We’re often talking to our Mae Mamas but today, we want to speak to the incredible doulas who are on the ground, doing the work to ensure we are best equipped for this pregnancy, postpartum, and motherhood journey.
Many doulas have heard about Medicaid reimbursement for their services at this point but if you are a doula, is this something you’ve considered? Curious about participating but not sure where to start? Mae is here to help!
Read on for a quick guide to understanding what it takes to become eligible for Medicaid reimbursement and how to get started.
What is Medicaid insurance reimbursement for doula support?
Medicaid is a state and federally-funded health insurance program for populations with limited income and resources. No matter what state you reside in, all Medicaid plans are required by law to cover a list of baseline healthcare services (such as primary care and hospital visits. A growing number of states have recognized doulas as essential participants in maternity care teams, and have begun to allow doulas to bill as healthcare providers to Medicaid plans for their doula services. To learn more about your state’s unique coverage requirements and additional benefits such as doula support, you can visit this link.
How to become eligible for Medicaid reimbursement:
Do Your Research
- See if the state where you live or are certified to offer support is reimbursing doulas under their Medicaid program. This can be figured out with a quick Google search or looking on Medicaid.gov to find your state’s specific Medicaid agency website.
- See if you are eligible. States that cover doulas under their Medicaid program will have a website that outlines the specific parameters including training qualifications (including specific training entities), administrative requirements, reimbursement rates, and any relevant care parameters or supplemental certifications needed.
- If eligible, the next steps include submission of a number of applications to qualify for state and plan billing and reimbursement, which will vary by state and be listed on the state’s Medicaid website. These will include but are not limited to:
- Application for an NPI Number (National Provider ID)
- Application for a Medicaid Provider ID (this process varies by state)
- Obtaining a Certificate of Liability Insurance
- Additional requirements, such as joining a state doula registry, CPR Certification, cultural competency training, etc. (this varies by state)
Plan Approvals
- Medicaid coverage is often administered in the form of individual health plans within each state, and each plan may require doulas to become providers in order to submit claims for reimbursement. (contracting processing and approval timelines may vary)
Finding Members to Support
- Once you are officially state-approved and contracted with a health plan, you can officially begin seeing members or clients of that plan and billing for your services.
- After working with a client, doulas must submit and manage claims for their services on their own behalf. The plan is there to support you in getting you set up in their systems for billing (electronically) and may offer training for claims submission as a new provider.
- Doula billing codes and parameters will vary by state.
- Billing, processing, and payment timelines may vary by health plan.
- It is important to ask your plan’s provider representative about this to give you a sense of expectations around receiving payment for your services after submitting a claim.
What if I live in a state that is not reimbursing for doulas…(yet)?
States are rolling out regulations for doula services on an ongoing basis, and some states have not initiated this process yet. If you live in a state that is not yet reimbursing broadly, you may still have an opportunity to participate. Some insurance plans work with partners like Mae in a pilot capacity to offer doula services if their states do not cover doulas under Medicaid.
- Research again! See if there are any plan or grant-funded doula reimbursement programs in your state.
- Get involved in the process – most states will ask doulas and key stakeholders to participate in the process as per the established parameters. Now is the time to ensure the policymakers hear from those on the ground, doing the work.
Mae helps streamline this process for doulas
This process can be cumbersome, lengthy, and overwhelming. It requires a lot of time that many doulas don’t have as they need to be in the field, supporting members.
Our goal at Mae is to streamline this entire process for the doulas we work with. If you’re an interested doula in a state where services are reimbursed under Medicaid (like Maryland, Michigan, or Virginia) or in a state where these services are not currently covered or in transition to covering (Iowa, Illinois, or Florida) reach out to us! You can click this link to learn more about how we can support your work.
But this isn’t about us – this is about ensuring every mother and birthing person who wants a doula has access to one and that every doula who wants to participate in a state Medicaid reimbursement program has access and the ability to do that too.
Find support and community among doulas!
Yes – in addition to lifting some of the administrative burden off of our doula partners across the United States, Mae is also focused on fostering community. Supporting those who support us is key and providing access to resources and information is essential.
- Research your state’s doula reimbursement status
- Get connected with local doulas
- Participate in the process
- Seek out support
Finally, contact us! We may not yet be in your state, but we are here to help drive this work forward in every way we can. We are happy to leverage the Mae community to support you.
Follow us on IG to stay connected!