Nutrition counseling and therapy Support network provider type: You must use a UMP Plus–PSHVN provider or a covered provider within the support network to receive network level benefits (see description in the “Support network providers” section). TIP: See the “Diabetes education” benefit for how these services are covered for members with diabetes. The plan covers up to 12 visits per lifetime for nutrition counseling and therapy services. Similar services may be covered under other benefits that are not subject to the 12-visit limit, including, but not limited to, the “Diabetes Control Program, “Diabetes education,” and the “Diabetes Prevention Program.” Obstetric and newborn care Pregnancy program As an expectant parent, the program helps you manage your health throughout pregnancy and offers access to a nurse line, pregnancy support, and education 24 hours a day, 7 days a week. It also includes a smartphone application to help you track milestones, identify symptoms, access education, and get one- click access to the nurse line. To enroll in the program, call 1-888-569-2229 (TRS: 711) or sign in to your Regence account (see Directory for link). This program is covered at no cost to you. Services for obstetric and newborn care See the “Covered and noncovered provider types” section for providers whose services are covered by the plan. Covered professional services include: • Amniocentesis and related genetic counseling and testing during pregnancy. • Care of complications associated with pregnancy, including pregnancies resulting from fertility or infertility treatment. • Prenatal and postnatal care. • Prenatal testing (as stated in Washington Administrative Code [WAC] 246-680-020). • Vaginal or cesarean delivery. • Placement of IUD including immediately after delivery. Note: Early elective deliveries may not be covered. See “Deliveries before 39 weeks gestation” below. For inpatient hospital charges related to a childbirth, you: • Meet your medical deductible. • Pay the inpatient copay. • Pay the coinsurance for professional services while hospitalized. • Meet your medical deductible for the newborn. However, if only covered preventive care services (see page 66) are billed for the newborn, you will not meet your newborn’s medical deductible, pay the inpatient copay, or pay the coinsurance when you see a network provider. For hospitalization of the newborn, you will also pay a separate inpatient copay for the newborn. 64 2024 UMP Plus–PSHVN (PEBB) Certificate of Coverage