Maternity Care

We are here for you each step of the way

Congratulations on your pregnancy

Here are some benefits you will want to know:

• You are covered for routine maternity care, which includes prenatal care, certain exams and tests, and post-partum care, with no member cost share. Member cost-sharing may apply to diagnostic tests or diagnostic laboratory tests when they are ordered as part of routine maternity care.
• No referral is required for routine maternity care provided by a Tufts Health Plan obstetrician, gynecologist, certified nurse midwife or family practitioner.
• Your plan provides coverage in full for the purchase of a manual or electric grade breast pump or the rental of a hospital grade breast pump. There is no coverage limitation based on brand, however, a fee may apply for an upgraded pump.
• Breast pumps must be ordered by a physician (PCP or OB/GYN) and obtained from a contracting Durable Medical Equipment (DME) provider.
• A pump may be obtained prior to delivery of your baby and the coverage period per pregnancy lasts 12 months from the date of your child’s birth.
• Flu Shot is covered with no cost share on most plans. According to the CDC, pregnant women should get a flu shot, not the nasal spray flu vaccine. Flu shots given during pregnancy help protect both you and your baby from flu. Vaccination has been shown to reduce the risk of flu-associated acute respiratory infection in pregnant women by up to one-half.¹ 

 

Additional benefits

• Childbirth Education Classes – These classes are a great place for you to ask questions, connect with experts who can help you make the best decisions for you and your baby.  Enroll and pay for a qualifying childbirth education class (Lamaze, infant safety, childbirth preparation) by a licensed medical professional or certified childbirth education and get up to $100 back per pregnancy.
• Lactation Consultation – Breastfeeding is rewarding but also can be challenging. Lactation consultants can help with any issues you may have with breastfeeding or help you meet your breastfeeding goals. Lactation consultation is a covered service for most members and no referral is required.
• Breastfeeding Classes – Learn breastfeeding basics or just get some extra support and tips to help you breastfeed your baby successfully. Enroll and pay for a qualifying breastfeeding support class performed by a licensed medical professional or certified childbirth education or certified lactation consultant and get reimbursed for the class fees.  

Post pregnancy (post-partem)

You have access to Behavioral Health care to help with any post-partem depression or anxiety you may experience—this is a fairly common issue that is very important to treat. You should talk to your provider about therapies that work to treat post-partem issues.

We have Behavioral Health professionals you can call to help you navigate the health care system. You also have free behavioral health visits through Teladoc® which you can access through our mobile app or member portal.² 

Take time to take care of yourself so you can take care of your baby.

1. Oxford Academic, 2018 Influenza Vaccine Effectiveness in Preventing Influenza-associated Hospitalizations During Pregnancy: A Multi-country Retrospective Test Negative Design Study, available at https://academic.oup.com/cid/article/68/9/1444/5126390
2. Available to members on fully-insured commercial plans and those on self-insured plans that did not opt-out of the service. Call the number on your ID card for questions.