I’m so excited to be able to now serve OHP families! If you are on Oregon’s Medicaid program, you can have me be a part of your birth team, for $0 out of pocket. My services will be 100% covered by your health plan. How fantastic is that! Read on for some important details.
If you are on OHP, your 2 prenatal sessions, continuous labor support and 2 postpartum visits are completely covered.
Alright, let’s break down how this works. Some FAQs:
Who qualifies for doula services as a covered benefit?
As of right now, if you are receiving healthcare coverage through Medicaid, you qualify. Your Medicaid coverage in Oregon is through Oregon health Plan (OHP). OHP then assigns you a Coordinated Care Organization or CCO.
Which CCOs are you able to bill for services?
CCOs in my service area are Jackson Care Connect (JCC) and AllCare. I am am able to bill both the CCOs for doula services. If you are insured through Medicaid as your secondary insurance, please read the next topic on ‘open card’.
What is open card?
Open card, typically, is how you are receiving benefits through Medicaid if you either 1) moved within Oregon, and wanted or needed to keep working with your medical team, or 2) you have OHP as your secondary insurance. With open card you have access to all OHP providers, regardless of their contracts with CCOs. Any OHP provider (your OB, midwife, pediatrician, chiropractor, etc.) can bill for the services they provide you through open card. Now, that’s not to say they do or want to, just that it’s available to them. It’s also not guaranteed that they will get reimbursed for services. You are not able to be enrolled with a CCO *and* open card at the same time.
Contact OHP directly for more info on CCOs and open card enrollment.
Are there any exceptions to coverage by OHP?
Currently the only combination that I cannot bill is if you are on open card for your full medical benefits and you are planning a home birth or a freestanding birth center (non-hospital) with a licensed midwife. The Oregon Health Authority (OHA) will not reimburse doulas for out-of-hospital births. However, Jackson Care Connect and AllCare will. You can always contact OHP member services and ask them about transferring care to a CCO.
What’s your service area?
At this time I am able to serve folks living and/or planning to give birth in the mid and lower Rogue Valley. That includes Ashland, Medford, Jacksonville and everywhere in between.
If you are planning a hospital birth, my service area includes Asante Ashland Family Birth Center, Asante Rogue Regional Medical Center and Providence BirthPlace Medford, even if you live beyond my usual service area. Not sure if you’re in my services area? Reach out and let’s chat!
I am currently only taking on a very limited number of clients planning to birth north of Medford. This includes birth places such as the Rogue Birth Center and Three Rivers Medical Center. Contact me to see if I have the capacity to travel into Josephine County for your due date!
How do I go about working with you?
First, check to see if you are within my service area. If you are not, reach out and let’s discuss. I may or may nor be able to travel a little farther out, depending on a few factors. I’m always willing to figure out if I can support you.
Second, schedule your complementary consultation (up in the menu, under Doula Services> Consultations). You’re also welcome to email me before scheduling a consultation, to check my availability for your estimated due date.
Third, if you decide you want to have me support you during pregnancy, labor and birth, tell me! I will get you set up in my online client portal where you will digitally sign the paperwork and we will be good to go!
So if I’ve got OHP, how do you get paid?
After you have given birth, I will bill your insurance directly for services rendered. As birth doula services by a Traditional Health Worker (THW) Birth Doula are a covered benefit, we don’t need prior authorization or anything like that. After your insurance approves my claim, they will pay me directly.