* Two years ago, from Capitol News Illinois…
Gov. JB Pritzker signed a law Monday that expands insurance coverage during and after pregnancy with the goal of lowering infant and maternal mortality rates, especially for Black Illinoisans.
The law requires insurers that provide state-regulated health care plans to cover pregnancy and postpartum services for covered individuals, including midwife services, doula visits, and lactation consultants for up to 12 months after the end of a pregnancy. Licensed or certified midwives will need to be covered by insurance providers starting 2025, while all other outlined services must be covered by January 2026.
* But getting that coverage has been a struggle for some families. The Sun-Times reports…
Private insurers were supposed to be ready to cover doulas on Jan. 1, but the law is still missing key pieces. Families are paying the price, a WBEZ / Chicago Sun-Times investigation has found. […]
Blue Cross and Blue Shield of Illinois told [Eleanor Grano] there are only five doulas in their network for the entire Chicago area, according to messages Grano showed a reporter. In-network providers are typically cheaper than those out of network. And if Grano could stay in her network, the doula bills Blue Cross, not her.
But the five doulas didn’t work out. She learned she’d have to pay up front, then ask for reimbursement. The cost: around $10,000 for a month of overnight stays. Grano and Fagan feared they never would get paid back. […]
“Requiring patients to have thousands of dollars available up front creates a significant financial barrier to accessing a covered benefit,” Grano wrote. “As a woman of color, the law’s goal of addressing racial inequities in maternal health is also deeply meaningful to me.” […]
[Rep. Robyn Gabel, D-Evanston, a lead sponsor of the legislation,] says the bill she plans to file in January would require network adequacy for doulas.
“There needs to be a little more pressure to make sure that the insurance companies recruit doulas and make sure that they have doulas in their networks,” Gabel says.
- Katie - Thursday, Oct 22, 26 @ 10:57 am:
Had a very similar experience trying to access postpartum doula care on my State of Illinois Blue Choice plan earlier this year. Nearest provider was in Aurora (I live in Edgewater), and when I called BCBS to see if I could finagle partial coverage for an out-of-network doula the customer service rep had never even heard of a postpartum doula before, let alone plan coverage for one (to be fair, she was a total sweetheart and gave me some tips for rolling the dice on submitting a claim). In the end I just did one visit and ate the cost.