Get Your Insurance to Pay for Your Doula!

Every once in a while I get a call from a mom who is really interested in having a doula attend her birth, but she doesn’t think she can afford it.  In NYC the average experienced doula charges around $1,000 per birth.  There are doulas who do frequent volunteer births, and others who work on a sliding-scale or a flat-rate low fee.  Wouldn’t it be great if women could interview doulas and not have to worry about money?  There are tons of lists floating around online about the questions you should ask your prospective doula, but very few remind you to ask if she has an NPI number.

What’s an NPI?

It’s been about a year since doulas have been able to apply for National Provider Identification (NPI) numbers.  The NPI number tells insurance companies that an individual is an actual service provider, and is used to process payments and/or reimbursement.  If you interview with a doula who is out of your price range, ask if she has an NPI number.  Having the NPI number alone doesn’t guarantee reimbursement, but it’s one major step in the right direction.  If you’re searching online and have come across doulas with whom you’d like to set up consultations, you can check to see if they have an NPI number here.

How do I know if my insurance covers doulas?

With this big advancement in the doula profession comes big confusion.  Coverage and reimbursement by insurance companies are different areas.  Coverage means that your insurance company will pay your provider’s fee when services are rendered.  I’m not aware of any insurance companies that cover doula services.  Reimbursement, on the other hand, requires that you pay your provider’s fee when services are rendered and your insurance company sends you a check after the fact.  Reimbursement can be in full or for a portion of what you actually paid.  I’ve heard of moms being reimbursed $375 of the $400 their doula charged, and a few other instances where reimbursement was within $200 of the doula’s fee.

Getting reimbursed

Get in touch with your insurance company and ask what the process is for reimbursement.  Your doula may be able to give you this generic form, but if your insurance company prefers that you use their forms it would be good to know that beforehand.  Your doula will provide you with the necessary information like the NPI number, and her S.S.# or EIN to help you complete the form.  In addition to the claim form, ask your doula for an invoice and a letter that describes her services.  The letter is helpful, because it shows the insurance company how the doula may have actually saved them money.  Many moms report having to submit twice before being reimbursed, so don’t desist in the process if you’re not approved the first time around!  Your doula does not have to be certified by any organization in order for her services to be rendered reimbursable.  However, if she is a member of a certifying organization she may be able to get advice from them with regard to helping you get some money back.

When expectant moms get in touch with me, but have concerns about how to pay for a doula, I remind them about the possibility of being reimbursed by their insurance.  Usually, they feel more at ease knowing that they may be able to get their insurance to pay for their doula!

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2 responses to “Get Your Insurance to Pay for Your Doula!

  1. Fantastic! Thank you for this research. I think it’s a great step in the right direction.

  2. Thanks Kimberly. I’m really interested to see where this all goes!

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