How to get a doula through Medicaid in Illinois

There’s good news for expectant families covered by Medicaid in Illinois: you can now access doula care through your insurance! As of December 2024, enrolled members can receive doula care during pregnancy, labor and delivery, and postpartum at no cost to them under Medicaid health insurance in Illinois. 

Doulas are trained, non-medical support professionals who provide emotional, mental, physical, and informational care to parents and families during throughout the perinatal period. Partum Health is proud to offer Medicaid-covered doula care with a team of enrolled doulas serving the greater Chicagoland area. 

Here’s what to know about Medicaid doula services in Illinois: what a doula does, how to find one, and how to get started.

What is Medicaid?

Medicaid is a government health insurance program that is available to families whose income is at or below specific income limits. In Illinois, it is sometimes called the Illinois Medical Assistance Program. If you have Medicaid as your insurance, you can get free or low-cost healthcare services, like doctor’s visits, prescriptions, and preventative care. 

In Illinois, there are five managed care organizations (also called MCOs, or health plans) that provide Medicaid to families. They are CountyCare, Molina IL, Meridian IL, BlueCross Community Health Plan, and Aetna Better Health of IL. 

If you are pregnant, you should know that that pregnancy is considered a qualifying life event to get health insurance coverage. If you did not have health insurance before you became pregnant, you can get coverage right away, and do not have to wait for the yearly open enrollment period. You may qualify for Medicaid or another type of health insurance, depending on your situation. 

What is doula care?

Doula care means having support from a trained professional who helps people during pregnancy, birth, and postpartum. Doulas give emotional, physical, mental, and informational support to pregnant people and their families. The care that doulas provide is individualized, which means it fits your own specific needs, preferences, and experiences. 

During pregnancy, a doula might help someone learn about and prepare for childbirth, including options like pain management and creating a birth preferences plan. During labor and birth, a doula stays with the birthing person and family the whole time (this is called continuous support). Doula care during birth can include steady encouragement, help with breathing or comfort measures like massage, and assistance in communicating with your medical providers. After birth, doulas support parents’ recovery, including infant feeding, emotional ups and downs, and adjusting to life with a newborn. 

Research shows multiple ways that having a doula can have a positive impact on a family’s pregnancy and birth experience. That includes a lower chance of having a Cesarean section, a lower chance of preterm (early) birth, a lower chance of experiencing postpartum anxiety or depression, a higher chance of adopting exclusive breastfeeding, and a higher chance of feeling happy and satisfied with the birth experience. Families who are covered by Medicaid can see some of the biggest benefits from doula care.

What does Medicaid cover for doula care in Illinois?

Medicaid in Illinois covers the three main areas of doula care: prenatal, labor and delivery, and postpartum. 

Prenatal doula care 

Prenatal doula care includes virtual or in-person visits during pregnancy. Doulas provide education and support about pregnancy, birth, and postpartum, especially to help parents plan and prepare.

The visits may include:

• Assistance in writing a birth preferences/plan
• Childbirth education
• Labor preparation
• Accompanying you to an appointment with your physician or midwife
• Making a postpartum plan
• Education about breastfeeding and other infant feeding options
• Processing a previous birth experience  

Under Illinois Medicaid, doula support is available during the whole pregnancy, no matter when you start care with your doula. There is no limit on how often you can meet with your doula prenatally. 

Labor & delivery support

Labor and delivery support from a doula happens in-person when you go into labor or are scheduled to give birth. Doula support is available for all kinds of births: vaginal, Cesarean, or a Trial of Labor After Cesarean/Vaginal Birth After Cesarean (TOLAC/VBAC). Doulas support you whether or not you choose to use pain medication like an epidural during your birth. Labor and delivery care from a doula may include:

• Suggestions of position changes
• Comfort measures like massage and breathing
• Support of your partner or other family members
• Encouragement and reassurance during labor
• Helping communicate your preferences and questions to your medical team

Doulas at Partum Health will meet you at the hospital or birth center when you are in labor or for your planned induction or Cesarean.  

Postpartum doula care

Postpartum doula care includes virtual or in-person visits after you have your baby. Visits can include:

• Education about newborn care and normal infant behavior 
• Education and support around infant feeding, including breastfeeding, pumping, combo feeding, and formula feeding
• Accompanying you to appointments with your doctor, midwife, or your baby’s pediatrician 
• Emotional support and guidance as you recover from birth 

Under Illinois Medicaid, postpartum doula support is available for up a year after your baby’s birthday (or, up to a full year postpartum). There is no limit on the amount of visits you can have with your doula after birth. 

How to find a doula 

To receive doula care with Medicaid in Illinois, you will need to find a doula who is in-network. In-network means that a doula is a provider who accepts Illinois Medicaid as payment for their services. 

Since it is a new program in the state of Illinois, the pool of available doulas is small, but growing quickly. Partum Health has a network of doulas who are in-network with Illinois Medicaid MCOs. We can quickly connect you with a doula so you can get support for your pregnancy, birth, and postpartum experiences. 

Get started with Medicaid doula care

Want to get started with doula care? With Partum Health, the first step is to reach out to us. From there, here’s what happens:

• A member of Care Team will contact you and confirm your eligibility for doula care. We do this by verifying your active insurance coverage with Illinois Medicaid
• Next, we match you with an in-network, available doula
• Then, we help you complete your intake paperwork, including information about your current pregnancy or postpartum 
• Within the first week after matching, you will meet with your assigned doula for an initial onboarding session
• You are recommend to meet with your doula at least once a month throughout your pregnancy and get support that fits you and your needs for pregnancy, birth, and postpartum

For Doulas

If you are an Chicago-based doula interested in serving families with Illinois Medicaid, here’s how to get started. There are four steps for doulas to be eligible to serve Medicaid members in Illinois:

1. Identification: Obtain a National Provider ID number (NPI) via the National Plan and Provider Enumeration System (NPPES). This is a unique number used to identify healthcare providers in the US.
2. Certify: There are two different doula certification pathways, based on your current credentials and status as a Certified Doula. All doulas will need to provide proof of birth support experience and training across specific domains to the Southern Illinois University’s Medical School. They will issue you a certificate that allows you to accept Medicaid. 
3. Credential: Enroll in the Illinois Medicaid Program Advanced Cloud Technology (IMPACT) system to receive your Medicaid number.
4. Contract: Sign contracts with individual managed care organizations so you can work with patients who have specific health plans. This means you can get reimbursed for your work through Medicaid. 

Partum Health will manage the whole Medicaid eligibility process for you, simplifying the steps for application, credentialing, and enrollment. We provide the technology to serve clients in a HIPAA-compliant way, plus we manage all billing so it’s easy for you to get paid for your work. Contact recruiting@partumhealth.com for more information.