Cigna insurance coverage for pregnancy

For some women, the breast tenderness, morning sickness, and fatigue of the first trimester ease up or disappear during the second trimester, while the physical discomforts of late pregnancy have yet to start.

Pressure on your bladder may be less as the uterus grows up out of the pelvis. Common symptoms you may experience during the second trimester of pregnancy include:. The third trimester lasts from week 28 to the birth. Many women have some discomfort during this time as their belly gets bigger. You might have trouble getting comfortable so you can sleep. And you might have a few other aches and pains. Common symptoms you may experience during the third trimester include:.

The first trimester of pregnancy is week 1 through week 12, or about 3 months. The second trimester is week 13 to week And the third trimester of pregnancy spans from week 28 to the birth. Your baby will change from week to week.

To learn more about how your baby is changing each month and about what tests you might think about having, see the Interactive Tool: From Embryo to Baby in 9 Months. During the week after fertilization, the fertilized egg grows into a microscopic ball of cells blastocyst , which implants on the wall of your uterus.

This implantation triggers a series of hormonal and physical changes in your body. The third through eighth weeks of growth are called the embryonic stage, during which the embryo develops most major body organs. During this process, the embryo is especially vulnerable to damaging substances, such as alcohol, radiation, and infectious diseases.

Having reached a little more than 1 in. By now, the uterus has grown from about the size of a fist to about the size of a grapefruit. The first trimester is a time of amazing development. The embryo starts out looking like a tiny seed, then a tadpole with a tail, and then more human. If this is your first pregnancy, you'll begin to feel your fetus move at about 18 to 22 weeks after your last menstrual period.

Although your fetus has been moving for several weeks, the movements have not been strong enough for you to notice until now. At first, fetal movements can be so gentle that you may not be sure what you are feeling. If you've been pregnant before, you may notice movement earlier, sometime between weeks 16 and During this time, the fetus is still building up body fat and starting to put on a lot of weight.

By the end of the second trimester , your fetus is about 10 in. The third trimester of pregnancy spans from week 28 to the birth. The fetus moves frequently, especially between the 27th and 32nd weeks. After week 32, a fetus becomes too big to move around easily inside the uterus and may seem to move less. Your due date marks the end of your 40th week.

During this final trimester, your fetus grows larger and the body organs mature. At the end of the third trimester , a fetus usually settles into a head-down position in the uterus. You will likely feel some discomfort as you get close to delivery. The emotional experience of pregnancy is different for every woman. It's common to have mixed emotions and to feel uncertain—even if your pregnancy was planned. Because of the increasing hormones and the fatigue of early pregnancy, mood swings can be worse than before pregnancy.

Many women worry that their baby will have a problem. Or they may feel anxious about childbirth. Your relationships with family and friends may change as you adjust to having a new family member. With all the changes in your life, you may feel stressed at times.

Try relaxation exercises and use time management tips and skills at home. Some women have health problems or concerns before they get pregnant. For other women, problems may come up during pregnancy. Your doctor or midwife will work with you to prevent or manage these problems to help you have a healthy pregnancy. If you have a health problem or concern, you may have a high-risk pregnancy. This means that your doctor or midwife needs to follow you closely. It doesn't mean that something will go wrong during your pregnancy.

During your prenatal visits, talk with your doctor or midwife about what you would like to happen during your labor. Consider writing up your labor and delivery preferences in a birthing plan, either in a childbirth education class or on your own. You can find examples of birthing plans on parenting websites. Because no labor or delivery can be fully anticipated or planned in advance, be flexible. Your experience after labor begins may be totally different from what you expected. If an emergency or an urgent situation arises, your plans may be changed for your own or your baby's safety.

When making plans for your baby's birth, consider the location of your delivery , who will deliver your baby , and whether you want continuous labor support from a doula , a friend, or family members.

If you haven't already, this is also a good time to decide whether you'll attend a childbirth education class, starting in your sixth or seventh month of pregnancy. Learn about labor and delivery ahead of time. Think through your preferences for comfort measures, pain relief, medical procedures, and fetal monitoring. And think through how you want to handle your first hours with your newborn.

To learn more, see the topic Labor and Delivery. Plan ahead for breastfeeding by learning about breastfeeding and finding a good lactation consultant ahead of time and buying necessary supplies. To learn more, see the topic Breastfeeding. Sometime during your pregnancy, you may get information about cord blood banking. Cord blood is the blood left in the umbilical cord after birth. Think about whether you want to bank your baby's umbilical cord blood for possible future use.

At any time during your pregnancy, call if you think you have symptoms of a blood clot in your lung called a pulmonary embolism. These may include:. At any time during your pregnancy, call your doctor now or seek immediate medical care if you:.

At any time during your pregnancy, call your doctor or midwife now if you:. At any time during your pregnancy, call your doctor or midwife today if you:.

If you are between 20 and 37 weeks pregnant, call or other emergency services immediately if you:. If you are between 20 and 37 weeks pregnant, call your doctor or midwife now or go to the hospital if you:. After 37 weeks, call or other emergency services immediately if you:. After 37 weeks of pregnancy, call your doctor or midwife now or go the hospital if you:.

Author: Healthwise Staff. This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content. To learn more about Healthwise, visit Healthwise. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated.

All rights reserved. All insurance policies and group benefit plans contain exclusions and limitations. For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative.

This website is not intended for residents of New Mexico. Selecting these links will take you away from Cigna. Cigna may not control the content or links of non-Cigna websites.

Special Enrollment See all topics Looking for Medicare coverage? Shop for Medicare plans. Member Guide. Find a Doctor. Topic Overview Is this topic for you? What can you do to have a healthy pregnancy? What kinds of exams and tests will you have? What changes can you expect in your body and your emotions? Health Tools Health Tools Health Tools help you make wise health decisions or take action to improve your health.

Decision Points focus on key medical care decisions that are important to many health problems. Actionsets are designed to help people take an active role in managing a health condition. Interactive tools are designed to help people determine health risks, ideal weight, target heart rate, and more. Prenatal Visits and Tests The first test you may have is the one you take at home to see if you're pregnant.

At-home pregnancy test If you think you might be pregnant, you can use a home pregnancy test as soon as you think you have missed your period. Testing For Birth Defects Tests in the first and second trimester can show if your baby has a birth defect. Health and Nutrition The best way to help yourself have a healthy pregnancy is to eat well, exercise regularly, get plenty of rest, and avoid things that could hurt your baby. Body Changes Pregnancy is a time of many changes. Normal physical changes and symptoms throughout pregnancy Although they can range from mild to severe, the following conditions are common during pregnancy: Fatigue Morning sickness Sleep problems Breast changes Heartburn Back pain and sciatica Pelvic ache and hip pain Leg cramps Many pregnant women also have: Changes in vaginal discharge.

A thin, milky-white discharge leukorrhea is normal throughout pregnancy. Also, the tissues lining the vagina become thicker and less sensitive during pregnancy. Nosebleeds and bleeding gums Hemorrhoids and constipation Varicose veins Hair changes Stretch marks, itchiness, and other skin changes Hand pain, numbness, or weakness carpal tunnel syndrome Mild swelling of your feet and ankles edema. First trimester The first trimester of pregnancy lasts from week 1 through week Other early signs of pregnancy, caused by hormonal changes, include: Fatigue.

Breast tenderness. Increased urination. Fullness or mild aching in your lower abdomen. Nausea with or without vomiting, also known as morning sickness. Pregnancy: Dealing With Morning Sickness Second trimester The second trimester of pregnancy from week 13 to week 27 is the time when most women start to look pregnant and may begin to wear maternity clothes.

Common symptoms you may experience during the second trimester of pregnancy include: Breast changes. Leg cramps. Back pain. Pelvic ache and hip pain.

Stretch marks and other skin changes. Hemorrhoids and constipation. Heartburn also a symptom of gastroesophageal reflux disease, or GERD. Nosebleeds and bleeding gums. Hand pain, numbness, or weakness carpal tunnel syndrome. Braxton Hicks contractions , which are "warm-up" contractions that do not thin and open the cervix do not lead to labor. Third trimester The third trimester lasts from week 28 to the birth. Common symptoms you may experience during the third trimester include: Braxton Hicks contractions , which are "warm-up" contractions that do not thin and open the cervix do not lead to labor.

Heartburn a symptom of gastroesophageal reflux disease, or GERD. Breathing difficulty, since your uterus is now just below your rib cage, and your lungs have less room to expand. Mild swelling of your feet and ankles edema. Pregnancy causes more fluid to build up in your body. This, plus the extra pressure that your uterus places on your legs, can lead to swelling in your feet and ankles. Difficulty sleeping and finding a comfortable position.

Lying on your back interferes with blood circulation, and lying on your stomach isn't possible. Sleep on your side, using pillows to support your belly and between your knees. Later in your pregnancy, it is best to lie on your left side. When you lie on your right side or on your back, the increasing weight of your uterus can partly block the large blood vessel in front of your backbone.

Frequent urination, caused by your enlarged uterus and the pressure of the fetus's head on your bladder. Baby Development Pregnancy is measured in trimesters from the first day of your last menstrual period, totaling 40 weeks. First trimester During the week after fertilization, the fertilized egg grows into a microscopic ball of cells blastocyst , which implants on the wall of your uterus.

Second trimester If this is your first pregnancy, you'll begin to feel your fetus move at about 18 to 22 weeks after your last menstrual period. Third trimester The third trimester of pregnancy spans from week 28 to the birth. Emotions and Relationships The emotional experience of pregnancy is different for every woman. Emotional changes occur throughout pregnancy. Changes in your relationship with your partner are to be expected as your focus shifts to your own and your baby's well-being.

Getting support from your partner is important to help you bond as a family and to help you have less stress. Handling pregnancy and parenting can be a challenge. Rest whenever you can. Prepare your other child or children ahead of time to help your family adjust to the demands of a newborn. Health Concerns Some women have health problems or concerns before they get pregnant.

Pregnancy when you have health problems Depression during pregnancy requires treatment to reduce risks to you and your baby, before and after pregnancy. If you have diabetes, it's important during pregnancy to keep your blood sugar in your target range. Planning diabetes care before and during the first few weeks of pregnancy can lower your risk of problems. Obesity during pregnancy can increase the chance of problems. But most women who are obese have healthy babies.

Your doctor will follow you closely and will plan a pregnancy weight gain that is right for you. If you have chronic high blood pressure during pregnancy , special care may be required. Your doctor may need to change the medicines you take to control your high blood pressure.

Managing asthma during pregnancy is important for making sure you and your baby are getting enough oxygen. Most, but not all, asthma medicines are safe to use during pregnancy. Having epilepsy during pregnancy may require you to switch medicine or make other changes. But stopping medicine is not always the best solution.

Having seizures during pregnancy can also harm the baby. Talk with your doctor about the best choice for you. Human immunodeficiency virus HIV during pregnancy requires early detection and treatment to prevent newborn infection. Cancer treatment during pregnancy is delayed whenever possible to prevent harm to the baby. But chemotherapy is sometimes used, when needed. Common infections during pregnancy Vaginal yeast infections are more common in pregnancy because of the increased levels of hormones.

Call your doctor or midwife if you have symptoms of a vaginal yeast infection or bacterial vaginal infection bacterial vaginosis. Urinary tract infection is common during pregnancy and must be treated with antibiotics to prevent a dangerous infection or preterm labor.

Medical groups and PHOs may in turn compensate providers using a variety of methods. This compensation method applies to Cigna Network plans and the in-network providers in our POS plans.

Capitation provides physicians with a predictable income, encourages physicians to keep people well through preventive care, eliminates the financial incentive to provide services which will not benefit the patient, and reduces paperwork for physicians. Salary : Physicians who are employed to work in a Cigna medical facility are paid a salary. The physician's compensation is based on a dollar amount, decided in advance each year, that is guaranteed regardless of the services provided.

Physicians are eligible for a bonus at the end of the year based on quality of care, quality of service, and appropriate use of medical services. Bonuses and Incentives: Eligible physicians may receive additional payments based on their performance. To determine who qualifies, Cigna evaluates physician performance using criteria that may include quality of care, quality of service, and appropriate use of medical services. Formulary Some patient advocates and independent pharmacists contend that drug formularies limit patient treatment options and can inhibit therapy.

In particular, media attention has focused on certain drugs not being included on formularies. Patient advocacy groups are seeking coverage for all FDA-approved drugs, regardless of whether they are approved for the treatment for which they are being prescribed. Legislative attacks are under way. The Susan Horn Study , concluded that use of formularies increased use of health care services, which resulted in lower quality and increased costs.

The Cigna formulary—a list of drugs covered by a member's benefit plan—was developed to assure quality and cost effective drug therapy. Drugs included in our formulary are carefully selected by physicians and pharmacists for their efficacy, and the formulary is reviewed and updated regularly.

This process allows our members to benefit on an ongoing basis from advances in pharmaceutical science that can dramatically improve the quality of people's lives. Hospitals have used drug formularies in the same way for many years. The Cigna national drug formulary contains 1, FDA-approved brand name and generic drugs.

These drugs are placed on the formulary by the Cigna Pharmacy and Therapeutic Committee, which meets quarterly and is composed of physicians and pharmacists. The Cigna Pharmacy and Therapeutic Committee reviews all FDA-approved drugs, groups them by therapeutic function, and then, within each group, compares their relative therapeutic effectiveness and potential side effects. Only when two or more drugs are determined to be therapeutically equivalent does cost become a consideration.

Cost is an appropriate and necessary consideration, since drug prices have risen three times faster than the rate of inflation over the last decade. We offer a variety of formulary structures, depending on the level of prescription drug coverage your employer chooses to offer.

Our Two-Tier Formulary covers generic drugs and preferred brand-name drugs that do not have generic equivalents slightly higher copayment required. Our Three-Tier Formulary covers generics, preferred-brand, and non-preferred brand drugs medications that have generic equivalents or one or more preferred-brand options available at a higher copayment level.

Your employer can tell you which formulary program you participate in or you can call Member Services. You can also review your specific formulary for covered medications online. Local Cigna plans may modify the national formulary to take into consideration local prescribing practices. If a physician wishes to prescribe a drug that is not on the formulary, the physician or a member may seek an exception to the formulary for coverage of a non-formulary drug.

It has resurfaced again in several state legislatures and at the federal level. Critics of managed care are making the argument that when a health plan denies coverage for a treatment or procedure, it is a medical decision—because the health plan is deciding what treatment it will cover—and should be subject to medical malpractice liability.

The underlying assumption is that treatment will not be given unless the health plan will pay for it. Health plan medical professionals make coverage determinations based on the terms of a member's particular benefit plan. Health plan medical directors use utilization management guidelines to assist in making such coverage determinations, but they are used as just that—guidelines—and are not a substitute for a clinician's judgment. The utilization management guidelines are a set of optimal clinical practice benchmarks for a given treatment with no complications and are based solely on sound clinical practices.

The Cigna utilization management guidelines are reviewed by each local health plan's quality committee, composed of Cigna-participating physicians practicing in the area, and are modified to reflect local practice. The guidelines are applied on a case-by-case basis. Mandated Benefits Mandated benefits require managed care companies and insurers by law to provide coverage for specific treatments and procedures and may set durational limits on coverage e. These laws, typically enacted by state legislatures, apply only to HMOs and insured plans, and do not apply to self-insured plans.

Federal mandates, however, apply to all employer-provided plans, whether insured or self-insured. One of the biggest concerns with mandated benefits is that they increase the cost of health care coverage. Some recent examples of mandated benefits include coverage for diabetic supplies, equipment and education, prostate screening antigen PSA testing for prostate cancer, bone densitometry for osteoporosis, breast reconstructive surgery following a mastectomy, and mastectomy length-of-stay requirements.

We are opposed to the government determining specific benefits to be included in managed care and insurance contracts.

We believe that the marketplace should determine the benefits available to health plan participants. Mandatory Point-of-Service Legislative mandates that would require all HMOs to offer a point-of-service plan—a plan that offers participants the option to choose out-of-network providers for covered services—have been introduced in several states and have been enacted in several others.

Legislators are attempting to guarantee that consumers are offered a health care coverage option other than a traditional HMO. We oppose legislative mandates that would require all HMOs to offer an out-of-network benefit. This mandate would increase costs for employers and members and would eliminate traditional HMOs as a product offering in the marketplace. Point-of-service plans are already an option widely available in the marketplace. Maternity Care We care about the health and well-being of our members.

We also provide expectant mothers with educational materials, including a handbook on pregnancy and infancy. If a high-risk pregnancy is identified, the woman will be followed throughout the pregnancy by a case manager who is a registered nurse. The case manager, trained in obstetrics, works with the doctor and member to develop and carry out an appropriate treatment plan that fosters a successful pregnancy and childbirth.

The time a mother and baby spend in the hospital after delivery is a medical decision. Shorter or longer lengths of stay may be approved at the request of the attending physician. Medically necessary home care services are available following discharge from the hospital.

Home care nurses are trained to give a full assessment of the mother's and baby's health as well as answer any questions. Many physicians find that home care is the most effective way to follow up with a new mother since it enables a complete assessment of both health and home environmental issues.

Mental Health Parity In , mental health advocates were successful in the passage of federal legislation that requires employers who provide mental health coverage to apply the same annual and lifetime dollar limits to the mental health benefits as are applied to benefits for physical illness.

Mental health advocates are now seeking state legislative mandates that would require mental health coverage be provided in all health plans at the same level of benefits as physical illness.

Some of the state proposals specify certain conditions, such as biologically based mental illnesses, while others would require all mental health conditions be treated the same as physical illnesses. We do not support government-mandated benefits; however, we do support appropriate care and treatment for mental illness. They are touted as preventing racially discriminatory practices in the selection of providers.

The concerns of minority providers have grown as more health plans have entered the Medicare market—and as states have turned to managed care systems for their Medicaid programs—because health plans, responding to pressures from employers and consumers, contract with board-certified providers only. Historically, minority providers have not applied for board certification. Cigna provider networks reflect the demographics of the provider community and the member population. In certain instances, this practice is considered to be experimental.

We do not prohibit off-label use of approved medications, but use of certain drugs does require preauthorization. Requests for coverage for off-label drug use are reviewed on a case-by-case basis. PHOs seek exemptions from federal antitrust standards, as well as state and federal solvency requirements and other consumer protection standards imposed on HMOs and insurers. As part of the Balanced Budget Act, PHOs were successful in their attempt to get special status to participate in the Medicare Risk program allowing them to meet less rigorous financial standards.

We believe that there should be a level playing field for all managed care players. All competitors should have to meet the same regulatory requirements. Several anti-gag clause provisions are currently pending before Congress. Consumer education and preventive care are the most significant tools a managed care company has to keep health care affordable and provide access to quality care.

Quality health care is possible only when there is an open, unencumbered dialogue between physicians and their patients. We believe that our members should be fully informed. Our members cannot make sound, sensible decisions if they have been given inadequate or incomplete information. In addition, physicians are free to discuss Cigna physician reimbursement with their patients e.

Consequently, we have never imposed restrictions on health care-related communication between physician and patient. Managed care emphasizes the importance of the primary care physician who is specially trained for this role. Most specialists do not meet the training requirements to be primary care providers. The primary care physician leads the team helping the member to manage their multiple health conditions and treatments—often, this includes assuring proper access to specialty care and making sure that all of the specialists are keeping one another informed.

This decision would be made as a part of our case management process, which is an integral part of all Cigna health plans. Utilization Management Utilization management is one of the tools Cigna uses to help make sure our customers get coverage for quality care.

It involves having health care professionals review tests and procedures that your provider orders to determine if your Cigna plan will cover the cost. They also make sure the treatment is medically necessary. Medical professionals make coverage decisions consistent with the terms of your health plan.

These professionals use established guidelines to help them make decisions about whether a procedure is medically necessary based upon the specific facts of each coverage request. Cigna medical professionals do not receive any financial or other reward or incentive from any Cigna company, or otherwise, for approving or denying individual requests for coverage.

Utilization management includes prior authorization for certain elective surgeries, procedures, and tests. Prior authorization is a request for coverage of a health care service or treatment that requires clinical review. Prior authorization not only helps protect customers from undergoing unnecessary procedures, but also promotes use of participating providers that meet Cigna standards for quality.

Another component of utilization management is concurrent review. It includes discharge planning, including assisting with arrangements for home health care services, when medically necessary. Cigna considers several sources of information to make consistent and accurate coverage determinations.

Utilization Management-Dental Utilization management UM is a program we use to make sure our customers get coverage for appropriate care. It involves having a dentist review procedures that your dentist submits. Our team of dental professionals reviews these procedures to determine if your Cigna plan will cover the cost. This helps save you money so you're not paying for unnecessary care.

How does the Cigna dental team decide what my plan covers and whether a treatment is medically necessary? Dental professionals make coverage decisions using the terms of your dental plan. They'll look to see what benefits your plan covers. They'll also look at what it doesn't cover. These professionals follow guidelines to help them decide if a procedure is medically necessary.

The guidelines are not a substitute for your dentist's judgment. This means that your dentist can discuss your situation with our team if there's a difference of opinion about whether a procedure is medically necessary. Please note that the use of clinical guidelines is not new. The dental community has traditionally used these guidelines as part of the utilization management decision-making process. Individuals involved in utilization management and the review process include Cigna employees in the Clinical, Quality Management, and Claim departments.

These employees do not get any financial reward or incentive from any Cigna company, or otherwise, for approving or denying coverage requests. If you have a Cigna Dental Care plan, you must choose a primary care dentist also known as your network general dentist.

This is the dentist you'll use for all of your basic care. If you need specialty care, your primary care dentist will give you a referral. For your plan to cover the cost of your care, all of the dentists you use must participate in the Cigna Dental Care network.

Your plan doesn't require any pre-authorizations. If you need a lot of specialty dental work done, you may be concerned about whether your plan will cover it. Cigna will review the treatment plan if you ask us. It's possible that we may deny a claim when we review it, if it doesn't meet your plan terms. If you have a DPPO plan, you can choose to use in-network dentists or go out of network.

You'll typically get better benefits if you stay in-network. The terms of your plan will tell you what benefits you are eligible for. You do not need to get pre-authorization for dental procedures.

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For availability, costs and complete details of coverage, contact a licensed agent or Cigna sales representative. This website is not intended for residents of New Mexico. Selecting these links will take you away from Cigna. Cigna may not control the content or links of non-Cigna websites. Special Enrollment See all topics Looking for Medicare coverage?

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