Your Benefits May Help Pay for Your Care
wouldn’t that be awesome!
Doula care and childbirth education may be eligible for coverage or reimbursement through your health insurance or employer-sponsored benefits. We’ll help you figure out what you have, what to ask, and what Modern Mama can provide.
We’re seeing more families receive coverage or reimbursement for doula care and childbirth education than ever before.
Some UnitedHealthcare and Blue Cross Blue Shield plans may include doula benefits or offer reimbursement, depending on the specific employer and plan. Employer-sponsored programs such as Carrot and Maven may also include benefits for pregnancy, birth, postpartum support, or childbirth education.
And don’t forget about the money you may already have set aside! HSA and FSA funds may be another option for eligible services. Childbirth education is commonly an eligible expense, while doula reimbursement through an HSA/FSA can depend on the type of services provided and the documentation required by your particular plan. (FSAFEDS)
The Catch? Every Plan Is Different.
Two people can have the same insurance company and have completely different benefits because coverage is often determined by the specific employer and plan.
That’s why we don’t want to tell you, “Yep, you have Blue Cross — you’re covered!” and have you find out later that your particular plan works differently.
Instead, we’re going to show you exactly how to check.
And yes… this may involve an actual phone call. We know. 😬
But if 20 minutes of hold music could potentially put hundreds — or even thousands — of dollars back in your pocket, we think it’s worth checking.
Have AHCCCS?
AHCCCS does offer doula benefits through qualified participating providers. At this time, Modern Mama Doula Services is not enrolled as an AHCCCS provider, so we aren’t able to bill AHCCCS for your doula services.
If you’d like to use your AHCCCS doula benefit, we’ll point you toward the official AHCCCS provider directory so you can search for a participating doula in your area.
Now, grab your insurance card and let’s see what benefits you have. 👇
First Things First… Yes, You Probably Have to Call Them 😬
We know. Calling your insurance company is approximately zero people’s idea of a good time.
There may be hold music. You may get transferred. You may have to explain what a doula is more than once. You may briefly reconsider every decision that led you to this moment. 😂
But hear us out — it could absolutely be worth the phone call.
Depending on your specific insurance plan or employer benefits, you may have money available for birth doula support, postpartum doula care, childbirth education — or a combination of all three.
So grab your insurance card, put the call on speaker, fold some laundry (or don’t… we support that too), and use the questions below as your cheat sheet.
You don’t need to understand insurance-speak. That’s why we made this.
Let’s see if there’s some money hiding in those benefits. 👇
How to Check Your Benefits
Step 1: Grab Your Insurance Card
Call the Member Services number on the back of your insurance card.
When someone answers, you can literally say:
“Hi! I’m currently pregnant and I’m checking my maternity benefits. I’d like to know whether my specific plan provides coverage or reimbursement for birth doula services, postpartum doula services, and childbirth education.”
Then work your way through the questions below.
Write down the answers! Insurance benefits can vary dramatically from one plan to another — even when two people have the exact same insurance company.
Step 2: Ask About Doula & Childbirth Education Coverage
Start with the big questions:
● Does my specific plan include a benefit for birth or labor doula services?
● Does it cover prenatal doula visits?
● Does my plan cover postpartum doula care?
● If postpartum doula care is covered, are there limits on the number of visits, hours, days, or total reimbursement?
● Does my plan cover or reimburse childbirth education or prenatal education classes?
Ask About Choosing Your Own Doula
● Am I required to use an in-network doula, or can I choose my own?
● If my doula is not in network, can I submit the services for out-of-network reimbursement?
● Does the doula need to meet specific certification or credentialing requirements?
● Does the plan require an NPI or other provider information?
Ask How Much They’ll Actually Pay
Because “it’s covered” and “we’re paying for it” are unfortunately not always the same thing. 🙃
Ask:
● Is there a specific doula benefit or allowance?
● Is there a maximum dollar amount?
● Is there a maximum number of visits or hours?
● Does my deductible apply?
● Is reimbursement based on a percentage of what I pay or an insurance-determined allowed amount?
● Will I have a copay or coinsurance?
Ask What Needs to Happen BEFORE Services Begin
This part is important.
Ask:
● Do I need prior authorization, pre-certification, or a referral before receiving doula services?
● Is there anything I need to submit before hiring my doula or before services begin?
● Do I need approval before I pay for services?
You definitely don’t want to discover after the fact that there was a form you were supposed to submit first.
Step 3: Find Out Exactly What They Need for Reimbursement
Ask your insurance representative:
“What documentation does my specific plan require from me and from my doula in order to submit for reimbursement?”
Depending on the plan, they may ask for things such as:
● An itemized invoice
● A paid receipt or proof of payment
● Dates and description of services
● Doula certification or training information
● NPI, if applicable
● Specific procedure or HCPCS codes required by your plan
● A particular doula reimbursement or claim form
If They Ask for Billing Codes
Ask:
“Does my plan require any specific billing information or codes for reimbursement? If so, please give me the exact information required by my specific plan so I can provide it to Modern Mama.
Write down exactly what they give you.
Then ask:
● Where do I submit the claim?
● Can I submit it online?
● Is there a specific doula reimbursement form?
● What is the deadline for submitting my claim?
If You’re Covered Through Your Partner’s Insurance
Totally fine!
If you’re the person receiving maternity care but your insurance is through your spouse or partner’s employer, you can still start by calling the Member Services number on your insurance card.
Say:
“I’m covered as a dependent on my partner’s employer-sponsored health plan. I’m pregnant and I’m calling about the maternity benefits that apply to me. Can you check my specific coverage for birth doula services, postpartum doula support, and childbirth education?”
If there’s any confusion, clarify:
“My partner is the primary subscriber, but I’m the covered dependent receiving the pregnancy and maternity services. I’m asking about the benefits available to me under this plan.”
Have Your Partner Check Their Employer Benefits Too
This is worth doing because sometimes the good stuff isn’t actually part of your regular health insurance.
Have your partner check their employee benefits portal or contact HR/Benefits and ask:
“My spouse/partner is covered under my benefits and is pregnant. Does our employee benefits package include doula care, postpartum support, childbirth education, maternity benefits, or a separate family-building benefit? If so, are covered spouses or dependents eligible?”
Don’t Forget About Employer-Sponsored Benefits
You or your partner may have additional benefits through work that are completely separate from your regular health insurance.
Check your employee benefits portal or ask HR about:
Carrot • Maven • family-building benefits • maternity/pregnancy benefits • fertility benefits • wellness benefits • HSA/FSA eligibility
If you have Carrot, Maven, or another employer-sponsored benefit program, log into the program or contact its Member Support team directly.
Ask whether your specific benefits can be used for:
● Birth doula services
● Postpartum doula care
● Childbirth education
And make sure you ask:
“Is there anything I need to do or have approved BEFORE I hire or pay for these services?”
Because nobody wants to find out about that requirement after they’ve already paid. 😬
Before You Hang Up…
We know you’re ready to get off the phone. 😂
But before you celebrate, make sure you’ve written down:
Insurance/benefit program
Representative’s name, Date of call, Call/reference number
What they cover: Birth doula coverage, Postpartum doula coverage, Childbirth education coverage
Maximum benefit or allowance ie: Visit/hour limits: Deductible or coinsurance requirements
Is there Prior authorization required or Documentation required?
What are their specific required procedure/HCPCS codes, if provided by your plan:
What is Claim form or website and where to submit:
When is the Submission deadline:
And ask one last question:
“Can you tell me where this benefit or exclusion is documented in my plan materials?”
Then you may officially hang up. 🎉
Got Your Answers? Send Them Our Way!
Once you’ve checked your benefits, send Modern Mama the information you collected.
If your plan allows reimbursement, we’ll review what they told you and let you know which requested documentation we’re able to provide for your Modern Mama services.
That may include things like itemized invoices, receipts, service information, doula certification information, or other reimbursement-ready documentation when applicable.
Please keep in mind: Insurance and employer benefits vary by individual plan. Coverage and reimbursement are determined by your insurance company or benefit administrator and cannot be guaranteed by Modern Mama Doula Services.
But if there’s money sitting in your benefits that can help pay for your support?
We absolutely want you to know about it. 💛
Your body. Your baby. Your birth.
