Technically, your insurance company would reimburse you for the fee you've already paid your doula.
Doulas Lower the Cost of Healthcare
Because doula services have been shown to reduce the need for use of an epidural, interventions to speed up labor, increase the likelihood of a spontaneous vaginal birth, and decrease cesarean sections, doulas can save insurance companies money!
Compared with no labor support, doula-provided labor support has been shown, on average, to involve a 28% reduction in cesarean births. Since Cesarean deliveries cost twice as much as vaginal deliveries, this is significant!
In fact, a recent study found that a doula could save insurance companies around $1,000 per birth.
Steps for Requesting Third Party Reimbursement
- Pay your doula in full.
- Get an invoice from her which includes the following information:
a. The doula's name and address
b. Her social security number/taxpayer ID number or NPI number
c. The date and location services were provided
d. The CPT code for the services provided (99499 for Labor Support)
e. A diagnosis code
f. The doula's signature
- Submit the invoice with a claim form to your insurance company. Within four weeks, expect a letter telling you either that
a. They need more information before they can process your claim.
b. This is not a covered expense.
- Ask your Doula to send you the following:
a. A copy of her certification (if she is certified)
b. Other credentials or relevant training
c. A letter detailing her training and experience and what she did for you
- If possible, ask your obstetrician or midwife for a letter explaining why a doula helped you, was necessary, or saved the insurance company money. (Did you have a high-risk pregnancy? Did the doula's suggestions appear to prevent complications or help your labor to progress more quickly? Did the doula's presence decrease your need for expensive pain medications?)
- Write a letter explaining why you felt the need for a doula and how you believe the doula was beneficial to your health. Submit to your insurance company: the doula's letter and credentials, the letter from the doctor your cover letter
- If they refuse it, write a letter to Health Services requesting that they review the claim, as you feel it was a cost-cutting measure and they should cover the cost. Follow up by telephone if necessary. If they refuse, write a letter to the CEO explaining why you feel that doula care should be a covered expense. They may not pay your claim, but they will consider it for the future.
Getting doula services reimbursed takes patience and persistence. Your insurance company may deny your request, but you can re-submit.
You can find some sample letters here, here, and here:
With the labor support of [doula's name and credentials], I was able to forego medical pain management and avoid interventions that are costly to [Insurance Company], including a cesarean birth, during my recent vaginal birth at [Hospital name and location] on [date]. The following were charged to [insurance company] during my labor and delivery:
- [insert items here from your bill, including epidural, cost of care, use of medications, etc]
This is a savings to [insurance company] of approximately [total up cost] . The cost of my labor support from doula [insert doula] was [insert cost], for which I am requesting reimbursement.
Support for Covering Doulas
See Insurance Coverage of Doula Care Brief from Childbirth Connection for more information on why insurance companies should cover doula services.
You could also submit with your letter the 2012 update to the Cochrane Review study, Continuous support for women during childbirth or 2016 Birth study, Modeling the Cost-Effectiveness of Doula Care Associated with Reductions in Preterm Birth and Cesarean Delivery.
Click here for a (old) list of Insurance Companies who have reimbursed for doula services.