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Maternity Services
Family Planning Services are available to ACCESS Plus Enrollees with or without a referral from their PCP. Family Planning Services include diagnosis, treatment, medications, supplies and related counseling.
Pregnancy Testing
An Enrollee can obtain a pregnancy test from her PCP, family planning provider, or any MA participating provider of obstetrical services.
Prenatal Care
An ACCESS Plus Enrollee does not need a referral from her PCP for prenatal care and may self refer to any MA participating provider of obstetrical services. The MA provider does not need approval from the Enrollee’s PCP for prenatal testing or obstetrical procedures. The MA provider may give the pregnant Enrollee a written prescription to present at any MA participating radiology and imaging facilities. Perinatal home care services are covered for ACCESS Plus Enrollees when medically necessary.
Healthy Beginning Plus Program
Healthy Beginnings Plus (HBP) is Pennsylvania’s effort to assist low-income, pregnant women who are eligible for MA to have a positive prenatal care experience. HBP significantly expands maternity services that can be reimbursed by MA. The intent of HBP is to render services that meet pregnant clients’ psychosocial needs in addition to rendering traditional medical/obstetric services.
Federal legislation permits Pennsylvania to extend MA eligibility to pregnant women with family incomes up to 185% of federal poverty guidelines. Pregnant clients may elect to participate in HBP or receive their prenatal care in the traditional MA system.
For more information regarding the identification of a HBP provider, please call the ACCESS Plus Provider Helpline at 1-800-543-7633.
In order to bill and render services as a HBP provider, your office must be enrolled as an approved HBP site. Questions regarding the HBP program or requests for applications for enrollment should be directed to the HBP coordinator at 717-772-6127.