NC Health<em>Smart</em>

Stork Rewards Program FAQs

What is the Stork Rewards program?
The NC HealthSmart Stork Rewards program is an incentive program to encourage pregnant members or spouses to use maternity coaching throughout their pregnancy to promote healthy pregnancies and babies. Members who enroll in the program will have their inpatient hospital copayment waived at the time of delivery, which is $233 for those enrolled in the 80/20 Standard plan and $291 for those enrolled in the 70/30 Basic plan.
Who is eligible to enroll in the program?
The Stork Rewards program is open to newly pregnant members or covered spouses (dependent children are not eligible). This is an NC HealthSmart initiative; members eligible for NC HealthSmart Services are members whose primary health coverage is through the State Health Plan.
How do I participate and receive the copayment waiver?
To qualify, members must call a maternity coach at NC HealthSmart at 800-817-7044 for an initial assessment during their first trimester. They must also complete one action item, as determined by a coach, for each trimester following enrollment in the program.
If I'm already pregnant, am I eligible?
Members who are in their first trimester are eligible to participate by calling a maternity coach to enroll in the program. Members who already participate in maternity coaching through NC HealthSmart are automatically enrolled in the program, but must complete the necessary action steps identified by their coach to qualify for the copayment waiver.
How will I know I'm enrolled in the program?
You will receive a letter from your maternity coach after your initial conversation welcoming you to the program.
What else does the program offer?
Participants will also receive a book to guide you through pregnancy and give tips on newborn care. You can also tap into numerous maternity resources available on your Personal Health Portal.
What does a maternity coach do?
Coaches are unbiased professionals to help you understand all the information given to you throughout your pregnancy. Your coach will create an individualized plan for you for the duration of your pregnancy. Support is available over the phone, on the web and through the mail.
When are maternity coaches available?
Maternity coaches are available by calling 800-817-7044 from 8:30 a.m. – 11 p.m., Monday-Friday and 9 a.m. – 2 p.m. on Saturdays.
What happens if I skip an action step with my maternity coach?
If you miss a participation requirement within a trimester, you will receive a letter informing you that you have two weeks to fulfill that requirement. If you do not fulfill that requirement you will no longer qualify for the incentive.
If I receive the inpatient hospital copayment waiver, will it appear on my bill or explanation of benefits statement?
It will not appear on your bill and your explanation of benefits (EOB) will state that a copayment was not needed. Should your EOB reflect a copayment charge, contact Customer Service at 888-234-2416 and a representative will address the matter for you.
How will the Stork Rewards program be impacted by the new 2014 plan options?
The Stork Rewards Program will still be available in the following manner:
  • Traditional 70/30 Plan – The inpatient copay of $291 is not applied
  • Enhanced 80/20 Plan –
    • If members deliver in a non-designated Blue Options hospital , the $233 inpatient copay will not be applied
    • If members deliver in a Blue Options Designated hospital, they will be reimbursed for the $233 inpatient copay. Members will also benefit from the Blue Options Designated incentive in which the hospital copay will not be applied.
  • CDHP – Members will receive into $250 to the HRA account after delivery