Insurance Coverage for Doula Services
By Tine Reese
October 15, 2009
How many times have I heard pregnant women say that they aren’t hiring a doula for their hospital birth because it is too expensive? TOO MANY TO COUNT. And it always saddens me because I know that they stand a much better chance of achieving a natural birth in the hospital with the assistance of a doula. As Doula.com says, “For the time and services that goes into doula work, you get an excellent deal for your money.” I have always believed this to be true, but understand that in these financially-troubling times families are hesitant to spend any extra money on something that isn’t absolutely necessary.
Up until now, the only way to get health insurance to pay for hiring a doula was to approach the insurer after the fact and file a Third Party Reimbursement claim or use a flexible spending account if your employer offers one. Both options require a lot of time and effort on the consumer’s part and don’t always end with a reimbursement for doula services. And if you’re like most people, you take one look at all the work you’d have to do and figure it’s not worth the effort.
I happen to think that a doula is a necessity and that it is worth the effort to get insurance to pay for their services…but I digress. At last, there’s good news to report on this front that I hope will make health insurance coverage for doula services easier to come by and less work for expectant couples!
The Childbirth and Postpartum Professional Association (CAPPA) has just announced that certified doulas will be able to file for insurance reimbursement on behalf of their clients. “Effective October 1, 2009, the National Uniform Claim Committee (NUCC) has approved and defined a taxonomy code for certified doulas in the United States. This code will enable certified doulas to obtain an NPI (National Provider Identification) number to submit reimbursement claims to Medicaid and third-party provider insurance companies.”
In answer to the question of whether this insurance claim code system guarantees reimbursement for doula clients, DONA says, “No, this does not guarantee reimbursement, but all parties should be considering it equally. The need for a taxonomy code and a NPI number has been an impediment to reimbursement in the past. DONA International recommends that doulas use appropriate caution as it remains unclear how, who, and what amounts will be covered. We encourage [doulas] to ensure a contract outlines all expectations and fee structures in the event that services are not covered.”
I talked to Spokane-area birth doula Terri Young about her thoughts on this news. She said, “Right now, people aren’t sure how this new system is going to work.” She and other doulas are waiting to hear what CAPPA and DONA have to say as the new rules are instituted and details are worked out. Terri does say, “I’m excited and hope it allows more people in our community to hire doulas!”
One thing is clear: enough people are hiring doulas to make these changes necessary and that’s great news! I will stay in touch with our local doulas about this topic and keep you updated on any further changes or news.
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