After doing much research regarding Doula services being covered by insurance, I found the best answer to be “some insurance companies offer doula coverage and some do not”. The good news is, most will as long as the doula has an NPI number! Doulas often help you file this with your insurance so that it isn’t as stressful!
A compiled list of the Insurance Companies that have reimbursed clients for doula care in the past includes:
- Aetna Healthcare
- Baylor Health Care System/WEB TPA
- Blue Cross/Blue Shield
- Blue Cross/ Blue Shield PPO
- Degussa, a German Chemical Company
- Elmcare, LLC, C/O North American Medical Management
- Foundation for Medical Care
- Fortis Insurance
- Glencare Managed Health Inc.
- Great-West Life & Annuity Ins. Co.
- HNTB (Peoria, IL)
- Houston New England Financial, Employee Benefits (Fort Scott, KS)
- Humana Employers Health
- Lutheran General Physician’s Organization
- Maritime Life
- Medical Mutual
- Oschner HMO, Louisiana
- Professional Benefits Administrators
- Prudential Healthcare
- Summit Management Services, Inc
- United HealthCare of Georgia (San Antonio, TX)
- United Health POS
- Wausau Benefits, Inc
In order to be reimbursed, your doula will need to provide a detailed invoice and a letter stating what exactly was included in the doula services you received. Please note: You are often responsible for paying the doula in full but should maintain a receipt with the detailed services and the doula’s signature. Submit the receipt and a claim form to your insurance company within 2 weeks of birth. Within 4 weeks, expect a response back from the insurance company either approving the reimbursement or asking for more information. They may potentially ask for your doulas’ certification, accreditation, and even a letter from your physician as to why the services were needed and how they were helpful.
Typically, after that is done, services are reimbursed. If for some reason the insurance company denies the claim, you have other options; such as writing a letter to the Health Services department of your insurance company requesting they look over the claim and explaining how doula services saved THEM money by assisting with your birth! If that doesn’t work, you can contact the CEO of the company. Eventually, you will get to the right person that will approve your claim.
Disclaimer: It is not a guarantee that your claim will be accepted and your doula charges will be covered.