Does My Insurance Cover a Doula?

"Does my insurance cover a doula?"

This is a very commonly asked question we receive from interested parents. And, as with all things birth and babies, the answer is not so simple.

We asked our friend Aron over at Quote Wizard to lay out the ins and outs of insurance and doulas for us Here's what they wrote....

Doulas and Your Health Insurance

In the early 20th century, nearly all births in the US happened at home. But with advances in medical technologies and support services, by the late 1960s, just 1 percent of births occurred in homes. Today, women now have many options when it comes to where and how they plan to deliver such as at home, water births, birthing centers, and hospitals.

Another option pregnant women can choose upon are support companions. The most recent data indicates that roughly 6 percent of US women use a doula to assist with childbirth. Extensive study has shown that mothers gain many physical and emotional benefits from using a Doula.

Women under doula care show to feel a great sense of control during labor and were more likely to have spontaneous birth.

Given the high cost of having a child, you should know if your health insurance covers doula care. This article aims to help you with that.

What is a Doula?

Doulas assist in the birthing and labor process. They provide emotional and physical care before and during childbirth. Benefits have been found having a doula on-hand after the birth as well.

The functions the doula provides include:

  • Childbirth education

  • Assistance during delivery with things like comfort measures, encouragement, keeping moms hydrated, and emotional support

  • Helping new mothers in the weeks after childbirth

While doulas are often not medical professionals, they provide valuable and sought-after services. Childbirth with the help of a doula can mean less time in labor and avoiding a C-section.  It can also result in a higher chance of giving birth with little if any, pain medications if that is your goal.

The Cost of a Doula

How much does a Doula cost? The answers to that are varied. The biggest cost factor is going to be where you live. Doulas in rural areas cost less than in urban areas, sometimes by a difference of thousands of dollars.

Another factor is how long you need a doula (for postpartum care). The longer you have the doula helping you, the more this will cost. The care that a doula can provide after birth can make it worthwhile, however.

If you can, do your research before choosing one doula or agency. Some groups such as High County Doulas will help women focus on ways to afford or save up for doula services. For example, grant-funded programs occurring through local health departments.

Is my Doula Covered by My Insurance?

While many insurers have started covering doula care, coverage is by no means the same across the industry. Insurers have different ranges of coverage for doulas. Some may cover all the expense, some only part. It is safe to assume that doula expenses will be an out-of-pocket expense.

A key point in your insurer covering the doula service is whether they're certified. Recognized groups such as ProDoula, DONA, CAPPA, and ICEA provide certification for doulas.

This is not to say you won’t get quality care from using an uncertified doula. It does, however, almost guarantee you’re going to be paying for your doula by yourself.

As of now, the only accurate way to know if your insurance covers a doula is to talk with your agent. If your insurance does cover doula care, find out if it’s full coverage and what parts aren’t covered if not.

If you have a doula picked out, make sure they have an NPI (National Provider Identification) number. They will need that for you to apply for repayment.

Submitting the Paperwork to Your Insurance Company

If your insurer does cover doula services, the claim process is direct. An experienced doula will be able to help you with the necessary info and service codes:

1. Pay your Doula in full for their services

2. Request an invoice from your Doula that includes the following:

  •  Their name and address
  • Their SSN/taxpayer ID number or NPI number
  • Date and locations of services provided
  • The CPT code for the services provided, including any postpartum doula services.
  • Diagnosis code
  • Signature of the attending doula

3. Submit the invoice with a claim form to your insurer. Check with your agent beforehand to find out which form they require.

Paying for a Doula Out-Of-Pocket

Should your insurance not cover doula services, it’s still and option you should consider. Overall, studies have shown childbirth to be a much more positive experience with a doula’s assistance.

Statistics show that doula-assisted births are four times less likely to result in a low birth weight baby, and two times less likely to have complications. Another study shows that many women also had shorter labor time with the help of a doula.

With some looking, you should be able to find a doula who fits your budget. It’s so important that you are comfortable and happy with every aspect of your birth plan. Consider how special this day will be for you. Similar to your wedding day, the day you give birth will be one you will remember for the rest of your life. Spending that extra bit of money on a doula for this special day can absolutely be worth it.

Postpartum Doulas

The value of doulas does not end after the baby arrives. The postpartum period can be a hard shift for new mothers. Having a doula on-hand to help during that phase is worthwhile.

A postpartum doula provides emotional and physical support for the needs of the mother after the birth. They allow the mother time to bond with the newborn, take care of things around the home, and provide empathy and support when the mother needs it.

The time after birth can be just as a trying experience as before birth. Having a doula to help with the beginning of motherhood takes a lot of tasks both big and small out of your hands.

We hope you have found this article helpful. Contact us to discuss your questions and financing options today.