Order Your Pump. Training and counseling for the people who help take care of you. Substance Abuse Intensive Outpatient Program*. This contact information is for WIC Staff Use only. Medical care and other treatments for the feet. Up to four visits per day for pregnant members and members ages 0-20. Just call 1-855-232-3596 (TTY: 711) to get your pump. To help you successfully breastfeed, EmblemHealth has made breast pumps available to you through participating vendors. Medical care and other treatments for the feet. 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. Doctor visits after delivery of your baby. Yes, for dental procedures not done in an office. Transfers between hospitals or facilities. This service also includes dialysis supplies and other supplies that help treat the kidneys. If you are interested in PDO, ask your case manager for more details. The American Academy of Pediatrics recommends that babies be given exclusively breast milk for their first six months of life or even longer. Limitations, co-payments and restrictions may apply. Home visit by a clinical social worker to assess your needs and provide available options and education to address those needs. 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. Medical supplies are items meant for one-time use and then thrown away. Up to 45 days for all other members (extra days are covered for emergencies). This includes having a case manager and making a plan of care that lists all the services you need and receive. Support services are also available for family members or caregivers. Home One initial evaluation per calendar year. You can call 1-877-659-8420 to schedule a ride. Provided to members with behavioral health conditions and involves activities with trained animals. sunshine health breast pump coverage sunshine health breast pump coverage on Jun 11, 2022 on Jun 11, 2022 Services that help children with health problems who live in foster care homes. Medical care that you get while you are in the hospital but are not staying overnight. Even though the American Academy of Pediatrics recommends that all mothers breastfeed for at least six months, that's not always possible. You'll also need breast milk storage bags, bottles and nipples, in addition to cleaning supplies. 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. That means you could receive a high-quality, name brand pump at no cost to you. One initial wheelchair evaluation per five years. 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. Services for women who are pregnant or want to become pregnant. We cover the following medically necessary services for children ages 0-20: We cover the following medically necessary services for adults: Statewide Inpatient Psychiatric Program Services. Expanded benefits are extra services we provide to you at no cost. A plan may cover 100% of the cost of a breast pump or may cover only a fraction of the cost. They also offer comfort through physical and emotional support. X-rays and other imaging for the foot, ankle and lower leg. You can use PDO if you use any of these services and live in your home: PDO lets you self-direct your services. They also help make sure your baby is growing and developing properly. E0602 Breast pump, manual Women's Health - Contraceptive Management* (with Diagnosis) . Please copy the WIC State agency Here are some resources that can help. One therapy re- evaluation per six months. Get up to $250 per year to help with living costs like utilities and more, Transition Assistance Nursing facility to community setting. These services are free. Call 1-866-796-0530 (TTY: 1-800-955-8770) for more information. If you need a ride to any of these services, we can help you. You can order this pump while still pregnant, or after you deliver. This could be on the bus, a van that can transport disabled people, a taxi, or other kinds of vehicles. Medical equipment is used to manage and treat a condition, illness, or injury. This service lets your caregivers take a short break. Specialized Therapeutic Foster Care Services. One initial assessment per calendar year. Breast pump, hospital grade rental; Sunshine Health is a managed care plan with a Florida Medicaid contract. Remember, services must bemedically necessary in order for us to pay for them. Provided to members with behavioral health conditions and involves activities with horses. One adult health screening (check-up) per calendar year. 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. Lets go over some of the basics of breastfeeding. Medical supplies are items meant for one-time use and then thrown away. X-rays and other imaging for the foot, ankle and lower leg. Substance abuse treatment of detoxification services provided in an outpatient setting. Infant Mental Health Pre- and Post- Testing Services*. Including health focused clinical interview, behavioral observations, and health and behavioral interviews for individual, group and family (with or without the patient). Must be diagnosed with asthma to qualify. If you need a ride to any of these services, we can help you. For more information contact the Managed Care Plan. Covered as medically necessary. Can be provided in a hospital, office or outpatient setting. You will need Adobe Reader to open PDFs on this site. Help taking medications if you cant take medication by yourself. This means you get to choose your service provider and how and when you get your service. Services to diagnose or treat conditions, illnesses or diseases of the brain, spinal cord or nervous system. These breast pumps are portable and lightweight, allowing for a comfortable pumping experience both at home and on the go. Individualized care planning and care management service to support children with complex needs who are at risk of placement in a mental health treatment facility. Well Child Visits are provided based on age and developmental needs. Durable medical equipment is used over and over again, and includes things like wheelchairs, braces, crutches and other items. Mental health therapy in a group setting. Your child must be enrolled in the DOH Early Steps program. get your motherhood essentials in 3 simple steps Provide your insurance information We verify your coverage and submit all required paperwork on your behalf 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. Services to treat conditions such as sneezing or rashes that are not caused by an illness. Find out what breast pump you qualify for through your insurance. Note: Pacify is only available to download in the App Store or Google Play Store. per provider recommendation. Additional coverage for items not covered under standard benefits, such as, wound supplies, hospital bed and mattresses, insulin pump and infusion pump. One per day and no limit per calendar year. Up to a 34-day supply of drugs, per prescription. Intensive outpatient treatment for alcohol or drug services and behavioral health treatment or services. Services to diagnose or treat conditions, illnesses or diseases of the bones or joints. One initial evaluation per lifetime, completed by a team. SMI Specialty Plan members are eligible to receive $35 per household worth of OTC items each month. Up to 480 hours per calendar year, as medically necessary. One communication evaluation per five calendar years. Medical care that you get while you are in the hospital. Family Training and Counseling for Child Development*. One frame every two years and two lenses every 365 days for adults ages 21 and older. There may be some services that we do not cover, but might still be covered by Medicaid. Eligible for the first 1,000 members who have received their flu vaccine. This means they are optional services you can choose over more traditional services based on your individual needs. They offer high-quality choices that can help you have a successful breastfeeding experience. Speech and language therapy services in the office setting. Sunshine Health is a managed care plan with a Florida Medicaid contract. You can get these services and supplies from any Medicaid provider; they do not have to be a part of our Plan. 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. The following are covered services: 1. Unlimited units for group therapy and unlimited units for brief group medical therapy. Call us after you deliver to see if breast pumps are offered. Download the free version of Adobe Reader. One initial evaluation and re-evaluation per calendar year. For more information on obtaining a breast pump, call Member Services at 1-866-796-0530, or TTY at 1-800-955-8770, Monday through Friday, 8 a.m. to 8 p.m. other than holidays. Expanded benefits are extra goods or services we provide to you, free of charge. You can rent one from the hospital, or buy one from an in-network durable medical equipment (DME) vendor. Children under age 21 can receive swimming lessons. After you have all the information you need from your insurance provider, order your pump. Apple Health covers deliveries provided by a licensed midwife, nurse midwife or physician. Must be in the custody of the Department of Children and Families. Medical care that you get while you are in the hospital but are not staying overnight. Once the newborn is discharged, the breast pump will no longer be covered; or A breast pump will be covered for babies who have congenital anomalies that interfere with feeding. Up to two office visits per month for adults to treat illnesses or conditions. Services for women who are pregnant or want to become pregnant. All other types of breast pumps require a prior authorization from your provider. Services for doctors visits to stay healthy and prevent or treat illness. One adult health screening (check-up) per calendar year. Behavioral health services provided in a group home setting for children ages 021 who have experienced trauma and are in the child welfare system. Breastfeeding may benefit society - The OWH . Services provided to pregnant women and newborns in hospitals that have special care centers to handle serious conditions. Our team of experts is ready to walk you through the process step by step until your insurance breast pump arrives at your door. These are in-home services to help you with: Personal Emergency Response Systems (PERS). Producing milk burns calories and helps you return faster to your pre-baby weight. Covered as medically necessary. FREE SHIPPING on orders over $75! Pregnancy, postpartum and newborn care and assessment provided in your home by a doula. Emergency services are covered as medically necessary. Mobile Crisis Assessment and Intervention Services*. Breast Pump Death. Services that help children with health problems who live in foster care homes. This service delivers healthy meals to your home. In some cases, you can rent or buy an electric breast pump. Individual therapy sessions for caregivers. * Limitations do not apply to SMI Specialty Plan. Breast pumps are covered through all health plans including Medicaid, CHIP, and Tricare. 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 Up to 150 minutes of brief behavioral health status assessments (no more than 30 minutes in a single day). 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. Available for long distance medical appointment day-trips. Some service limits may apply. The Florida Dept. Some plans offer additional breastfeeding support services such as breastfeeding consultations. Supervision, social programs and activities provided at an adult day care center during the day. A. We cover the following services for members who have no transportation: Medical care or nursing care that you get while living full-time in a nursing facility. Doulas are trained non-medical companions that support pregnant people. As medically necessary, some service and age limits apply. It also lets you build a stash of milk that someone else can feed your baby, giving you the chance to grab a yoga class or get a much-needed haircut. Services can include housekeeping; help with bathing, dressing and eating; medication assistance; and social programs. One-on-one individual mental health therapy. Insertion of thin needles through skin to treat pain, stress and other conditions. Medical equipment is used to manage and treat a condition, illness, or injury. Prior authorization may be required for some equipment or services. The following are included in the rental payment for a hospital-grade breast pump: Set-up and education on the proper use and care of the pump; Contact your care manager to determine eligibility. 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. NOTE: Services marked with an asterisk (*) are behavioral health in lieu of services. The table below lists the medical services that are covered by Sunshine Health. Breast pumps, depending on the type, are covered in full as a preventive service. You can also view more information about Sunshine Health in our Member Handbook. Pump more and save more when you purchase your Willow pump with insurance. Lightweight, portable pump with single and double pumping capability, quiet pump motor, and 100% anti-backflow design helps eliminate wasted milk. Services to help people who are in recovery from an addiction or mental illness. After 4 to 6 Weeks: And remember, while there are plenty of benefits to breastfeeding, if you need to supplement or switch to formula, your baby will still grow and thrive. 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. 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. Up to three visits per day for all other members. Breast pumps are covered under your Sunshine Health Medicaid plan.