Circumcision of the penis is covered as a medical benefit (subject to your medical deductible and coinsurance). Because this is not a preventive service, your out-of-pocket cost may include your newborn’s medical deductible, coinsurance for professional provider services, and an inpatient copay for inpatient services. Note: The Newborns’ and Mother’s Health Protection Act (NMHPA) requires a hospital length of stay in connection with childbirth for a mother or her newborn and may not restrict benefits for the stay to less than 48 hours following a vaginal delivery or 96 hours following a delivery by cesarean section. A newborn dependent of a covered gestational parent is covered by the plan from birth to at least 21 days following birth. Even if the newborn is later enrolled in different coverage, the newborn will still be covered under the gestational parent’s plan coverage for the first 21 days. Visit the HCA website at hca.wa.gov/erb for what you need to do for continued coverage. If your obstetric care began while covered under another health plan, and your providers are not part of the UMP network, contact UMP Customer Service to discuss your options. Deliveries before 39 weeks gestation Vaginal or cesarean deliveries before 39 weeks of gestation are covered when the services are medically necessary. Examples include: • A medical emergency affecting the member or baby. • A medical condition of the member or baby for which a delivery is medically necessary. • Labor begins naturally (without medical intervention) before the member reaches 39 weeks of gestation. Vaginal or cesarean deliveries before 39 weeks of gestation are not covered when the services are: • Scheduled for convenience and not for medical necessity or medical emergency affecting the member or baby. • Neither the member nor baby have a medical condition for which immediate delivery is medically necessary. Talk to your provider about whether early delivery is for a medically necessary reason. For questions about this policy, contact UMP Customer Service. Services covered as preventive The following services are covered as preventive (not subject to your medical deductible or coinsurance when you see a network provider): • HIV counseling and testing. • Purchase of manual and electric breast pumps for pregnant and nursing members, plus supplies included with the initial purchase. Hospital-grade pumps are not covered. • Screening for diabetes during pregnancy. See “The UMP Preferred Drug List” section for prescription drugs that are preventive. They are listed as "Preventive" in the Tier column. Lactation (breastfeeding) counseling Lactation counseling is covered at the preventive rate during pregnancy and after birth to support breastfeeding when members receive services by a covered provider type. Note: Donor human milk from an approved milk bank for inpatient use may be covered when medically necessary. 2024 UMP Plus–UW Medicine ACN (PEBB) Certificate of Coverage 65