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Insurance is Paying for Doula Support

 

        Times are changing and the insurance companies are realizing what a great benefit it is to have a doula on the birth team. The change has also come about due to the people in America calling and asking their insurance to cover doula support. We are so glad to see more people realize the value of doulas. Did you know that having a doula as part of a birthing team can decrease cesarean sections by 50%, shorten the time of labor by 25%, and decrease the need for other medical interventions by well over 50%? That's amazing!

 

        Currently, we know of 6 insurance companies that will pay for doula services. If yours is not on the list, please call your insurance and ask it they will cover doula support. Also, ask them the process for that and who pays and when. It is a new world for you, but to make sure your hire the right doula and that payment is made, you need to ask questions and learn about the insurance processes.

 

The insurance companies that cover doula support are:

 

1. Tricare Insurance for military families.

    *Depending on the insurance plan, some pay the doula directly and others reimburse the parents.

Your doula will need to be certified with one of these programs: 

• BirthWorks International
• Childbirth and Postpartum Professional Association
• Doulas of North America (DONA) International
• International Childbirth Education Association
• toLabor

 

2. Carrot Fertility

    *They will reimburse for any certified doula from any doula program as long as she attests to:

• I am a certified, trained doula and have taken doula education courses.
• I do periodic certification renewals and/or continuing education to keep myself updated on the latest developments for doulas.
• I have attended at least 24 hours of evidence-informed training that included one or more of the following areas: physiology of labor, labor doula training, antepartum doula training, postpartum doula training, or bereavement training.
• I am at least 18 years of age.
• Within the past three years, I have spent a minimum of 15 hours providing doula services in one or more of the following areas: For labor doulas Continuous labor support for at least three childbirths (including two vaginal births) as the primary doula supporting the birthing parent, as well as antepartum and postpartum support for at least one birth. For postpartum doulas Postpartum support following at least three childbirths. For bereavement doulas Bereavement support for at least three pregnancy losses.
• I do not work through an on-call rotation. Outside of unforeseeable circumstances (or rare planned absences), I intend to be the primary doula assigned to support this member.

 

3. Wal-Mart employees

    *This was just announced this week so we are still learning about it. It covers the doula cost up to $1000. You can read an article about it here: 

Your doula will need to be certified with one of these programs:

• Doulas od North America (DONA) International
• National Black Doulas Association (NBDA)

 

4. CVS Employees and spouses

    *You may choose any doula who has attended doula and cultural competency trainings. They pay $1,200 per year for birth doula services. Another client was told they had a $1600 max to use for postpartum doula services. Another client was told that CVS will reimburse employees up to $10,000 towards a birth and postpartum doulas

 

5. Microsoft Empolyees with Health Connect Plan through Premera Blue Cross

    *Pays $1000 for doula support. You will need to pay for doula expenses out of pocket, then complete and submit the Doula Claim Reimbursement Request form for reimbursement. Eligible doulas do not have to be in the Health Connect Network.

Your doula must have a current certification under a recognized doula certification organization: (examples include)

• PALS Doulas 
• BirthWorks International
• Childbirth and Postpartum Professional Association
• Doulas of North America (DONA) International
• International Childbirth Education Association
• toLabor

 

6. PNC Bank Employees

    *Pays up to $2,000 per pregnancy for reimbursement of birth and postpartum doula support to promote maternal health outcomes and reduce maternal health disparities.

 

Depending on what state you live in, families have reported getting reimbursed for doula support from the following insurance companies:urances:

• Aetna Healthcare
• Blue Cross/Blue Shield
• Blue Cross/Blue Shield PPO
• Cigna
• Humana Employers Health
• United Health POS
• Medicaid in some states
• Co-ops like Samaritan Ministries

 

We have doulas across the nation who reported that the following companies paid for their doula services:

• Salesforce (birth & postpartum)
• Twitter (birth & postpartum)
• Reddit
• Google
• Target
• Stripe (reimbursed at 80% for birth and postpartum doula services)
• HashiCorp

 

*to get reimbursed, get a receipt from your doula that includes the following information and submit it to your insurance:

1. The doula’s name & address
2. The doula’s social security number/taxpayer ID number and/or NPI number
3. Diagnosis Code (V22.2, intrauterine pregnancy/ V24.2, routine postpartum follow up)
4. The CPT code for the services provided ( 99499, labor support/ 99501 and/or 99502, postpartum care)
5. Taxonomy Code (374J00000X)
6. The date and location services were provided
7. The doula’s signature
8. The mother’s name
9. Total charge for services
10. Dates & amounts of payments
11. Payment method

 

On a more hopeful note, "In 2021, Rhode Island became the first state to pass legislation requiring doula coverage in private insurance plans." Read more about it by visiting their website:

 

I am excited to see people seeking better support and education. Hats off to the companies who have paved the way and decided to go ahead and cover doula support for their employees.