Are Doulas Covered By Insurance?

Does insurance cover doulas?

In recent years, more and more expecting parents are learning about the benefits of having a doula to help support and prepare them for pregnancy, labor, and parenthood. Having a doula during the process yields a number of observed benefits. For example, birthing people who work with a doula have lower rates of cesarean birth, are less likely to need an epidural due or other medical pain management, tend to have shorter labors overall, and report having a better birth experience than those who do not have doulas.

These outcomes are a major reason why doulas are rapidly rising in popularity. But given that having a baby is already an expensive process and having a doula has been proven to improve outcomes, many people are wondering: “Will my insurance cover a doula?”

Unfortunately, because doulas are not medical professionals and are not currently seen as “essential care,” most insurance companies will not include them in coverage. However, because we are increasingly seeing evidence of the medical benefits of doula care, there have been steps taken to include doulas in medical insurance.

When is a doula covered by insurance?

While most standard private insurance plans may not cover the costs of doula services, many providers offer optional maternity care bundles that allow birthing people to access doula care without breaking the bank. If you have that option through your employer-provided or privately purchased healthcare benefits, it’s a great way to ensure you get the maternity, birth, and postpartum support you need.

Another way to pay for doula support is through an HSA/FSA account. The IRS maintains a list of qualified medical expenses that people can access using their HSA or FSA account, and almost all expenses related to childbirth are eligible. This includes doulas!

Low-income folks are almost always the people who have the most difficulty accessing necessary maternity care and birthing support. Fortunately, there has been growing support in national politics for including doula services in Medicaid coverage. Currently the states of Oregon, Minnesota and New Jersey are covering birth doula support for patients with Medicaid, and many other states are soon to follow. If these efforts are successful, legislation may be passed to ensure lower-income individuals and families have access to doula support and care nationwide.

There has also been an increase in private-pay insurance companies covering birth doula services in their plans. Be sure to ask your insurance company if they are one of the wise early adaptors of labor doula coverage.

Even if your insurance company does not cover doula services, they may still reimburse you for some or all of the cost for a doula. Your doula can provide you with a “superbill” that has specific information related to their care which includes:

• Their Name and NPI (national provider) number

• Their EIN

• One or more CPT codes: (Birth doula = 99499; Postpartum doula = 99501 and 99502) 

• Diagnosis Codes: (Birth doula = V22.2; Postpartum doula = V24.2) 

• Dates and descriptions of services rendered  

Are in-person doula services covered by insurance?

There is archeological evidence of midwifery dating back to ancient times, and certainly before the advent of Zoom meetings. 

In-person doula support and care can take place at home as you prepare for home birth, in a hospital setting, or in a birthing clinic. The location won’t impact your insurance coverage.

Are virtual doula services covered by insurance?

Increasingly, birthing folks have been turning to virtual midwife and doula services – especially during the COVID-19 pandemic. But virtual doula support can be an excellent choice for people who live in rural areas or simply connect with a doula who doesn’t live in close proximity to them. 

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

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

We’re here to support birthing people in the incredible journey to parenthood, and beyond. Contact Wildwood Birth today to speak to a qualified, compassionate Portland-based doula and get all your questions answered!