Expectant & New Parents
When You Are Expecting
Blue Cross Blue Shield Plan Benefits for Pregnancy and Delivery
Benefits for Eligible Expenses incurred for Maternity Care will be determined on the same basis as for any other treatment of sickness.
Services and supplies incurred by a Participant for delivery of a child shall be considered Maternity Care and are subject to all provisions of the Plan.
Charges for well-baby nursery care, including the initial examination, of a newborn child during the mother's Hospital Admission for the delivery will be considered Inpatient Hospital Expense of the child and will be subject to the benefit provisions as described under Inpatient Hospital Expenses. Benefits will also be subject to any Deductible amounts shown on your Schedule of Coverage.
Blue Cross Blue Shield PPO Summary of Benefits
Blue Cross Blue Shield HDHP + HSA Summary of Benefits
Please see the BCBS PPO Managed Care Book or the BCBS PPO + HSA Managed Care Book for additional information regarding Maternity Care.
Selecting a Pediatrician
Use the Blue Cross Blue Shield Provider Finder to search for an in-network pediatrician within your area. You will need to select 'primary care physicians' under the provider type and then select 'pediatrics' under specialty. Then, simply enter your location and click on the 'find' button.
Blue Cross Blue Shield Special Beginnings Maternity Program
If you are expecting, the Special Beginnings® maternity program can help guide you through your pregnancy and postpartum care. This confidential program provides support and education, pregnancy risk factor identification and ongoing communication/monitoring from early pregnancy until six weeks after delivery. Enrolled mothers-to-be receive personal contact from program staff who can help them better understand and manage their pregnancies and coordinate care with their doctors.
- A pregnancy calendar to help keep track of the pregnancy and what to expect in each trimester
- Videos about pregnancy and childbirth with professionals such as clinical psychologists and registered nurses
- A pregnancy due date calculator
- Educational articles
- Level of program support anticipated to receive during her Special Beginnings program participation
- Ability to change the website background to match the baby's gender - or keep it green if waiting to be surprised!
Explore the Special Beginnings online resource now. You can also find a link to the online resource on the Blue Access for Members' My Health tab.
To enroll in the maternity program, call Special Beginnings at 888-421-7781, 8:00 a.m. - 6:30 p.m., CT.
Blue Cross Blue Shield Special Beginnings Maternity Program Flyer
Breastfeeding Support and Supplies
Effective April 15, 2013, Blue Cross Blue Shield of Texas expanded its implementation of preventive services under the Affordable Care Act (ACA) to include coverage for electric and hospital grade breast pumps. This coverage applies to non-grandfathered plans and policies (Baylor's medical plan is a non-grandfathered plan), and expands the breastfeeding support options available to members without cost-sharing. Electronic breast pumps will only be eligible for 100% reimbursement if received from an in network provider or Durable Medical Equiment supplier. A prescription for medical necessity is required, meaning the employee must be pregnant or currently breastfeeding. Retail purchases will not be covered (Wal-Mart, Target, etc.). Hospital grade breast pumps are only eligible for rental up to the purchase price when rented from an in network Durable Medical Equipment supplier. Retail purchases are not covered. Breast Pump Supplies (Codes: A4281-A4286) are covered at 100% without cost-sharing. (A4281 is tubing and A4284 is the shield.)
|Manual Breast Pump E0602
||100% no cost-share
||In-Network, Out of Network, Retail
|Electric Breast Pump E0603
||100% no cost-share
||In Network Provider or contracted Durable Medical Equipment (DME) supplier only
||Two per calendar year
|Hospital Grade Breast Pump
||100% no cost-share
||In Network or contracted DME supplier
||Coverage is the rental cost up to the purchase price
|Breast Pump Supplies A4281-A4286 are covered at 100% without cost-sharing.
Below are a few in-network providers that carry electric breast pumps and will ship to any address. There are very few plans that these providers are not contracted with, but they are remote ancillary providers and must follow the claims filing rules. Request that they call Blue Cross Blue Shield customer service (1-800-521-2227) to make sure they are in network for your plan. (They must be in network with the state where the patient lives/the breast pump is shipped to.)
- Byram Health Care - breast pump department - 877-73-1972
- Edgepark Medical Supply - 800-307-5930 - OPT 1 - breast pump department
Baylor has a maternity and primary caregiver policy for faculty and staff that is covered under its Family and Medical Leave (FMLA) policy.
To learn more about how this applies to faculty, please see BU-PP 418A - Faculty.
To learn more about how this applies to staff and non-contract faculty, please see BU-PP 418B - Staff.
Baylor University’s Paid Parental Leave Policy gives parents time and flexibility to bond with their new child(ren) and to foster work-life balance that is vital to families’ capacity to flourish.
This benefit is available to all full-time benefit eligible staff members immediately upon their employment with Baylor University and provides up to four (4) weeks (160 hours) of Paid Parental Leave for full-time benefits eligible staff.
For additional information regarding Paid Parental Leave, please see Baylor's Paid Parental Leave webpage.
Once Your Baby is Born
Adding Your Newborn To Your Benefits
Please be sure to make your changes by completing and submitting the appropriate forms to Human Resources within 30 days of the birth of your child(ren). If you do not add your child(ren) within 30 days of the event, IRS regulations require you to wait until the next Open Enrollment period.
You must complete the steps below within 30 calendar days of the Qualified Life Event to make changes to your benefit elections:
- View this step-by-step guide to log in to SmartBen™ and choose the life event that occurred, and view the Qualifying Events Enrollment page.
- Upload any supporting documentation of the life event within 30 days.
For additional information on adding your new child(ren) to your benefits, please see Baylor's Life Events webpage.
Well Baby Visits and Immunizations
Covered at 100% without the need to make a copayment or meet a deductible. For additional information, please see The Affordable Care Act: Preventive Services at 100%.
Is there a new baby bear in the family?
The Baby Bear Program supports Baylor's caring community by celebrating new additions to the Baylor family. Upon the birth or adoption of a child by a full-time faculty or staff member, we will provide a congratulatory gift to celebrate the wonderful event.
In order to provide the family with a timely delivery of their gift, all requests must be processed within the first three months following the baby's birth or adoption (when child is 12 months or younger).
Returning to Work
Fitness for Duty Certification
Prior to returning to work, the faculty or staff member on FMLA will be required to provide Human Resources with a statement from their Health Care Provider that specifies the date that they will be released to return to work, and if applicable, restrictions and duration of the stated restrictions. (Note: It is possible for a faculty or staff member to return to work, and continue to be covered under FMLA on an intermittent basis.) The Fitness for Duty Certification form may be used for reporting the Health Care Provider's statement.
All Baylor University faculty and staff are eligible for an accommodation for the purpose of expressing breastmilk for her nursing child for up to one year after the child's birth.
For additional information regarding Lactation Accommodation, please see Baylor University's Lactation Accommodation webpage.
Dependent Day Care Flexible Spending Account
Offset the cost of childcare by participating in a Dependent Day Care Flexible Spending Account. Pre-tax dollars can be set aside for day care expenses for eligible children.
Expenses are eligible if they are for the care of your dependent children (up to age 13), or a dependent of any age if he or she lives with you and cannot care for himself or herself, such as an elderly parent or disabled child.
The following are some expenses not covered under the Dependent Day Care Flexible Spending Account:
- 24-hour nursing home expenses
- Day Care with a primary purpose of education or enrichment
- Expenses you expect to claim as a dependent day care tax credit
- Services provided by one of your children under age 19
- Expenses for overnight camps
- Expenses that allow you or your spouse to perform volunteer work
- Transportation, entertainment, food, and clothing expenses
- Expenses incurred during a medical leave longer than one pay period
The Dependent Care Spending Account annual limit is $5,000 for individuals who are married and filing a joint return or persons who are single and filing head of household. If married and filing a separate tax return, the annual limit is $2,500.
Whether the Dependent Care Account or the tax credit is more advantageous to you depends on your personal tax situation. Unfortunately, we cannot provide tax advice to you. You should consult your tax advisor. Another resource to check is the IRS publications.
For additional information regarding Flexible Spending Dependent Care accounts, please see our Flexible Spending webpage.