Maternity - Length of Stay

The postpartum period during which maternity patients stay in a facility after delivery may vary according to the complexity of the delivery. HMSA has set basic length-of-stay guidelines consistent with recent federal legislation. The suggested lengths of stay are two days or fewer from the time of delivery for normal vaginal deliveries and four days or fewer from the time of delivery for normal cesarean deliveries. All newborns are covered for services for the first 48 or 96 hours. After the first 48/96 hour time period, eligible newborns with congenital defects and birth abnormalities are covered for the first 31 days of birth even if not added to the subscriber’s coverage. All other newborns are covered only if they are added to the subscriber’s coverage within the timeframe from birth designated by the plan.

It is not necessary to obtain precertification of benefits prior to admitting a maternity patient for delivery or for cases in which the length of stay is expected to exceed the guideline.

If a complication or medical condition causes the postpartum hospital stay for a patient to be extended, the physician should order the appropriate medical care.

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