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Interpregnancy Care Benefits

P4HB® Interpregnancy Care (IPC) Enrollees Get Great Healthy Benefits.

The P4HB® program also provides Interpregnancy Care (IPC) services to women who have had a very low birth weight (VLBW*) baby. The program also includes Resource Mothers Outreach.

Who is Eligible?

Women ages 18 through 44 who:
  • Have had a very low birth weight (VLBW*) baby on or after January 1, 2011, and
  • Do not qualify for another type of Medicaid

What Does P4HB® IPC Offer?

  • All of the family planning services at no cost
  • Primary care visits
  • Limited dental services
  • Non-emergency transportation
  • Substance abuse treatment
    • A referral is required. Call WellCare of Georgia at 1-866-231-1821 with questions or to find a provider in your area (TTY 1-877-247-6272).
  • Detoxification
    • Intensive outpatient rehabilitation
    • Early identification of special needs
    • A referral is required. Call WellCare of Georgia at 1-866-231-1821 with questions or to find a provider in your area (TTY 1-877-247-6272).
  • Case management
    • Early identification of special needs
    • Assessment of risk factors
    • Care planning
    • Referrals and help to ensure timely access to care
    • Resource Mothers Outreach
      • Help with personal and social problems
      • Nutrition guidance
      • Referrals to help quit smoking
      • Help with medical appointments for you and your baby
      • Emotional support following substance abuse treatment
      • Mentoring

For more information, please call Customer Service toll-free at 1-877-379-0020 (TTY 1-877-247-6272) or go to the Planning for Healthy Babies® website.

Do you have questions about your coverage? Please call Customer Service.

You can also see the Enrollee Handbook for more information.

*Note: VLBW is a birth weight below 1,500 grams (3.3 pounds).


Member Handbook

Your Enrollee Handbook explains your plan coverage in detail. It includes important information about your benefits, your rights, and key contact addresses and phone numbers.

P4HB Pharmacy Documents and Forms

A preferred drug list is a list of drugs covered by your plan.

A preferred drug list is a list of drugs covered by your plan.

This is a list of changes to our preferred drug list. We made the changes as a result of the latest WellCare Pharmacy & Therapeutics meeting on 06/13/2019.

Fill out and submit this form to request prior authorization (PA) for your Medicaid prescriptions.

Fill out and submit this form to request an appeal for Medicaid medications.

Health Services & Co-Pay Information

Prescriptions

Folic acid and/or a multi-vitamin with folic acid

Co-Pays: $0

Behavioral Health Services

Substance abuse (detoxification and intensive outpatient rehabilitation)

Referral required

Call us at 1-800-424-5412 (TTY 1-877-247-6272) with questions or to find a provider in your area.

Case Management Services

You are assigned a personal nurse to assist you with your medical needs.

Risk factors assessment

Care planning

We offer referrals and assistance. We make sure you have timely access to care. We also help with coordination of care with providers.

Resource Mother Outreach

Co-Pays: $0

Dental Services

Two exams per benefit year

X-rays once a year

Two cleanings per benefit year

Deep gum cleaning

Call the number on the back of your ID card. They will help you with questions and finding a dentist near you.

Co-Pays: $0

Primary Care Services

Five office/outpatient visits

Co-Pays: $0

Vaccination Services

P4HB Participants age 18:

  • All vaccines under the Vaccines for Children (VFC) Program; talk with your PCP about these vaccinations

P4HB Participants ages 19 and 20, as needed:

  • Hepatitis B (HepB)
  • Tetanus-Diphtheria (Td)
  • Tetanus-Diphtheria and acellular pertussis (Tdap)

Co-Pays: $0

Emergency Transportation Services

Co-Pays: $0

Non-Emergency Medical Transportation Services

See the Transportation Services section for more details.

Co-Pays: $0

Family Planning Services and Supplies

Contraceptive supplies and follow-up care

Contraceptive management, education and counseling

Diagnosis and treatment of sexually transmitted infections (except for HIV/AIDS and hepatitis)

Drugs, supplies or devises related to women's health services that are prescribed by a physician or advanced practice nurse

Drugs for treatment of lower genital tract and genital skin infections/disorders and urinary tract infections, when the infection/disorder is identified or diagnosed during a routine/periodic family planning visit (a follow-up visit for the treatment/drugs may be covered)

Initial and annual complete physical exam, including a pelvic exam and Pap test, as well as follow-up visits (up to four)

Pregnancy testing

Co-Pays: $0

Federally Qualified Health Center Services

Co-Pays: $2

Rural Health Clinic Services

Co-Pays: $2

Abortions and Related Services

Not covered

Co-Pays: --

Hysterectomies

Not covered

Co-Pays: --

Tubal Ligations (Sterilizations)

Covered only if participant:

  • Is at least age 21 or older and mentally competent
  • Voluntarily gives consent and completes all required documentation
  • Is not institutionalized in a correctional facility, mental hospital or other rehabilitative facility

Co-Pays: $0

  • Prescriptions

    Prescriptions

    Folic acid and/or a multi-vitamin with folic acid

    Co-Pays: $0

  • Behavioral Health Services

    Behavioral Health Services

    Substance abuse (detoxification and intensive outpatient rehabilitation)

    Referral required

    Call us at 1-800-424-5412 (TTY 1-877-247-6272) with questions or to find a provider in your area.

  • Case Management Services

    Case Management Services

    You are assigned a personal nurse to assist you with your medical needs.

    Risk factors assessment

    Care planning

    We offer referrals and assistance. We make sure you have timely access to care. We also help with coordination of care with providers.

    Resource Mother Outreach

    Co-Pays: $0

  • Dental, Primary Care and Vaccination Services

    Dental Services

    Two exams per benefit year

    X-rays once a year

    Two cleanings per benefit year

    Deep gum cleaning

    Call the number on the back of your ID card. They will help you with questions and finding a dentist near you.

    Co-Pays: $0

    Primary Care Services

    Five office/outpatient visits

    Co-Pays: $0

    Vaccination Services

    P4HB Participants age 18:

    • All vaccines under the Vaccines for Children (VFC) Program; talk with your PCP about these vaccinations

    P4HB Participants ages 19 and 20, as needed:

    • Hepatitis B (HepB)
    • Tetanus-Diphtheria (Td)
    • Tetanus-Diphtheria and acellular pertussis (Tdap)

    Co-Pays: $0

  • Transportation Services

    Emergency Transportation Services

    Co-Pays: $0

    Non-Emergency Medical Transportation Services

    See the Transportation Services section for more details.

    Co-Pays: $0

  • Family Planning Services and Supplies

    Family Planning Services and Supplies

    Contraceptive supplies and follow-up care

    Contraceptive management, education and counseling

    Diagnosis and treatment of sexually transmitted infections (except for HIV/AIDS and hepatitis)

    Drugs, supplies or devises related to women's health services that are prescribed by a physician or advanced practice nurse

    Drugs for treatment of lower genital tract and genital skin infections/disorders and urinary tract infections, when the infection/disorder is identified or diagnosed during a routine/periodic family planning visit (a follow-up visit for the treatment/drugs may be covered)

    Initial and annual complete physical exam, including a pelvic exam and Pap test, as well as follow-up visits (up to four)

    Pregnancy testing

    Co-Pays: $0

  • Health Center and Clinic Services

    Federally Qualified Health Center Services

    Co-Pays: $2

    Rural Health Clinic Services

    Co-Pays: $2

  • Additional Services

    Abortions and Related Services

    Not covered

    Co-Pays: --

    Hysterectomies

    Not covered

    Co-Pays: --

    Tubal Ligations (Sterilizations)

    Covered only if participant:

    • Is at least age 21 or older and mentally competent
    • Voluntarily gives consent and completes all required documentation
    • Is not institutionalized in a correctional facility, mental hospital or other rehabilitative facility

    Co-Pays: $0

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Last Updated On: 6/16/2017
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