Are doulas covered by insurance? The short answer is yes. But unfortunately, it’s not that simple.
Insurance-covered doula services are relatively new: A benefit that didn’t exist nine years ago when I first learned about doulas.
I first heard the term “slave” when I was eight months pregnant with my first son. At the time, I had been working in healthcare for over a decade as a biomedical engineer at some of the top medical device companies in the country. With a focus on research and development for medical devices specifically for women’s health, I thought I knew everything there was to know about pregnancy and new mom life.
So imagine my surprise when a friend dropped the word “doula” at me and my face went blank. There I was, just weeks before giving birth, only now learning that there was an option to have a dedicated support person to help me physically and emotionally through pregnancy, labor and delivery. How did I not know this? It turns out that this type of non-medical, professionally trained support person can improving health outcomes during labor and delivery for both mom and baby, that is if you can pay for it out of pocket. And because I felt so overwhelmed and lost before the birth, I decided it was a cost I would take.
My doula helped me through pregnancy, labor, delivery, and those first few days postpartum are some of my fondest memories. The support I received, the confidence she instilled in me to support my wants and needs, and the guidance that helped me thrive as a new mom in those early days was invaluable.
It got me thinking: Why hadn’t I heard this earlier in the pregnancy? Did others know this was an option? Why wasn’t this the standard of care? And what did families do if they could not afford to pay for this clinically beneficial service without insurance coverage?
I started talking about my experience with my doula and quickly realized that many people didn’t know doula services existed. And those who needed these services most could not afford them.
That was something I couldn’t live with—and that’s what led me to find it Flourish Care, a maternal healthcare company that combines technical and personal care, empowering families with wellness programs and insurance-covered doula support from pregnancy to parenthood. Now, nearly a decade later, the US is finally starting to provide community care benefits like doula care through insurance, mostly for Medicaid participants, but it’s growing.
Here’s a breakdown of what this insurance coverage for doulas looks like, what you need to know to access it, and the benefits that doula care will provide you during your pregnancy and parenting journey.
Which states have insurance-based doula services?
The number of states taking action on Medicaid doula reimbursement has more than doubled from 2022 to 2024. Currently, 43 states and Washington, DC are working to provide families with doula reimbursement options, with 14 states actively reimbursing Medicaid patients. Those states that actively reimburse for doula care include Massachusetts, New York, New Jersey, Maryland, Virginia, Michigan, Florida, Oklahoma, Minnesota, Oregon, Nevada, California, and Washington, DC.
Currently, only Rhode Island, where Flourish Care is based, and Louisiana are covered with doula care for those with commercial insurance plans under the law. But it is worth celebrating the fact that states recognize the benefit of doulas in improving the health crisis of the mother.
What are the benefits of using a doula?
A doula works directly with the birthing parent and medical care team to make sure the birthing parent has the confidence to advocate for themselves and feel supported during labor and delivery.
Of clinically proven that patients who add doulas to their care team reduce their risk of preterm birth, reduce their risk of delivering their baby in the Neonatal Intensive Care Unit (NICU), reduce their transition to unnecessary or unwanted C-sections, and reduce birth disparities.
In addition to providing support during pregnancy and childbirth, postpartum doulas, who are also now covered by some insurance plans, can help new parents in those immediate weeks after having a baby. These services include help with caring for the newborn, help with food preparation and laundry, to name a few.
Finally, most insurance plans that cover doula support offer coverage for all situations, including patients who give birth at term, patients who give birth prematurely, or in the event of pregnancy loss or termination. Through these new reimbursement laws, patients gain access to a support system that can help alleviate stress and provide much-needed support to patients.
How do I know if I am eligible for doula services covered by insurance?
One of the biggest challenges with state or insurance doula coverage is that it can be difficult to find out if your insurance covers doulas, how much out-of-pocket support you are entitled to, and then finding a doula that meets your specific needs and preferences your. This is one of the many reasons I started Flourish Care. as a way to take the burden off you and your doctors. If you’re reading this and you live in Massachusetts or Rhode Island, you can visit Flourish Careenter your insurance information and we’ll let you know your eligibility based on your coverage—and match you with a doula within a week.
If you’re reading this and live in another state, here are some ways to find out if you qualify for doula services and how you can pay for them.
- Ask your doctors: A doula should work in conjunction with your medical care team. So the first place to go is your OB-GYN office. If you want to incorporate a doula into your care team, support this support and ask your doctor how she can help you find out if insurance will cover the additional care. Your doctor is your first line of defense.
- Call your insurance company: This isn’t my favorite tip, but unfortunately, in today’s landscape, it’s one of the only ways to find out if your insurance plan covers doula services. We’re on a mission to change that, but until then, if you call the number on the back of your insurance card, you can find out if your insurance covers it. Here are some talking points that can help you get to the right person, faster:
- The first step is to call member services and ask if you have doula privileges
- If you have privileges, member services will give you a list of providers in your area
- You can inform member services that doula services are usually included in maternity benefits. If it’s not listed there, it means your insurance doesn’t cover doula services. In terms of compensation, this may vary depending on your situation. But it can be anywhere from $750 to $3,200 for services.
- Use your HSA or FSA cards: If your insurance doesn’t cover services or you’re looking for more coverage than your plan offers, you can often use an HSA or FSA card.
- Talk to your employer’s Human Resources Department: If your company offers Maven or Carrot benefits, you could have access to doula services. All you have to do is contact your company’s HR department and ask if Maven or Carrot benefits cover doula services. Many times you will have access to funds from there that can help you pay for antenatal, birth or postnatal services. It’s another way to get doula services without having to pay out of pocket.
Why should we support universal, insured doula services?
The US has the worst maternal mortality rate of any developed country. But the numbers don’t add up: There’s no reason why the US spends more on health care than any other high-income country and also has the highest maternal mortality rate. And given the fact that over 80% of maternal deaths in the US are considered preventable with the right care and necessary interventions — it’s not crazy for insurance companies to cover doula services.
Doulas are a standard of care in almost every other country in the world. Research shows that adding this type of community care provider to the care team improves birth outcomes, reduces stress for the birth parent and partner, shortens labor times, and provides culturally competent care and support to expectant parents in minority or low-income communities . Oh, and it’s decreasing health care costs.
So, while only a few states and insurance companies currently provide reimbursement for doula care, I am on a mission to cover doula services from all insurance companies, both for Medicaid patients and those patients with commercial or private policies. And I’m not alone in my quest: A handful of US lawmakers have recently reintroduced it Mamas First Act, a federal bill that would expand Medicaid to include doula and midwife support. The goal of the legislation is to combat the maternal health crisis by expanding coverage to include community-based supports such as doulas.
My doula changed my birth and new motherhood experience for the better. This kind of care for new parents should be the norm. As mothers, we deserve the best. And insurance-covered doula care is one way to help us get it.
