How it Works
Basic Health members who are pregnant usually receive care through the Maternity Benefits Program (a Medicaid program). This program allows you to receive maternity benefits through the same health plan you choose for Basic Health. When selecting a provider for your maternity services, make sure (s)he contracts with your chosen health plan.
If you are eligible for the Maternity Benefits Program, Basic Health will cover maternity services for only 30 days after your doctor verifies your pregnancy. To continue your maternity coverage without interruption, Basic Health must receive your Maternity Benefits Application within 30 days of the date your pregnancy is verified. If you do not apply within that time, you'll have to pay the full cost of any maternity care you receive beyond 30 days after your pregnancy is verified.
The Maternity Benefits Program allows you to receive other services called First Steps, which includes maternity support such as:
- Child-birth education classes,
- Child care, and
- Transportation to medical appointments.
If you are pregnant when you apply for Basic Health, your application will be referred to Medicaid to determine your eligibility for the Maternity Benefits Program. If you want to be enrolled in Basic Health while your eligibility for the Maternity Benefits Program is being determined, you must specifically request that on your application. If you do not qualify for the Maternity Benefits Program, you may be able to receive maternity services through Basic Health.
If you are pregnant and your income is higher than Basic Health's income guidelines, go to your local Community Service Office to apply for the Maternity Benefits Program. The Health Care Authority determines eligibility for the Maternity Benefits Program based on Medicaid eligibility criteria. There are some differences between Medicaid and Basic Health eligibility criteria. For example, Medicaid criteria will count your unborn child when determining your family size, while Basic Health does not count the child until birth. As a result, you may be eligible for one program, but not the other.
How to Apply
Download a Maternity Application (Eligibility Review form) .
When Coverage Begins
Coverage for maternity services will begin only when your Basic Health coverage begins. (If you're eligible, Medicaid may provide other assistance for maternity services received during the most recent three months before your Basic Health coverage starts.)