NC Medicaid Extension of Postpartum Coverage

A few weeks ago Breastfeed Durham had the pleasure of meeting with Brianna Monk, MA, MPH, from the NC Department of Health and Human Services. Brianna took the opportunity to remind us that NC Medicaid postpartum health care coverage has increased from 60 days to 12 months for eligible beneficiaries. Please take a moment, right now, to share this link with your networks:

Beneficiaries are eligible to receive 12 months of ongoing postpartum health care coverage beginning  the date their pregnancy ends through the last day of the month, 12 months after the birth event. Beneficiaries remain eligible even if certain changes occur that may affect eligibility (such as a change in income or household/family unit).

Extension of Postpartum Coverage | NC Medicaid
NC Department of Health and Human Services.
ncdhhs.gov

We also took the opportunity to discuss accessing breast-pump’s. UHC Community Plan NC Medicaid is the only plan that covers breast pumps. The rest of North Carolina Medicaid does not cover breast pumps. And we know that the Durham County WIC program does not always have the resources to cover all the needs of Durham families. We also asked Brianna to look into the issue of accessing breast pumps, and this is what she shared….

NC Medicaid is currently considering adding coverage and medical necessity criteria for breast pumps and supplies. Until then, please remember that there are no absolute exclusions for coverage on Durable Medical Equipment (DME), supplies, or appliances at NC Medicaid. DME items not listed for coverage may be submitted by an enrolled DME supplier for Prior Authorization (PA) review on a case-by-case basis by NC Medicaid and the Managed Care health plans. We recommend contacting your health plan directly for guidance on this process. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is also a resource that can provide breast pumps.  Additionally, WIC provides nutrition education, breastfeeding support, healthy food, health referrals and other services free of charge to North Carolina families who qualify. Please visit North Carolina WIC Families – Referral Form | NCDHHS to request help.

Brianna Monk, MA, MPH
Manager, Medicaid Communications & Engagement
NC Medicaid
Division of Health Benefits

We want to thank Brianna for taking the time to meet with us. We are so excited to spread the word about NC Medicaid’s extension of postpartum coverage!