If you are a mother-to-be in the SC State Health Plan, you must take advantage of the maternity management program that Medi-Call administers. Prenatal care is a good way to ensure your health and your baby's health.
You must call Medi-Call within the first trimester (three months) of your pregnancy to precertify your pregnancy. If you do not call Medi-Call within the first trimester of your pregnancy or you refuse to participate in the Maternity Management Program, you will pay a $200 penalty for each maternity-related hospital or skilled nursing facility admission. This penalty will be in addition to the existing Medi-Call precertification penalty and the $2,000 coinsurance maximum will not apply.
You are automatically enrolled in the program when you call Medi-Call to pre-certify your pregnancy. As a participant in the program, you will receive a letter from Medi-Call welcoming you to the program and a packet full of information you will want and need to refer to during your pregnancy.
A case management nurse will complete a Maternity Health Assessment form when you enroll. This form identifies potential high risk factors during your first trimester. If the process identifies high risk factors, you will receive periodic follow-up calls. If there are no identified risks, you should call with any changes in your status. Otherwise, you will receive a reminder card with benefit information during your third trimester.
Plus, you can call Medi-Call any time you have questions. A maternity case management nurse will be there to help you throughout your pregnancy.