Summary of Benefits and Coverage

Maternity Care
A healthy, 28-year-old woman decides to start a family and begins taking prenatal vitamins in
January. Her doctor confirms she is pregnant at the beginning of April. She receives routine,
prenatal care, as recommended by national guidelines. She attends a cycle of childbirth and
breastfeeding classes. In December, she gives birth to a healthy child; the delivery is normal and
uncomplicated. Mother and child are released on the second hospital day. The mother is
discharged with pain medications and a stool softener.

DISCLAIMER: This narrative and the accompanying benefit scenario illustrate care for a
hypothetical patient receiving maternity care. The care, and cost of care, will vary for each
patient. No portion of this narrative or the accompanying benefit scenario should be construed
as recommendations for care, or cost of care, by the United States Government.

OMB Control Numbers 1545-2229, 1210-0147, and 0938-1146