Postpartum care

Frequently asked questions

• What is well-baby care?

  • Oscar covers well-baby (and well-child) care, which consists of routine physical examinations such as vision and hearing screenings, developmental assessment, anticipatory guidance, and laboratory tests ordered at the time of visit, as recommended by the American Academy of Pediatrics. 

    Immunizations and boosters as required by ACIP are also covered. This benefit is provided to members from birth through attainment of age 19 and is not subject to copayments, deductibles, or coinsurance when provided by a participating in-network provider.

• Are postpartum visits covered?

  • Oscar covers postpartum visits under your Oscar plan, if done with an in-network provider. 

• What kind of postpartum visits can I expect?
  • Standard guidelines recommend a postpartum visit at 4-6 weeks for all new mothers. Mothers with complications (e.g. gestational diabetes, preeclampsia) may go earlier. Post-delivery care typically consists of services provided by the registered professional nurse or physician, including:

    • Physical assessment of the Newborn and mother
    • Parent education
    • Assistance and training in breast or bottle feeding,
    • Education and services for complete childhood immunizations
    • Any necessary and appropriate clinical tests
    • Submission of a metabolic specimen satisfactory to the state laboratory
• Is a breast pump covered by Oscar, and how do I get one?

  • One breast pump is covered per pregnancy. You can order this pump while still pregnant, or after you deliver. Breast pumps, depending on the type, are covered in full as a preventive service. (Note: these items cannot be returned.) You can rent one from the hospital, or buy one from an in-network durable medical equipment (DME) vendor. To order a pump through a DME vendor, please contact: Byram Healthcare for Breast Pumps: 877-773-1972; or EdgePark Medical Supplies: 800-321-0591.

• Are lactation consultations covered by Oscar?
  • All members of Oscar are eligible up to five visits with a certified lactation consultation during pregnancy or the duration of breastfeeding. Visits can be in an individual or group setting. Services provided during a lactation consultation include: 

    • Comprehensive maternal, child, and feeding assessment related to lactation 
    • Developing and implementing a personalized feeding plan 
    • Providing guidance and support to enable mothers to meet their breastfeeding goals 

    If you can’t find an in-network lactation consult, Oscar will need to sign a contract with your chosen lactation consult to have your visits covered. Your Care Team can help you through this process. Log in to your Oscar account online or in the Oscar app, or call 1-855-672-2755.
• When (and how) should I add my baby to my health insurance plan?

  • Babies are typically covered for a certain length of time under the mother’s plan before they will need their own coverage, however, this is dependent on the state in which you live. 

    If you’re based in California: Please notify Oscar or Covered California to add your newborn to your policy. If you enrolled through the marketplace, you’ll need to contact the marketplace to have your child added. As always, reference your Certificate of Coverage, or call your Care Team at 1-855-672-2755 to find out the timeframe for enrolling your baby in their own coverage. (You’ll need a copy of birth certificate or proof from the hospital reflecting the date of birth.)  

    If you're based in New York: New York offers a health insurance plan for children, called Child Health Plus (CHP). Newborns who are eligible for CHP can receive coverage from Oscar until their CHP coverage kicks in. Please contact Oscar for more details.

• I think I’m experiencing postpartum depression. What should I do?
  • Oscar offers mental health services for all our members, including counseling and resources for postpartum depression. Connect with a virtual mental health provider through Oscar’s partnership with Ginger. To get started, download the Ginger app. The cost of these visits depends on your plan benefits. If you’re looking for in-person mental health care, our partnership with Optum provides you with mental health care services and in-network providers that can meet your needs.You can schedule an in-person visit through Optum, and search for providers via their online search portal. When calling a provider's office to book an appointment, just let them know that you have Optum through Oscar.If you feel that you’re in a crisis situation and need to speak to a therapist right away, please call Optum directly, or call us at 855-672-2755, and we’ll transfer you to their crisis line right away.