31/10/2021
As promised, here is the most recent update from TriCare regarding the Doula Demonstration beginning next year! It is a lot of information, I have done my best to summarize it below.
This demo recognizes the benefits a Doula can have both emotionally and physically for a pregnant person, their family, and their birth outcomes. It will begin 1 January 2022 and continue for 5 years. When those 5 years are up, the program will be re-evaluated.
TriCare Prime and TriCare Select beneficiaries who are currently stationed in the Continental United States are eligible for Labor Support and Lactation Consultations. Beneficiaries must be 20+ weeks pregnant and must plan to deliver the baby with a TriCare authorized provider, with emergency cases possibly being an exception. This includes home-births, birth center births, and hospital births! **I am looking for clarification but the website reads as if the member must be delivering OFF BASE and not in an MTF**
The Doula may charge TriCare directly, or the beneficiary may pay out of pocket and then file for a reimbursement. The coverage will include 6 (total) prenatal and postpartum meetings (max charge of $46 each) and 1 event of continuous labor support (max charge of $690).
Of course, TriCare has set some prerequisites for Doulas before they are able to become TriCare approved:
- Certified with a TriCare approved organization
- Attend a minimum of 24 hours of training that meets TriCare regulations
- Attend a breastfeeding course
- Attend a Childbirth Education Course
- Have attended minimum of 3 births, in the last 3 years. 2 of them must be vaginal births.
- Provide prenatal and postpartum support for at least 1 family in the last 3 years.
- Infant, child, and adult CPR Certification
- License or certification for applicable states
- NPI number
At this time, Utz Doula Services is not eligible for TriCare coverage and we are evaluating what this means for our business, our clients, and a way ahead.
Please see the below link or reach out if you have any questions or are looking for other details. We will continue to keep you all updated as the program evolves!
https://www.federalregister.gov/documents/2021/10/29/2021-23583/establishing-a-tricare-childbirth-and-breastfeeding-support-demonstration?fbclid=IwAR26-FZ9hzg4Mf07Rs4Bc0RZGMah9y3b2R9iOIpoTsF2njvjZcsWN0p41vw