Are Doulas Covered by Insurance?

June 5, 2023

Everything you need to know about doulas and insurance coverage.

Does insurance cover doula support?

Expecting parents are learning more about the benefits of doulas supporting them thoughout their pregnacy, labor, birth, and early postpartum. There are many benefits to having a doula. For example, birthing people who hire and work with a birth doula have lower rates of cesarean sections, are less likely to have to use medical interventions, they tend to have shorter labors, and have reported having a more positive birth experience than those who have chosen not to hire a doula.

This contributes greately to the popularity and increase in doula support. Let’s be honest, having a baby is already an expensive process! However, having a doula has been proven to improve outcomes. This makes expecting families quesiton, “Will my insurance cover the cost of having a doula?”

Doulas are not medical professionals and are not seen as “essential care” in the eyes of most insurance companies and so they will not cover the cost of doula support. Fortunately, there have been steps taken to include doulas in medical insurance.

When are doulas covered by insurance?

Even though most private insurance plans don’t cover the cost of hiring a doula, many offer optional maternity care bundles. This allows families to have access to doula care without too much strain on their budget. Check with your insurance to see if this is included in your health benefits. This is a great way to get them prenatal, birth, and postpartum support you deserve.

There is also the option of using your HSA/FSA account. Under the IRS regulations, you can pay for 100% of a doula’s fee out of your HSA or FSA account! (See eligible HSA expenses here and eligible FSA expenses here).

To be legally compliant, you must receive a receipt/invoice from your doula and have your doctor sign a “Letter of Medical Necessity.”

Low-Income Families

Low-income families are more likely to have difficulty accessing necessary maternity care and birthing support. Fortunately, there has been growing support in national politics for including doula services in Medicaid coverage. Families that qualify for low-income, Medicaid covers birth doula support at this time in Oregon and several other states. Legislation is working to ensure that lower-income individuals and families have acccess to doula support nationwide.

What are the next steps?

Be sure to reach out to insurance company to see what their current policies are and how you can go about getting labor doula support covered.

If your insurance doesn’t cover doula support, they still may reimburse you for some if not all of the cost of hiring a doula. You will need to have your doula provide you with a “super bill”. This will have specific information on it related to the care they provided.

Information that needs to be included:

  • Their Legal Name, Business Name, Address, & Phone Number
  • Their NPI (Naitonal Provider) number
  • Their EIN/Tax Number or SSN of Doula
  • One of more CPT Codes: (Birth Doula- 99499 & Postpartum Doula- 99501 & 99502)
  • Diagnosis Codes: (Birth Doula- V22.2 & Postpartum Doula- V24.2)
  • Dates and description of services rendered
  • Doula’s Signature
  • Submit the invoice with a claim form to your insurance company.

What doula services are covered by insurance?

In-Person Support:

In-person doula support can be given in your home as you prepare and have a home birth, in a birth center, or even a hospital. Location doesn’t impact your insurance coverage.

Virtual Support:

Increasingly, birthing families have been turning to virtual midwife and doula services – especially during the COVID-19 pandemic. This is still a very popular option for those that live in rural areas or for those that connect with a doula that doesn’t live in their area.

If your insurance covers in-person doula services, it will also cover virtual doula support.

If you have more questions about insurance coverage and doula support, we are here to help!

Contact Birthing Days today to speak to a knowledgeable Portland-Metro based doula to get all your questions answered!