For Doula Services
Some insurance companies, though not all, provide coverage for your labor support or postpartum doula's services. Depending on your situation, you may be reimbursed for the cost of your doula.
Here are some major healthcare providers who have provided coverage in the past:
- Aetna Healthcare
- Travelers
- Fortis Insurance
- Qualchoice
- Blue Cross/Blue Shield PPO
- Cigna
- Foundation for Medical Care
- AltPro
- Wausau Benefits, Inc.
- Professional Benefits Administrators
- Humana Employers Health
- Glencare Managed Health Inc.
- Lutheran General Physicians Org
- Elmcare, LLC c/o No American Medical Management
- Prudential Healthcare
- Great West Life & Annuity Insurance Co.
- United Healthcare
- Mamsi
- MDIPA
- Alliance
- Mail Handlers
Here are some instructions on how you can go about receiving reimbursement for doula services:
- Pay your doula in full for services
- Print out all insurance reimbursement forms from the Kairos site(files attached below).
- Give sample letters to your OB/midwife and ask them to write you a letter to submit to your insurance company which says, they feel the additional support of a doula would be beneficial to you ( the 99 diagnostic codes for doula services are miscellaneious codes , which always need a letter from a doctor explaining why he feels the services is necessary. Whether it be from a doula, a nurse practitioner, a massage therapist, a physical therapist, etc, it must be accompanied by a doctors letter, or the insurance company will deny the services.)
- Fax or mail to your insurance company the following
forms:
- letter from OB/midwife
- general letter to insurance company
stating benefits of doula care, with
all blanks filled in (please
supply a copy of this form to Kairos
by fax or mail, in case a
representative of
your insurance company should call
for further information.)
- "Doulas make a difference"
- "What the experts say about one-to-
one professional support in labor"
- position papers for appropriate
services you are requesting,
either postpartum support or labor
support
- invoice from doula, marked paid in
full, detailing the services
provided, with the proper CPT and
diagnostic codes
- You may also wish to add a letter
yourself, stating how and why you
feel the doulas presence was
beneficial to you (please supply
a copy of this form to Kairos by fax
or mail, in case a representative of
your insurance company should call
for further information.)
- letter from OB/midwife
In some cases you may hear from the insurance company before your due date arrives. In most cases you will not receive an answer until after your birth, when you have been able to submit an invoice showing services were paid and detailing services rendered. You may receive a letter denying the claim. If you do, resubmit the same information once again for a secondary review, and cc the information to the CEO explaining why you feel this service should be covered. If your insurance company covers your doula services, please be sure to let your doula know, as well as reporting what you did to DONA, Doulas of North America, www.DONA.org, as they are compiling information on third party reimbursement and every bit of information they receive may help others to gain reimbursement for their birth support services.
Allison Harris NCTMB,LMT,CD (DONA)
Director, Kairos Holistic Healing Arts
Birth Support Services
Please click the following links to see the sample insurance letters:
- General letter to insurance company: Click here
- Sample letter to your OB, LS or PP, w/o complications: Click here
- Sample letter to your OB, LS or PP w/ complications: Click here
Here are some of the articles, mentioned above, that you may wish to send to you insurance company along with the letter from your doctor.
- Doulas of North America ( DONA) research on effects of a birth doula: Click here.
- Doulas of North America position papers the labor support doulas contribution on maternity care: Click here.
- Doulas of North America position papers , the postpartum doulas role in maternity care: Click here
- Cappa position paper antepartum doula support for high risk pregnancy: Click here