Insurance Reimbursement for Doula Services

Insurance coverage of doula services is becoming a more common occurrence in the birthing world. Cocoon Birth encourages you to take the following steps to attempt reimbursement of your doula services through our programs. We are happy to provide you with the necessary documentation to move forward with an insurance reimbursement.

Insurance and Flexible Spending Account Coverage

Some insurance companies will pay for doula services by reimbursing you. You may also submit to your medical flexible spending account (cafeteria plan) to help reduce your costs.

How to get reimbursement for doula services:

1. Pay in full for the doula services provided.
2. Get a receipt from your doula. The receipt will include the following information:
   • the doula’s identifying information
   • the diagnosis code
   • the CPT (Current Procedural Terminology) code for the services provided
   • the date and location services were provided
   • the mother’s name
   • total charge for services
   • dates and amounts of payments
   • payment method
3. Submit the receipt with a claim form to your insurance or flexible spending account company’s claims department.
4. Within 4 weeks, you should receive a response. If you receive a letter denying the claim, do not be discouraged. Prepare a new packet to resubmit to your insurance company for a secondary review, and copy everything in the packet to the insurance company’s CEO explaining why you feel services should be covered (and be sure to point out how much money the insurance company saved because of the services your doula provided, i.e. if you forewent medical pain management because of your doula or feel you avoided other interventions that are costly to insurance providers, such as augmentation of labor or cesarean birth). In this resubmission packet, you should include the following:
   • another copy of the receipt
   • a letter from you to the CEO explaining why you think this should be covered
   • a letter from your doula stating the benefits of doula care
   • Cochrane’s Review of Continuous Labor Support
   • DONA’s Position Paper: The Birth Doula’s Contribution to Modern Maternity Care
   • Include a letter from your midwife or doctor stating why s/he feels the additional support of a doula was beneficial Did you have a high-risk pregnancy or postpartum? (Did the birth doula’s presence and/or suggestions appear to prevent complications, help your labor to progress more quickly or decrease your need for expensive pain medications? Did the postpartum doula’s presence and/or suggestions help you or your baby in the postpartum period, increase breastfeeding success or appear to prevent postpartum complications?)
5. Be persistent. Make phone calls if necessary. If your claim is ultimately denied, call and ask for a specific reason why. If they refer you to your policy, ask them exactly what clause and what wording in your policy excludes doula services.

Information on this page is attributed to DONA International