Special delivery
Get to know your maternity benefits
We’re glad to be with you at this exciting time. In this guide, you’ll find information on programs, resources
and benefits available to help during pregnancy, for the birth of your baby and after delivery.
i
Support throughout pregnancy
Be sure to get the support you need on this special journey. A great place to start
s to nd a network doctor you feel comfortable with. You can access the provider
search tool on your:
• Aetna® member website at Aetna.com
• Aetna Health℠ app
Need some help? Your Aetna Service Advocate can help you understand your benets and
coordinate your care. Call 1-800-884-9565 (TTY: 711) to:
• Learn about programs and resources.
• Find an Ob/Gyn, pediatrician or other specialist.
• Understand your maternity and baby coverage.
• Receive one-to-one support for a high-risk pregnancy. Ask to speak with a nurse care manager.
• Receive one-to-one support for fertility services. Ask to speak with a fertility advocate.
Policies and plans are insured and/or administered by Aetna Life Insurance Company or its aliates (Aetna).
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Resources
Here are some programs and resources that can help support you before and after the baby arrives.
Aetna
®
maternity support
We’re here to help you throughout your journey, from
pregnancy to parenthood. Find trusted resources by phone
and online to answer your questions and provide information
for every stage along the way.
Aetna Enhanced Maternity Program
™
With the Aetna Enhanced Maternity Program, you can count on
us to support you throughout your entire pregnancy journey.
The program is included in your Aetna plan. To get started:
• Text BABY to 66902.*
• Enroll on your Aetna member website.
• Call your Aetna Service Advocate at
1-800-884-9565 (TTY: 711).
You’ll learn about what to expect before and after delivery, early
labor symptoms, newborn care and more. We can also:
• Oer you phone-based genetic counseling and screening,
as well as convenient, condential and cost-eective
genetic testing
• Help you make informed decisions throughout your pregnancy
• Provide personalized nurse support for at-risk pregnancies
• Give you advice on lowering your risk for early labor
• Help you cope with postpartum depression
Enroll early and get a reward when you sign up by the 16th
week of pregnancy.
Maternity Support Center
Log in at Aetna.com to access the Maternity Support Center.
Find information on planning for baby, pregnancy and post-
delivery, including:
• Pre-pregnancy checklists
• Coverage details, like ultrasound costs
• Breastfeeding and postpartum support
• Baby-care tips
*Y ou’ll receive a one-time automated text message with a link
to information about the Aetna Maternity Support Center.
Consent is not a condition, directly or indirectly, of purchase or
participation. Message and data rates may apply. Text HELP to
66902 for info. Text STOP to 66902 to cancel. Access the full
terms and conditions and privacy policy here.
SimpliFed
SimpliFed oers one-on-one virtual baby feeding support at no
cost to you. Get help with:
• Breastfeeding
• Latch and positioning
• Low supply or oversupply
• Cracked or sore nipples
• Pumping
• Formula feeding
• Formula and bottle prep
• Pace feeding
• Combo feeding
• Transitions
• Prenatal baby feeding plan
• Returning to work
• Traveling
• Introducing solid foods
• Weening
Learn more at SimpliFed.com. To get started, click
Start Getting Care or text BABY to
1-888-458-1364.
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Resources continued
Emotional support
Stress can come with big changes like a new baby on the way. Be sure to take care of your mental health along with your
physical health. Try one of these resources for some extra support, from self-help tools to face-to-face sessions.
Your medical plan
Your Aetna® medical plan covers inpatient and outpatient
behavioral health treatment. Services are covered the same as
other care under your medical plan. Call your Aetna Service
Advocate at 1-800-884-9565 (TTY: 711) and ask to speak with
a behavioral health specialist.
Spring Health
Spring Health, Adobe’s Employee Assistance Program (EAP)
provider, gives you easy access to condential, short-term
counseling services and work-life resources. You’re eligible for
up to 12 no-cost counseling sessions each calendar year.
To enroll:
• Go to Adobe.SpringHealth.com, access code: adobe.
• Call 240-558-5796. For crisis support and immediate
assistance, press 2.
• Download the Spring Health Mobile app.
Teladoc Health
Teladoc Health oers video sessions with a psychiatrist,
psychologist or other behavioral health provider.
• Psychiatrist (initial visit): $190 per session
• Psychiatrist (ongoing visit): $95 per session
• Psychologist, licensed clinical social work, counselor or
therapist: $85 per session
Set up your account at TeladocHealth.com/Aetna. When you
want to use the service, visit the site or call 1-855-835-2362.
AbleTo
AbleTo is an eight-week program that lets you talk by phone
or video with a therapist and behavior coach. Get help with
issues such as depression, anxiety, postnatal recovery and
caregiver stress. To get started, call AbleTo at 1-844-422-5386.
The program is covered at 100% once you’ve met your annual
deductible.
Behavioral health televideo
Behavioral health televideo services provide counseling from
anywhere for the same cost as an oce visit. To get started, call
one of the provider groups below, or call your Aetna Service
Advocate at 1-800-884-9565 (TTY: 711) for additional options.
Contact
At
Array 1-800-442-8938
ArrayBC.com
accepts patients age 5 and older
MDLIVE® 1-855-82
4-2170
MDLIVE.com/BHCOMM
accepts patients age 10 and older
Telemynd 1-866-991-2103
Telemynd.com/aetna
accepts patients age 5 and older
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How your plan pays
Here’s how your Aetna® medical plan covers services after you meet your annual deductible:
Plan provisions Aetna HealthSave Basic
In network Out of network*
Aetna HealthSave
In network Out of network*
Aetna Out of Area
HealthSave
In network
Routine prenatal care
(See Routine vs. diagnostic
prenatal care on page 6.)
100%, not subject
to the deductible
60% 100%, not subject
to the deductible
70% 100%, not subject
to the deductible
Global delivery fee
Includes delivery and
postnatal ob/gyn visits**
80% 60% 90% 70% 80%
Lab tests 80% 60% 90% 70% 80%
Ultrasounds 80% 60% 90% 70% 80%
Inpatient hospital
(3 days for vaginal delivery
and 5 days for C-section)**
80% 60% 90% 70% 80%
Lactation consultation 100%, not subject
to the deductible
60% 100%, not subject
to the deductible
70% 100%, not subject
to the deductible
Breast pump 100%, not subject
to the deductible
60% 100%, not subject
to the deductible
70% 100%, not subject
to the deductible
Well-baby visits 100%, not subject
to the deductible
60% 100%, not subject
to the deductible
70% 100%, not subject
to the deductible
Prescription drugs
After you meet your deductible, you pay the following copays when you use a network pharmacy. You’ll pay more if you use an
out-of-network pharmacy.
Retail or CVS Specialty®
pharmacy
30-day supply***
$15 for generics
$45 for brand-name drugs on the Aetna Performance Drug List
$65 for other brand-name drugs
Mail order or
CVS Pharmacy®
90-day supply***
$30 for generics
$90 for brand-name drugs on the Aetna Performance Drug List
$130 for other brand-name drugs
* If you go outside the network, your share of costs is not based on a negotiated amount, but rather on the recognized amount/
charge. You may be responsible for the entire dierence between what the provider bills and the recognized amount/charge.
And that additional amount doesn’t count toward your out-of-pocket maximum.
** All inpatient and certain outpatient services require advance approval (precertication).
*** Benets are reduced if you obtain drugs at an out-of-network pharmacy. Copa
ys count toward your out-of-pocket maximum.
Getting preapproval
Your medical plan requires advance approval (called precertication) for a hospital stay and genetic testing. As long as you stay in
the network, your doctor will take care of getting authorizations for you.
If you go outside the network, ask your doctor to contact Aetna to start the process. If the doctor doesn’t handle this process, you
may need to call Aetna yourself.
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Know your benets
Most prenatal, delivery and postnatal services are covered under your medical plan. Some services may be
covered as preventive care at 100%, while others may be subject to the deductible and coinsurance. It’s important
to understand how services are covered and that you might need to pay some expenses out of your pocket.
Pregnancy
Genetic testing
The Aetna Enhanced Maternity Program™ oers genetic testing and genetic counseling by phone at low
discounted rates. Call your Aetna Service Advocate at 1-800-884-9565 (TTY: 711) to learn more.
Routine prenatal care
Covered at 100% in network. See Routine vs. diagnostic prenatal care on page 6.
Covered maternity services
Include lab work, ultrasounds, prenatal vitamins, maternity pantyhose and the fetal non-stress test.
Parenting, prenatal and birthing classes
Not covered.
Delivery
Birthing centers and midwives
Covered the same as other medical expenses.
Doulas
Doulas are not recognized medical providers and are not covered.
Inpatient delivery
• Hospital charges, including room, board and miscellaneous charges, are covered the same as other
medical expenses.
• Ob/gyn charges are covered under the global delivery fee.*
After delivery
Baby’s doctor visits
• Routine checkups, including immunizations, are covered at 100% in network.
• Sick visits are covered the same as other medical expenses.
Breast pumps and lactation consultations
Covered at 100% when you use network providers.
In-hospital baby care after delivery
Includes circumcision, pediatrician and nursery care and is covered under the baby’s medical coverage.
Postnatal visits
Covered under the global delivery fee.*
*The global delivery fee is a one-time fee billed after delivery. It includes delivery and postnatal ob/gyn visits. Other charges are billed
at the time of service.
NOTE: Deductibles and coinsurance limits start over each plan year on January 1. Keep this in mind if your delivery date
is expected in the new plan year.
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Routine vs. diagnostic prenatal care
Routine prenatal care and diagnostic care are covered dierently, so it’s important to understand the dierence so you know what
you can expect to pay.
Here are some examples. You can always call your Aetna Service Advocate at 1-800-884-9565 (TTY: 711) if you’re not sure.
Preventive
Routine prenatal care is considered preventive and is covered
at 100%, as long as you stay in the network. Examples include:
• Routine prenatal visits, including physical exam and blood
pressure check
• Checking baby’s heart
• Routine urinalysis
• Anemia screenings
• Bacteriuria, urinary tract or other infection screenings
• Diabetes screenings
• Expanded counseling on tobacco use
• Hepatitis B counseling (at the rst prenatal visit)
• Maternal depression screening and counseling
• Rh incompatibility screening, with follow-up testing for
women at higher risk
Diagnostic
Diagnostic prenatal care is not preventive and is subject
to your deductible and coinsurance. Examples include:
• Non-routine prenatal visits
• Specialist visits
• Amniocentesis
• Fetal stress tests
• Ultrasounds
• Non-routine lab tests
Miscarriage
During this dicult time, the last thing you need is unexpected medical bills. So we want to be sure you know how your
care is covered. Since a miscarriage is not routine prenatal care, all associated medical expenses would be subject to
your deductible and coinsurance.
If you need emotional support during this challenging time, be sure to take advantage of the emotional well-being
resources described on page 3.
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Timeline for a healthy pregnancy
Use this chart as a guideline for what to expect at doctor visits.
0–28 weeks
Visits every four weeks
Initial medical history
Physical exam
Weight
Pregnancy test
Blood pressure
Urine test
Check baby’s heart
Ultrasound if needed*
CVS/amniocentesis if needed*
Blood tests
28–36 weeks
Visits every tw
o weeks
Physical ex
am
Weight
Blood pressure
Urine test
Check baby’s heart
Ultrasound if needed*
Quad screen*
Tdap, RhoGAM (if Rh negative)*
Kick counts
Labor and delivery precautions
36 weeks to b
irth
Visits e
very week
Physical exam
Weight
Blood pressure
Urine test
Check baby’s heart
Ultrasound if needed*
Don’t forget to keep up with your regular preventive dental care during your pregnancy.
*Billed outside of global delivery fee.
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Preparing for a newborn
It’s not too soon to start understanding and planning for the benets available after the baby arrives.
Leave benets
Adobe maternity leave benets include medical disability leave
and parental leave. For more information, please review the
Leaves of absence page on Benets.Adobe.com.
Medical coverage for baby
You may add your baby to your medical coverage, but you
only have 31 days from your baby’s date of birth to do so. Visit
the Adobe benets enrollment site to enroll or make other
changes to your benets. Once you complete the enrollment,
you’ll receive new ID cards.
Breast milk transportation
Milk Stork is a breast milk delivery service for moms traveling
on Adobe business. The service provides no-fuss, refrigerated,
express shipping or easy toting of breast milk home to
your baby.
To learn more or schedule service, visit MilkStork.com/adobe
or call 510-356-0221.
Childcare resources
Through TRI-AD, you have access to a Dependent Care
Flexible Spending Account (FSA) that, if you’re eligible,
allows you to set aside pre-tax dollars to reimburse childcare
expenses. When you enroll, Adobe makes a contribution,
too! Visit the Adobe benets enrollment site to enroll or
make changes.
To learn more, review the Dependent Care FSA page on
Benets.Adobe.com or call TRI-AD at 1-855-482-3623.
Bright Horizons® oers resources and discounts for daycare
options, as well as support for special needs children:
• In-center care
• Babysitters and nannies
• Backup care
• Special needs support
To learn more, visit Clients.BrightHorizons.com/adobe
(username: ASI, password: Benets4You) or call 1-877-242-2737.
Providers are independent contractors and are not agents of Aetna®. Provider participation may change without notice. Health
information programs provide general health information and are not a substitute for diagnosis or treatment by a health care
professional. Refer to Aetna.com for more information about Aetna plans.
Te
ladoc Health is not available to all members. Teladoc Health and Teladoc
Health physicians are independent contractors and are not agents of Aetna.
Visit TeladocHealth.com/Aetna for a complete description of the limitations of
Teladoc Health services. Teladoc Health is a registered trademark of Teladoc
Health, Inc.
CCG ADOBE-0063 (9/23) ©2023 Aetna Inc.
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