New Parents Package

You must be a current Carolina Complete Health member to receive this Value-Added Service. Notice of Pregnancy Form is Required.

To qualify to receive New Parents’ Package supplies, members must have a completed Notification of Pregnancy (NOP) Form (PDF) on file with Carolina Complete Health.

If you have not completed the Notification of Pregnancy (NOP) Form (PDF), your New Parents Package request will NOT be processed.

If you need assistance in filling out a Notification of Pregnancy (NOP) Form (PDF), please contact Member Services at 1-833-552-3876 (TTY 711).

At Carolina Complete Health, we understand that having a new baby is a life-changing event. To help support you and your baby during the first year, we offer New Parents’ Package supplies including a choice between a car seat OR a breast pump and diapers OR a pack 'n play. To receive New Parents’ Package supplies, please fill out the form below.

We want to help you and your baby grow healthy and stay healthy. Start Smart for Your Baby® is our program for pregnant and new moms. It is designed to customize the support and care you need for a healthy pregnancy.

Eligibility Statement: You must be a current Carolina Complete Health member to receive this Value-Added Service. To qualify to receive New Parents’ Package supplies, members must have filled out a Notification of Pregnancy (NOP) Form (PDF), be expecting a new baby, and/or have delivered a new baby within 12 months of the request. Eligibility for New Parents’ Package supplies will be confirmed by the Carolina Complete Care Management Team. One request per eligible member will be fulfilled every 12 months.

Note: Please allow at least 14 days for review and processing of your request. New Parent's Package items cannot be sent to P.O. boxes. A responsible party must sign for the delivery of the package. For assistance, please contact us at 1-833-552-3876 (TTY 711).

NEW PARENTS PACKAGE FORM

Member Name (As it appears on your Medicaid ID card if Member) * Please enter the member name as it's displayed on your Carolina Complete Health Member ID card. Member entered must have a valid Notice of Pregnancy form on-file with Carolina Complete Health.

Member ID Number * Please enter the Member ID number as it's displayed on your Carolina Complete Health Member ID card.

Member Date of Birth * Please enter the date of birth as it's displayed on your Carolina Complete Health Member ID card.

Member Address (Must match address on file with Carolina Complete Health) * New Parent's Package items cannot be sent to a Post Office (P.O.) box. Please enter a physical mailing address. Any requests submitted with a P.O. Box listed will not be processed.

City *

Zip Code *

Name of Person filling out this form (If different from Member)

Phone Number *

Email Address *

Do you have a current Notice of Pregnancy (NOP) Form on file with Carolina Complete Health? Yes No

Choose the New Parents Package you would like to receive. * Car Seat Double Electric Breast Pump Kit and Diapers Pack 'n Play We will make every attempt to fulfill your order with the branded item you selected. In the event we cannot, we will replace it with an equal brand and value for fulfilment.

What car seat style would you like? Adjustable Infant Car Seat Infant Cart Seat

You are unable to submit a New Parents Package request because you do not have a current Notification of Pregnancy (NOP) form on file.

If you need assistance in filling out a Notification of Pregnancy (NOP) Form (PDF), please contact your Care Manager or call Member Services at 1-833-552-3876 (TTY 711).

This Value-Added Service requires the recipient or a responsible party to sign for the delivery of their package. * I agree

This form will send your message to Carolina Complete Health as an email. The email is not encrypted and is not transmitted in a secured format. By communicating with Carolina Complete Health through email, you accept the risks associated thereof. Carolina Complete Health does not accept responsibility or liability for any loss or damage arising from the use of email. To ensure the safety of your protected health information (PHI), please send us a message through the Secure Member Portal or Provider Portal, or you can call us at 1-833-552-3876 (TTY 711) to speak directly to a member service representative.

If you need assistance filling out this form, please call Member Services at 1-833-552-3876 (TTY 711).