Medicaid Doula Reimbursement Form

HUGE STRIDES FOR BIRTHING PEOPLE IN LOUISIANA!

Insurance* companies in Louisiana are finally recognizing the positive birth outcomes/experience of moms who had a doula present during pregnancy, birth and the postpartum period.

Doulas help shorten the length of labor, decrease the use of medical interventions during labor, Reduce the need for cesarean surgery (C-section), reduce the need for forceps or vacuum extractor, reduce the use of pain medication (epidurals, morphine, etc. and increase overall birth satisfaction/experience, according to DONA International. Every family deserves a doula, no matter the birth setting. Doulas can attend home births, birth centers, hospital births and planned cesarean births. We are vital additions to any birthing team and I look forward to the day all birthing people can have a DOULA in LOUISIANA!

Currently we only accept Humana Healthy Horizons and AmeriHealth Caritas for Doula services*

What is a Doula?

Low Income/Medicaid

Name

First Name

Last Name

Phone

(###)

###

####

Email

Due Date

MM

DD

YYYY

Do you have private or public health care?

Public (i.e. Medicaid, etc.)

Private

If you have private health care, please list your provider:

Private health insurance is a plan provided through an employer or union; a plan purchased by an individual from an insurance company; or TRICARE or other military health coverage.

Which Medicaid health plan do you currently have?

Louisiana Medicaid health plans beginning January 1, 2023.

Humana Healthy Horizon

Aetna Better Health

AmeriHealth Caritas

Healthy Blue Louisiana

Louisiana Healthcare Connections

UnitedHealthcare

Medicaid Case Manager Name:

Case Manager Number/Email:

Please use this space for additional details. questions or concerns