Can You Get Doula Support Covered by Insurance? Here’s What You Need to Know
For a long time, doula care has been viewed as a luxury rather than an essential part of maternity care. But, in the last few years, especially in Illinois, I am hearing more and more about coverage being offered to my clients through their own insurance plans. The Illinois legislature enacted HB 5142 in July 2024, requiring that beginning in 2026, state-regulated private plans cover prenatal visits, labor and delivery support, and postpartum home visits with a perinatal doula. While I am already contracted through Tricare and Illinois Medicaid, I am getting more questions every day and more insurance plans are beginning to recognize the value of doulas. While coverage can look different depending on your plan, there may be options available to help offset the cost of care.
Why Insurance Coverage for Doulas Is Expanding
Doulas provide non-medical, evidence-based support that complements medical care not replaces it. Studies have shown that doula support is associated with:
Lower rates of cesarean birth
Reduced use of medical interventions
Shorter labors
Improved breastfeeding outcomes
Higher overall birth satisfaction
From an insurance perspective, these outcomes can mean lower healthcare costs and healthier parents and babies, which is why more plans are beginning to explore reimbursement for doula services.
What Insurance Coverage Might Look Like
Doula coverage does not look the same across all insurance plans. Here are the most common ways families are getting support covered:
1. Reimbursement After Birth
Some insurance plans allow families to submit doula services for out-of-network reimbursement. This typically means:
You pay for doula services upfront
You submit a receipt or “superbill” to your insurance which I can provide
Your plan reimburses a portion (or occasionally all) of the cost
2. HSA or FSA Funds
Many families are able to use Health Savings Accounts (HSA) or Flexible Spending Accounts (FSA) to pay for doula care. These accounts allow you to use pre-tax dollars, which can significantly reduce the overall cost. I can accept both of these payment options directly, or provide a receipt for reimbursement.
3. Insurance Programs and Pilots
Some insurance companies, Illinois Medicaid program, Tricare and employer-sponsored plans such as GEHA and Blue Cross Blue Shield of Illinois now contract directly with doulas. Though Illinois law has stated that doulas support should be part of all insurance plans, not many private programs have implemented the onboarding and billing supports that are needed for doulas specifically. It is important to reach out to your plan directly for clarification!
What Insurance Typically Requires
If your plan does offer reimbursement, they may ask for:
An itemized invoice or receipt
A diagnosis or procedure code
A letter of medical necessity or referral letter (sometimes required)
Your Doulas NPI number and proof of certification from a known organization. I have also been asked to provide practice insurance and CPR certifications.
How to Find Out If You’re Eligible
Before assuming doula care isn’t covered, I encourage families to ask their insurance company directly. Helpful questions include:
Do you reimburse for out-of-network maternity support services?
Can doula care be covered under preventative or maternal health benefits?
Are HSA or FSA funds eligible for doula services?
Is preauthorization required?
If you’re interested in doula support and wondering whether insurance can help cover the cost, I’m always happy to talk through your options and provide documentation to support reimbursement. Even partial coverage can make doula care more accessible and every step toward broader coverage is a win for the families I support.
If you’d like help exploring your insurance options or learning more about working together, feel free to reach out.
