How do I get my doula care covered by insurance?

by Brood

The journey of pregnancy and childbirth marks a profound milestone in life, and the presence of a doula can offer invaluable support, greatly benefiting expecting parents.

However, the costs associated with doula care can be a challenge for many families. While doula services may not be explicitly covered under provincial healthcare plans in Canada or state plans in the US (yet!), there are strategies individuals can employ to navigate insurance coverage and potentially have doula care included in their benefits, or by other means. So, let’s get into it!

First of all, what is a doula exactly? If you’re here, you probably already know why doulas are such an important part of family health care, or maybe you need some more reasons to hire a doula? Either way, a doula is a specialised care worker who supports birthing people and their families with continuous physical, emotional, and informational support. Doula care is customised for you and your family – whether you need a birth doula, or postpartum doula to support you. Learn more about the different types of doulas here (there are many!). 

Whether you hire a doula for birth support, or a postpartum doula to help you out during those long nights, it usually comes at an extra cost, and is often one that is overlooked or not budgeted for. Studies have shown that the presence of a doula during childbirth is associated with a range of positive outcomes. According to research published in the Cochrane Database of Systematic Reviews, individuals supported by doulas are less likely to request medical interventions, such as epidurals or cesarean sections. Additionally, a study published in the Journal of Perinatal Education found that the continuous support provided by doulas is linked to shorter labors and a reduced likelihood of complications. We also see a decrease in postpartum related mental health challenges like PPD.  And although statistics underscore the life-saving impact of doula care, it still isn’t covered by MSP, or most medical service and insurance providers in North America. 

The good news? This is changing, however slowly. In the US, The National Health Law Program’s Doula Medicaid Project has been tracking doula Medicaid implementation efforts since 2019. Each year since then, the number of states introducing bills related to Medicaid coverage for doula care, or working to expand access to doula care in other ways, has steadily increased. So if you live in the US, check to see whether medicaid covers doula care in your state. 

In Canada, it’s a bit of a different story and there isn’t a short answer. Currently it is not covered under MSP, although many different insurance and benefits programs offer it within their extended healthcare plans or health spending accounts. The best thing to do? Reach out to your insurance provider and find out more. Live in Alberta, BC and want to get your doula care covered? Take a look at Doula Brielle’s list of specific insurance providers in that province.

Let’s dive in a little deeper.

How much should I expect to pay for a doula? In North America, the expenses associated with hiring a birth and postpartum doula can vary, influenced by factors like geographical location, experience levels, and the range of services offered. Typically, the fees for a birth doula fall within the $800 to $3,000 range, with urban areas often commanding higher rates. Postpartum doula services usually cost between $35 and $65 per hour, often requiring a minimum number of hours. Some doulas may provide package deals encompassing both birth and postpartum support, offering a comprehensive care plan. For more information about Brood Doula services and packages, click here.

Brood birth doula packages range from $800 – $3,000 and use the Green Bottle Sliding Scale method

Brood’s postpartum doulas provide support during the day and overnight. Our day shifts are 5 hours – you pick the hours, we show up. Our overnight care is always from 10 pm to 6 am. All shifts are $47 per hour. 

Learn more about our doula services and offerings here.

Understanding Insurance Coverage: Most insurance plans, particularly extended health coverage, have provisions for complementary healthcare services or something called a healthcare spending account. While doula care may not be explicitly listed, exploring these avenues can lead to surprising discoveries. If you are paying into a plan as a contractor or single person (not through group benefits), it’s unlikely you’ll be able to get this service covered.

  • Review Your Insurance Policy: Carefully go through your insurance policy documents or contact your insurance provider to inquire about coverage for alternative or complementary therapies. Some plans might include allowances for doula services under broader categories like wellness or support care.
  • Ask for Clarification: If your policy seems ambiguous or unclear regarding doula care coverage, don’t hesitate to reach out to your insurance provider for further clarification. Inquire if there’s a possibility of making a special claim or exception for doula services. 
  • Request Employer Support: If you have employer-provided insurance, consider discussing the inclusion of doula care in the benefits package. Sometimes, employers are open to expanding coverage based on employee needs and requests. You don’t get what you don’t ask for, and here at Brood we are ALL about asking for help!

Documenting Medical Necessity: One approach to securing coverage for doula care is to emphasise its medical necessity and get a recommendation from a medical provider. 

  • Doctor’s Recommendation: Consult with your healthcare provider and request a letter or documentation outlining the potential benefits of having a doula. This could emphasise the role of doula support in enhancing the childbirth experience and overall maternal health.
  • Submit Claims with Detailed Information: If your insurance plan allows for flexible claims, ensure that all submitted documentation includes comprehensive details about the necessity and benefits of doula care. This might increase the likelihood of a successful claim.

Advocacy and Negotiation

Advocating for doula care coverage within your insurance plan involves proactive communication and negotiation.

  • Advocate for Policy Changes: Engage with your insurance provider, expressing the importance of including doula services in their coverage. Collaborate with other policyholders or community groups to amplify this message.

Non-insurance Based Doula Services Coverage

Whether you live in the US or Canada, getting doula services covered isn’t like going to the doctor or dentist – yet. You’ll likely have a harder time getting this covered, so getting creative about ways to have your community support you is another avenue to explore. Many Brood families crowdfund their doula – gathering cash gifts from family, friends and colleagues to invest in their care! Planning on having a baby shower with a registry? Consider adding a doula fund to the list, or making that the ONLY thing on your list. At the end of the day, you’ll want to be taken care of more than a few extra cute onesies and stuffies for your baby. We promise.

Securing coverage for doula care through insurance in Canada and the US requires diligence, clear communication with insurance providers, and advocacy for policy adjustments. By thoroughly reviewing insurance policies, documenting the medical necessity, and engaging in discussions with both healthcare providers and insurers, individuals can strive to make doula care a covered service within their insurance plans. Personal advocacy and negotiation play pivotal roles in making doula care more accessible and financially feasible for expectant parents seeking this invaluable support. Hopefully someday soon, doula support will be available for everyone.

Need more support or have questions about the cost of doula care and what we offer? Visit us here and send us a note!

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We work and live on the unceded and occupied territories of the Sḵwx̱wú7mesh Úxwumixw (Squamish), səl̓ilw̓ətaʔɬ (Tsleil-Waututh) and xʷməθkʷəy̓əm (Musqueam) Nations. Since time immemorial, the original peoples of these lands have cared for their families and communities. We are committed to honouring their teachings, legacy and their sovereignty.

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