Moda Health now covers birth doula services for eligible members enrolled in medical benefits through the Public Employees Benefit Board (PEBB).

This benefit starts on 1/1/2025.

Find doula provider information here.

What's covered?

PEBB members can have prenatal, labor, and postpartum support service provided by a Traditional Health Worker (THW) Birth Doula, who is enrolled with the Oregon Health Authority (OHA) and is an Oregon Medicaid Provider.

This benefit includes up to eight (8) visits throughout pregnancy and postpartum, as well as support during labor and delivery.

This benefit is only eligible for members enrolled in medical benefits through the Public Employees Benefit Board (PEBB).

This benefit starts on 1/1/2025.

There is no member cost sharing associated with this benefit, however, Moda will only pay up to the OHA Medicaid reimbursement amount. Members may be responsible for any charges above that amount. It is suggested that you discuss pricing with your Birth Doula.

• Pre-natal and post-natal visits are reimbursed at $215 (up to 8 visits).
• Birth and Delivery support are reimbursed at $645.

What is a doula?

A doula is a member of the care team that provides non-medical support to birthing parents and families throughout the stages of pregnancy, childbirth, and post-partum. Having the additional emotional, physical, and educational support enables birthing parents to have a more safe, memorable, and empowering birth experience.

Doulas provide a variety of services throughout and after pregnancy. Prenatal visits may include:

• Discussing birth preferences
• Providing evidence-based information
• Learning labor positions
• Practicing coping techniques.

During labor, a doula can support with various comfort measures such as breathing, position changes to aid with pain management; and emotional support. Postpartum support may include non-medical newborn care, infant feeding education, physical recovery assistance, emotional support, or help with light household tasks.

Why seek a doula?

No two pregnancies are the same and everyone may be facing different circumstances. No matter your age, location, experience or support system, there are many advantages of using a doula.

While childbirth is a very natural process, it is not without risk. Doulas help reduce the need for cesarean birth, shorten the length of labor and/or decrease the need for medical interventions like medication (if desired) or invasive procedures. They also can provide tools to birthing parents to aid in their communication with their medical team prior, during and after their pregnancy. Doula services promote birthing choice and lead to positive birth outcomes for both parent and infant.

How to choose a doula?

To be eligible for coverage, doulas must be state certified as a Traditional Health Worker Doula and enrolled with the OHA as an Oregon Medicaid provider (OHP) with an Oregon Medicaid ID. To find a covered doula through OHA, visit their website at traditionalhealthworkerregistry.oregon.gov/Search. Select Birth Doula under the Certification Type drop-down. Be sure to ask the doula you want to use if they are DMAP-registered.

Selecting a doula is a highly personal decision. Consider compatibility, comfort level, and any specialized skills you are seeking during and after your pregnancy.

Here are some tips to help you select a doula:

• Compile a list of priorities and concerns about your pregnancy and birth.
• Set up an interview and ask about things like availability, how they handle conflict with medical providers, or what type of support they provide.
• Afterwards, ask yourself if this person makes you feel heard and supported? Can you spend long lengths of time with them? Do they understand and respect your priorities?

Questions? We're here to help.

For questions, call the Moda 360 Health Navigator team at 844-776-1593 or email PEBBcustomerservice@modahealth.com.