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Maternity Benefits and Member Supports

Sunshine Health cares about the health and safety of new mothers and babies. We offer an array of benefits and resources to support members from pregnancy to birth and beyond.

Learn More About Accessing These Resources

Community Connections Team

Sunshine Health Member Services

 

Standard Benefits

  • OBGYN visits (no limit).
  • Reproductive services for those who are pregnant or trying to become pregnant.
  • Confidential family planning services without prior approval for ages 18 and under.
  • Primary care physician visits for mother and child (no limit).

 

Expanded Maternal/Child Benefits

  • Biometric Equipment
  • Care grant (for CW specifically)
  • Cell phone
  • Chiropractic services
  • Circumcision (newborns)
  • Doula
  • Flu prevention kit
  • Home delivered meals*
  • Massage therapy*
  • Non-emergency medical transportation
  • Nutritional counseling*
  • Over-The-Counter baby supplies
  • Swimming lessons

* Prior authorization required.

 

Special Programs

  • $50 NOP Incentive: Providers eligible for a $50 incentive for each Notice of Pregnancy form sent to our Secure Provider Portal within 30 days of a member’s first prenatal visit.
  • The Doula Network: Pregnant members receive up to 3 doula visits, in-person labor support and 24/7 on-call support for 37 weeks until birth. Prior authorization is not required.
  • Mom’s Meals High Risk Maternity Program: A meal delivery program for high-risk maternity members with documented food insecurity, gestational diabetes, hypertension and preterm labor to improve birth outcomes beginning at 20 weeks gestation through delivery. 
  • Nurse-Family Partnership®: Families develop a close relationship with a nurse who advises and supports them through a healthy pregnancy to raising a healthy child.
  • Optum: Provides support, education and resources to improve neonatal health outcomes for preterm births and newborns admitted into the Neonatal Intensive Care Unit (NICU).
  • Start Smart for Your Baby®: Provides support and care for pregnant women and new moms, including help with housing, food, clothing, cribs and access to licensed medical staff if any issues occur during pregnancy.
  • WIC: Women, Infants and Children is a supplemental food and nutrition program for families that also offers referrals to healthcare, immunizations and community services.

 

Mental Health Special Programs

  • Brave Health: Telehealth mental health care offering counseling, therapy, psychiatry and medication-assisted treatment. Note: No child patients; CW and CMS Health Plan not included in contract.
  • LunaJoy: Live, virtual, holistic mental health counseling for women through every phase of their lives with an emphasis on maternal mental health.

 

Substance Abuse Special Programs

  • HALO: The Health Assistance, Linkage & Outreach program uses evidence-based care and a predictive model to treat members with an opioid use disorder.
  • Puff-Free Pregnancy: Pregnant members who complete 4 Tobacco Cessation Health Coaching Sessions within 6 months of the first are eligible for a $5 reward for each completed session.
  • StrongWell: Helps expecting and new mothers with anxiety, depression and substance abuse through a wide range of support to help them deliver and nurture a healthy baby.

 

Healthy Rewards

Medicaid and Serious Mental Illness (SMI) Specialty Plan Members

Amount Activity Description
$20 Notification of Pregnancy Form Complete, sign NOP form during first trimester
$10

Notification of Pregnancy Form

Complete, sign NOP form during second trimester

$50

Substance Use Treatment for Pregnant Members Using Drugs

Complete five Medication Assisted Treatment visits before delivery; provide evidence of completed counseling and medication sessions

$20

Annual Well Child Visit Ages 7-13

One visit with a PCP per calendar year

Children’s Medical Services (CMS) Health Plan and Child Welfare (CW) Specialty Plan Members

Amount Activity Description
$20

Notification of Pregnancy Form Age 12-20 years

Complete, sign NOP form within first trimester

$20

Prenatal Care

Complete a prenatal visit

$10

Annual Well Child Visit Age 0-30 months

One visit with a PCP per calendar year

$20

Annual Well Child Visit Age 15-20 years

One visit with a PCP per calendar year

$20

Immunizations for Adolescents Combo 1

Tdap and meningococcal vaccines for ages 10-13 years