nm o u n t i nc r e . o r g Ph o n e : - 80 0 - 2 5 0 - 8 4 27 W e b s it e : h t t p s w ye q u it y c a r e a c s - i nc . c o m/ Ph o n e : 3 0 7 - 77 7 - 7 5 3 V I RG I N I A – M e d i c aid a n d CH I P M e di c a i d W e b s i t e: h tt p w w w c o ve r v o r g p r o g r m s _ p r e m iu m _ s s i s t nc e c fm M e di c a i d Ph o n e : - 8 0 0 - 43 2 - 59 2 4 C HI P W e b s it e: h tt p w w w c o ve r v o r g p r o g r m s _ p r e m iu m _ s s i s t nc e c fm C HI P Ph o n e : - 8 55 - 2 4 2 - 8 2 82 T o s ee if a n y o t h e r s t a t es h a v e added a p r e m i u m a s s i s t a n c e p r o g r am s i n c e J u ly 3 1 , 2 0 1 8 , o r f o r mo r e i n f o r m a t i o n o n s p e c ial e n r o ll m e n t r i g h t s , c o n t a c t ei t h e r