Are doulas covered by insurance? How to use your insurance for doula services
June 9, 2023
In general, insurance does not typically cover doula services. While there is growing recognition of the benefits of doula support during pregnancy, birth, and postpartum, most insurance plans do not consider doula services to be a covered benefit.
However, some insurance plans may offer coverage for certain aspects of doula care. For example, some plans may cover childbirth education classes or lactation consulting, which may be provided by a doula. Additionally, some states have Medicaid programs that cover doula services for low-income individuals and families.
If you are interested in working with a doula and would like to explore insurance coverage options, it's best to contact your insurance provider directly. They can help you understand what specific services are covered under your plan and if there are any exceptions or limitations to coverage for doula services. Alternatively, there are some non-profit organizations and sliding-scale fee options that can help make doula care more affordable. Read this post to explore your options and find a doula who meets your needs and budget.
What aspects of doula care are covered by insurance?
While doula care is generally not covered by insurance, some insurance plans may offer coverage for certain aspects of doula care, such as childbirth education or lactation consulting.
Childbirth education classes may be covered as part of prenatal care under some insurance plans. These classes can help parents prepare for childbirth by teaching them about the stages of labor, pain management techniques, and other important information about the birthing process. Lactation consulting may also be covered under some insurance plans. Lactation consultants can help new mothers with breastfeeding challenges, such as latching difficulties or low milk supply.
It's important to note that coverage for these services may vary by insurance plan and by state. Some insurance plans may require prior authorization or a referral from an in-network provider before covering these services. It's best to check with your insurance provider to understand what specific services are covered under your plan and what your out-of-pocket costs may be.
Does health insurance cover doula care in other ways?
In addition to coverage for specific aspects of doula care, some health insurance plans may offer coverage for doula care under certain circumstances. For example, some plans may offer coverage for doula care if it is recommended or prescribed by a healthcare provider as medically necessary. This may be the case if the individual has a high-risk pregnancy or medical condition that could benefit from doula support.
However, coverage for doula care in these cases can vary widely depending on the insurance plan and the specific circumstances of the individual's care. It's important to check with your insurance provider and your healthcare provider to understand if doula care is covered under your plan and what the specific requirements are for coverage.
It's also worth noting that some states have enacted laws requiring insurance coverage for doula care. As of 2021, Oregon, Minnesota, New York, and Illinois have laws that require private insurance plans to cover doula care. In these states, insurance coverage for doula care may be more widely available and accessible.
Ultimately, the availability and extent of insurance coverage for doula care can vary widely depending on a variety of factors. It's best to check with your insurance provider and your healthcare provider to understand what coverage is available under your plan and what out-of-pocket costs you may incur.
How to find doulas covered by insurance
Finding doulas covered by insurance can be challenging. However, there are some steps you can take to explore your options:
- Contact your insurance provider: Contact your insurance provider directly to ask if they cover any aspects of doula care, such as childbirth education or lactation consulting. If they do offer coverage, they may be able to provide you with a list of in-network providers or a referral for a covered doula.
- Check with your healthcare provider: Your healthcare provider may have a list of doulas they work with who are covered under certain circumstances. They can also advise you on whether doula care is medically necessary for your specific situation and whether it may be covered by insurance as a result.
- Look for non-profit organizations: There are some non-profit organizations, such as the Doula Access Project, that provide doula services to individuals who cannot afford them. These organizations may also be able to help connect you with a doula who accepts insurance.
- Search online: You can search online for doulas in your area who accept insurance, but be sure to verify their credentials and experience before working with them.
- Contact doula associations: Doula associations, such as DONA International or the National Black Doulas Association, may be able to provide you with a list of doulas who accept insurance or offer sliding-scale fees.
While finding a doula covered by insurance may be challenging, it's worth exploring all of your options to find the care you need. It's also important to discuss costs and payment options with any doula you are considering working with to ensure that you can afford the care you need.
What to do if you can’t afford a doula
If you are unable to afford a doula, there are several options that may be available to you:
- Non-profit organizations: There are several non-profit organizations that provide free or low-cost doula services, such as the Doula Access Project, the Ancient Song Doula Services, or the HealthConnect One Community-Based Doula Program. These organizations may provide services on a sliding scale fee based on income or may provide services for free.
- Ask for sliding scale fees: Some doulas offer sliding scale fees based on a person's income and ability to pay. You can ask the doula if they offer this option and what the criteria are for eligibility.
- Payment plans: Some doulas may offer payment plans or other arrangements to help make the cost of services more manageable. You can discuss these options with the doula directly.
- Bartering or trading services: Some doulas may be open to bartering or trading services. For example, you could offer to provide a service in exchange for doula services.
- Family and friends: Consider asking family or friends to provide doula support. While they may not have the same level of training and experience as a professional doula, they can still provide emotional support and practical assistance during childbirth.
It's important to explore all of your options for affordable doula care and to communicate openly with your doula about your financial situation. Together, you can work to find a solution that meets your needs and ensures that you receive the care you need during your pregnancy and birth.
How SuperBill helps with doula insurance
If you do have OON benefits, or you’re unsure if your insurance covers doulas, SuperBill may be able to help! SuperBill verifies your benefits, then files and tracks your out-of-network claims. We will update you on the status of your claim at every interval, and do everything we can to get it reimbursed. We even help with medical bill negotiation!
You can jump through all the hoops to make sure you get your doula covered by insurance, OR you can let SuperBill for insurance handle it all for you. We have worked with countless patients to get them the reimbursement they deserve.