Print this pageHow it Works
Basic Health members who are pregnant usually receive care through the
Maternity Benefits Program (608.8 KB) (a Medicaid
program). This program, jointly administered by Basic Health and the Department
of Social and Health Services (DSHS), 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.
More Services
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.
Eligibility
If you are pregnant when you apply for Basic Health, your application will be referred to DSHS 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 DSHS Community Service Office to apply for the Maternity Benefits Program. DSHS 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 Benefits Application (304.9 KB).
When Coverage Begins
Coverage for maternity services will begin only when your Basic Health coverage begins. (If you're eligible, DSHS may provide other assistance for maternity services received during the most recent three months before your Basic Health coverage starts.)
