Getting Your Health Insurance to Reimburse Doula Fees: A Doula's Guide

A Doula's Guide to Getting Your Insurance to.jpg

Many people want to know if doula fees are covered by insurance. To date, insurance doesn't specifically cover birth, postpartum doula, or childbirth education fees, but some insurance plans may reimburse all or part of what you have paid for those services. Here are the steps  you can take to see if your particular insurance will reimburse you:

  1. Pay for your services in full.
  2. Receive an invoice from your doula and request her:
    • Name & Address
    • National Provider Identification number (NPI)
    • Taxpayer ID
    • Date & Location of Services
    • Signature
  3. Write a cover letter detailing how you believe your doula benefited you and your baby during pregnancy, labor, and/or postpartum.
  4. Submit to your insurance the cover letter, invoice, and a claims form provided by your insurance company. 

It is important for you to know that doulas are not permitted to use CPT or diagnostic codes. Only your healthcare provider can use these special codes.

If your insurance provider denies your claim, or requests more information, you can request from your doula and submit to your insurance a:

  • Copy of professional certification or credentials, or proof of professional training
  • Letter detailing the services provided to you

You can also try requesting and submitting a:

  • Letter from your primary healthcare provider during your pregnancy overviewing your pregnancy and birth, and highlighting ways that your doula may have helped you, was a necessary part of the team, and/or may have saved the insurance company money.

If your insurance provider again denies your claim, you can write a letter to the attention of your insurance company's Health Services. In it you can:

  • Request a review of the claim.
  • Explain how you believe the presence of a doula saved the insurance company money on services.
  • Stating that you believe that a professional doula should be a covered expense.

You can also call your insurance company and speak with someone live, requesting to speak with a manager or head of services.

Finally, you can appeal in writing to the CEO of your insurance company.

At Tender Beginnings, we are happy to work with any of our clients in the greater Cincinnati and Dayton area to try to receive full or partial reimbursement from insurance. We would love to hear if you or someone you know has any success in getting reimbursement for any fees you have paid for doula services!

Comment