Are Doulas Covered by Insurance? A Guide for Expectant Families

You’re growing a teeny, tiny little human inside of you, you’re planning for labor, and somewhere in the middle of all of this, you’re still trying to figure out what’s actually covered… And I get it! Budgeting for birth AND postpartum can feel overwhelming (to say the very, veeeery least), and sometimes the most important support (like a doula!) doesn’t even show up in your insurance app. One question we hear from families all the time is: Are doulas covered by insurance? And honestly speaking, it’s a great one to ask!

Doula support is one of the most meaningful ways to feel more confident and cared for during pregnancy, birth, and postpartum. But that being said, knowing how (or if) that care fits into your budget is incredibly important. 

I know it’s a lot to consider, especially on top of all the other thousands of things you’re already considering for your new life with baby… That’s why in this post, I want to try and ease your mind a little on the subject. I’ll walk you through what’s currently possible when it comes to insurance, flexible spending accounts, and alternative ways families are making doula support more accessible!

Are Doulas Covered by Insurance?

The short answer to this? Sometimes…

While traditional health insurance doesn’t automatically cover doula services in most cases, there are exceptions… and things are actually beginning to change for the better regarding this! More employers are now starting to recognize the incredible value of doula support, especially in postpartum recovery and maternal mental health outcomes.

While every insurance plan is different, here’s how some families have managed to make it work:

• Employer-Provided Programs: Some employers offer family-focused benefits programs such as Carrot Fertility, Maven Clinic, or Progyny. These kinds of programs may include reimbursement for postpartum doulas or lactation consultants.
  
• Private Health Plans: In rare cases, a private insurance provider may offer partial reimbursement if you submit a detailed invoice. It’s worth asking your provider directly, though, just to be absolutely sure about this before booking a doula.
  
• Medicaid (in select states): While North Carolina doesn’t currently offer Medicaid reimbursement for doulas, several states are piloting programs that do—and there is growing advocacy for expansion.

Bottom line here: postpartum doula insurance coverage isn’t guaranteed, BUT… it’s always worth asking. And knowing what questions to ask when that time does come can make all the difference.

How to Ask Your Insurance Provider About Doula Coverage

Even if doula care isn’t listed in your benefits package, you may still be able to submit for partial reimbursement, especially if your doula offers itemized receipts and documentation.

Here are a few tips for navigating the conversation with your insurance provider or HR department:

• Use the Right Terminology: You can specifically ask if your plan covers “out-of-network support services,” “labor support,” “postpartum care,” or “lactation consultations.” Doulas and postpartum support usually fall under these categories or terms.
  
• Request a Letter of Medical Necessity: In some cases, your OB or midwife can write a letter supporting the need for additional postpartum care. You can then submit this letter to your insurance provider alongside receipts.
  
• Get Total Clarity on Submission Requirements: Ask what documentation you’ll need for reimbursement (invoice format, dates of service, provider info, etc.). When you know which documentation you need, it will help you be more prepared and organized when you do find a doula who suits your needs and preferences.
  
• Follow Up: Don’t hesitate to follow up after submitting your requests or documentation. Trust me, persistence DOES pay off, and many families are surprised at what’s actually possible in their healthcare plans.

Remember that asking these questions doesn’t make you pushy. It makes you informed—and the more informed you are, the better decisions you can make that impact your life, baby’s life, and your family’s life.

Can You Use an HSA or FSA for Doula Services?

In many cases, yes, you can!

If you have a Health Savings Account (HSA) or Flexible Spending Account (FSA), you may be able to use those pre-tax dollars to pay for doula care, especially if the care is tied to physical or mental recovery postpartum. One parent-to-be we worked with didn’t realize their HSA could be used for postpartum doula care—until they called their provider and asked. A five-minute call saved them hundreds.

Here are still some tips to keep in mind, though:

• Check with your plan administrator about eligible services 
• Keep ALL receipts and documentation
• Some HSA/FSA providers may request a Letter of Medical Necessity
• Even if your doula is not a medical provider, postpartum support is increasingly being recognized as a legitimate health expense

Using an HSA or FSA can be a more accessible path for many families, especially if insurance reimbursement isn’t an option. So, if you’re looking to find a doula to support you, make sure you’re well-informed about this beforehand so that you can make the right decisions.

Other Creative Ways Families Are Affording Doula Support

We’ve worked with so many families who found flexible ways to make postpartum care fit their budgets—and often, it just takes a little planning or creative thinking.

Here are a few options that have worked for our clients:

• Add Doula Support to Your Baby Registry: Let friends and family gift you the support you’ll really use in those early weeks. (Many people love gifting help instead of another swaddle blanket you’ll eventually add to the pile you ALREADY have!)
  
• Use a Gift Certificate: Queen City Doulas offers gift certificates. These are perfect for showers or group gifts, so let your closest ones know, just in case you’re considering it. You can reach out to us personally to ask us about our gift certificate options!
  
• Customize Your Packages: Some families choose to book smaller shifts or shorter packages. With Queen City Doulas, you can book our minimum package of 40 hours of total support—this can be used over any time period. If you need to book less than 40 hours, please don’t hesitate to reach out. If possible, we would love to accommodate you!
  
• Plan for It Early: If you’re planning ahead for other baby-related expenses, adding postpartum support to your “baby fund” can help ease the financial pressure later on.

Doula care isn’t just a nice-to-have thing. It’s real, restorative support during one of life’s biggest transitions. We have literally sat beside parents who were trying to breastfeed while balancing sleep deprivation and the questions that just kept on coming. We’ve answered 2am texts from new mamas who were doubtful and unsure if they were “doing it right”… 

Honestly speaking, that kind of support is hard to put a price on—but it really matters more than most people realize.

Is It Worth It If It’s Not Covered?

Admittedly… we might be a little biased—but yes, absolutely!

While it would be amazing for all insurance plans to recognize doula care as a standard part of birth and postpartum recovery, many families still choose to invest in support even without having coverage. 

Why? Because being cared for, heard, and supported can literally make all the difference in how you experience the early days of parenthood.

Think of it like this: you wouldn’t hesitate to prepare your home with safe gear for your baby. Preparing yourself with emotional and practical support is just as valuable… If you’re still in doubt, you can try our Doula Cost Calculator!

Let’s Talk Through Your Options

Every single family’s situation is far different than another’s. That’s why we’re always happy and more than willing to answer questions about payment, planning, or insurance-related documentation. 

If, right now, you’re not sure where to begin or whether this kind of support could even fit into your budget, let’s talk. No pressure or anything; we’ll just give you some clarity, help you lay your options on the table, and support you!