How are Families Paying for Postpartum Doula Services?

As you take the leap into postpartum doula work, or as you consider training with us, it’s important to understand the many ways that families can pay for your services. We want all doulas to feel confident not just in the direct services they provide, but also in their backend business systems. This article is meant to outline the most common ways that you may take payment in your doula practice. 

If you are a new doula, do not feel pressure to use all of these right out of the gate. Likewise, if you are an experienced doula, you may know that you don’t have the capacity to utilize all options. It’s important to reflect upon your capacity to learn new systems, as well as your values, and how you can put them into practice through your business. 

Private Pay

This is the most straightforward and common option, but it is also an option that is not available to all families. Many doulas take payment via online invoicing systems like QuickBooks Online, Square, Stripe, or if they use a customer relationship management (CRM) system, there may be invoicing and payment options integrated into that software. Venmo for Business, PayPal Business, cash, or check are other private pay options that may suit some doula businesses.

Sliding Scale

Some doulas offer equity-based sliding scale rates for folks who don’t have insurance coverage but can’t afford the full rate. This is a great guide to sliding scale considerations, language, and models. Some folks who offer sliding scale decide on a certain number of sliding scale spots per month/year, while others may always offer a sliding scale, allowing clients to self-select the rate that aligns with their complex economic situation. 

HSA and FSA

Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) may cover doulas' services, but there may be a few extra hoops clients have to jump through in order to be eligible. This may include getting a letter of medical necessity from their provider to submit to insurance. 

The process for both of these types of accounts typically involves paying the doula directly and then seeking reimbursement through your HSA or FSA vendor. Clients are responsible for looking into their HSA or FSA rules and submitting the correct documents. As the doula, your main responsibility will be to issue a detailed invoice and document the payments the client has made.

Benefits and Supplemental Benefits 

Some companies directly reimburse families for doula services; however, this is fairly rare and is mostly limited to a few tech companies. More and more companies, however, are offering a range of supplemental, perinatal benefits that support individuals as they grow their families. These include third-party companies such as Carrot, Maven, Prodigy, and Kindbody. 

Different companies pay for different levels of coverage for their employees, so it’s important that clients confirm their coverage with a benefits coordinator. For some of these supplemental benefits, doulas will be required to take specific steps (such as registering for a directory, which requires providing certain documentation like certification and insurance) in order for families to be eligible for reimbursement.

Medicaid

The National Health Law Program’s Doula Medicaid Project has a tracker that offers up to date details about each state and their current progress towards Medicaid reimbursement of doula services. There are often specific training requirements that doulas will need to fulfill in order to be eligible to be reimbursed for doula care, so it’s important to understand the status and requirements in your state. Many states do not offer Medicaid coverage of Postpartum Doula services. 

Registry

In our tips for creating your registry, we highly recommend that folks consider adding postpartum doula support to their registry– pass this along to your clients, too! One way to do this is through Be Her Village, another is by creating a doula fund on Babylist. There are lots of baby items to go around via Buy Nothing groups (free!), local mom’s groups, and Facebook Marketplace or other second hand retailers. That said, folks in their support systems may be delighted to spend their money on your clients’ care and recovery. 

Join Us for Postpartum Doula Training

ABG offers both online (self-paced) and in-person training for folks who are interested in becoming postpartum doulas. We’d love to support you in becoming a confident, well-rounded doula, both as a service provider and business owner.

*Photo credit: Taylor Gray on Unsplash