Doula Services Coverage Criteria
Defines coverage of doula services for pregnant and postpartum members under Anthem/Empire Medicaid Managed Care, including eligibility and service limits; affects members and participating doulas.
Anthem Blue Cross and Blue Shield HP will cover doula services during pregnancy and up to 12 months after the end of pregnancy beginning April 1, 2025.
Members can receive up to eight visits with a doula during and after pregnancy and continuous labor support is included.
Eligibility renews with each pregnancy; unused visits do not carry over between pregnancies.
Coverage Criteria for Doula Services
Covered services and eligibility
Covered when ALL of the following are met
Applies per pregnancy episode; eligibility restarts with a new pregnancy
Services that began with Medicaid-enrolled doulas before 2025-04-01 remain covered through 12 months after the end of pregnancy
Unused visits do not carry over to subsequent pregnancies
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