1. Due Date Requirements:
The estimated due date must be at least 12 months after the membership start date or switch date. This ensures that the membership has been active long enough to share in maternity expenses.
2. Household Requirement:
Maternity expenses are only eligible for memberships with two or more members (one being the mother) in the household.
3. Eligible Services:
- Antepartum Care: Care provided during pregnancy.
- Labor and Delivery: Costs associated with childbirth.
- Postpartum Care: Care provided after childbirth.
- Well-Baby Visits: Well-baby visits for the first three years are sharable if the membership has been part of REDEEM Enhanced for 12 months prior to the delivery date. These services are not subject to the Annual Unshared Amount (AUA) or co - share amounts.
- Ruptured Fallopian Tube: Expenses regarding a ruptured fallopian tube will be shared.
4. Adding Newborns to Membership:
The baby must be added to the membership within 30 days of delivery to be considered a member from birth.
5. Birth Defects and Conditions:
Any known birth defects or conditions in the baby from a preexisting maternity are not eligible for sharing. If birth defects or conditions are discovered after the mother joins, these will be sharable after the AUA is met.
6. Expenses Not Shared
Procedures directly related to the termination of a living, unborn child and/or removal of the living, unborn child from the mother due to an ectopic pregnancy are not shared (e.g. methotrexate, salpingectomy, salpingostomy), unless the removal of the child from its ectopic location was for the primary purpose of saving the life of the child or improving the health of the child
By following these guidelines, you can ensure that maternity expenses are eligible for sharing within the REDEEM HealthShare community, providing financial support during this important time.