top of page

Medicaid Breakdown (Visits & Payments)

For the most part, the details below are how states list the coverage for Medicaid recipients:


Two levels of doula care have been approved for Medicaid reimbursement, (1) standard care, and (2) enhanced care for members aged 19 or younger:


Standard care (8 perinatal visits-1 labor support visit, i.e., 8-1).

  • Up to 8 visits in the prenatal or postpartum period, including the option of 1 initial prenatal visit.

  • Attendance at the delivery.


Enhanced care (12 perinatal visits-1 labor support visit, i.e., 12-1). Enhanced care delivery is available to members who are 19 years old or younger at the time of the first doula service visit.

  • Up to 12 visits in the prenatal or postpartum period, including the option of 1 initial prenatal visit.

  • Attendance at the delivery.


Doula services are available starting in the prenatal period and continuing up to 180 days (6 months) postpartum as long as the member retains Medicaid/NJ FamilyCare eligibility.


Can you have multiple doulas? Here is what the information says:

The 8-1 or 12-1 visit limits apply to each doula-member pair. In the event that a beneficiary receives care from multiple doulas, the beneficiary’s visits to the first doula do not count against the visit limit for any subsequent doula.

Sounds to me you can work with an additional doula, or even split the care you receive between doulas.

Recent Posts

See All

Other Payment Options

If you do not have Medicaid, general health insurance or can't be reimbursed under an insurance benefit for doula care - $cash is always an option. Cash payments can be done in full or under a payment

Insurance Coverage (Non-Medicaid)

As of now and to my knowledge the only health insurance company also known as MCO's (managed care organization) that has doula coverage is Horizon Blue Cross Blue Sheild. Please do not get this confus

Getting The Best Coverage

If you reviewed the "breakdown", you know the visits are 8-1 or 12-1. Most families do not need 3 or 4 visits during the prenatal stage. However, the visits can be altered to accommodate a families ne

Comments

Rated 0 out of 5 stars.
No ratings yet

Add a rating
bottom of page