Family enjoying breakfast together in the kitchen

PREGNANCY & FAMILY PLANNING

Your pregnancy, your family, your plan.

Pregnancy and family planning comes with lots of questions. See what answers your LifeWise plan can bring.

Prenatal visits and billing

You might not see an invoice just for prenatal care. Most doctors invoice with one “global bill” that includes prenatal care, delivery, and one postpartum visit. Some labs, ultrasounds, and hospital care services are billed separately.

Covered pregnancy care

Your LifeWise plan offers coverage for pregnancy, delivery, and post-pregnancy services offered by license professionals. Licensed midwife services are included. Doulas are not included as they are not licensed healthcare providers.

Lactation services are often included during your hospital stay and through your pediatrician or OBGYN. A lactation counselor is covered independent of a clinic or hospital if they are a licensed provider.

Adding a baby to your plan

From the date of birth, a 60-day special enrollment period begins during which you can add your new baby to your LifeWise health plan. If you bought your plan through a producer or the Washington Health Plan Finder, contact each directly to add your baby.

Order a breast pump

Breast pumps are covered in your LifeWise plan. Simply order online from one of these services.

Family planning and sexual health

Birth control

Many generic contraceptives will be covered at no out-of-pocket cost to you on most plans. Because coverage varies by plan, sign in to your secure member account and use the drug search tool to see if your preferred brand is covered on your specific plan.

Doctors sometimes prescribe birth control for other issues, such as balancing hormones or acne, which would not be covered at 100 percent by your plan. Talk to your doctor about finding the right option for you.

All FDA-approved methods of birth control are covered under most plans, including:

  • Barrier methods such as diaphragms, condoms, spermicide and sponges, and emergency contraception such as Plan B® and ella®. You can buy these over the counter without a prescription.
  • Hormonal methods such as birth control pills, patches, and vaginal rings.
  • Implanted devices such as intrauterine devices (IUDs), Depo-Provera, Implanon, and Nexplanon.
  • Sterilization procedures such as tubal ligation (“tying the tubes”), implants (Essure®), and vasectomies.
  • Patient education and counseling with your doctor.

Tip: Be sure to take any over-the-counter contraceptives to the pharmacy counter and present your member ID card so the pharmacist can check your coverage for those products.

Abortion

Plans purchased on Washington Healthplanfinder require that money used for abortion benefits go into a separate fund. This is noted in your statement. No federal funds are used for terminations of pregnancy.

Fertility

Conception tests for men and women are available and are billed as medical tests and are subject to copay and deductible. Hormone tests and labs are covered if they are not coded for infertility. Fertility enhancement medications and treatments, such as in-vitro fertilization (IVF) are not covered.

Erectile dysfunction

Our plans do not cover erectile dysfunction. If you take medication, sign in and go to Pharmacy Services to search and see if it is covered on your plan.

Sexually Transmitted Diseases (STDs)

If you've had unprotected sex or want to put your mind at ease, ask your doctor about STD tests. Some STDs don't have symptoms, so getting tested is a good way to protect you and future partners.

There is no single test for all STDs, so talk to your primary care physician about the tests you need. Preventive STD tests, meaning tests done without signs or symptoms of infection, are covered at 100 percent on most health plans. If you are tested because you are exhibiting symptoms, your tests could be billed as diagnostic, which is subject to your plan's copay and deductible. Getting treatment early can prevent risk to you and others.

Certain HIV Pre-exposure Prophylaxis (PrEP) medication is covered at no cost when used as a preventive measure for those identified as high risk for HIV infection. For additional details, including the effective date of coverage for PrEP at no cost under your health plan, please call member services.

Your privacy

When a member is 13 or older, explanations of benefits are sent directly to that member, even if he or she is a minor on a parent's plan. This is done in accordance with Washington state law, and means that parents are unable to see this dependent’s claims in the online member account and are unable to discuss sensitive claims with customer service representatives unless the dependent minor gives permission. Members 13 and older must set up their own online member accounts if they want to view their claims and explanation of benefits statements online.

Your health plan covers preventive care services as required by state and federal law. For more information, review the "A" and "B" rated services on the United States Preventive Task Force, immunizations recommended by the Centers for Disease Control and Prevention and preventive care and screening recommended by the Health Resources and Services Administration. See the list on healthcare.gov.