Doula Care & Insurance Reimbursement
Helping Dallas Families Maximize Their Benefits
At Great Expectations Dallas, we are committed to helping you navigate the financial side of your birth and postpartum support. While doula care is traditionally an "out-of-pocket" professional service, many of our clients successfully receive partial or full reimbursement through their health accounts and private insurance providers.
We only work with certified doulas that meet all credentialing requirements set out by the various third party payers. One less worry for you!
1. HSA & FSA (Health Savings & Flexible Spending Accounts)
This is the most seamless way to pay for doula care. Doula services are considered an eligible medical expense under IRS guidelines, you can use your pre-tax dollars to cover our fees.
How it works (so easy!): You can pay your deposit and balance directly using your HSA/FSA debit card. You do not need to do anything else
2. Private Insurance Reimbursement
With the expansion of maternity benefits, many private carriers (such as UnitedHealthcare, Aetna, and BCBS) have introduced or expanded doula reimbursement policies.
The Superbill: Following your birth or the completion of your postpartum care, we can provide an official Superbill. This document contains the necessary CPT codes (such as 99499) and provider information your insurance company requires to process an out-of-network claim.
Gap Exceptions: If your insurance company lists doula care as a covered benefit but lacks "in-network" providers in the Dallas area, you may be able to file for a Gap Exception to have our services covered at the in-network rate.
3. Employer-Sponsored Benefits (Carrot, Maven, etc.)
Many major Dallas-area employers now offer "Family-Forming" stipends through third-party platforms like Carrot, Maven, or Progyny.
Our agency is experienced in providing the specific invoices and verification forms required by these platforms so you can easily access your employer-provided doula stipend.
Once you sign your contract and pay your first payment, we will provide you with the necessary documents to submit for reimbursement. Each company is a bit different but we work with all of them.
Great Expectations Dallas is an out-of-network provider. All service fees are paid to the agency according to your contract schedule. We then provide the documentation needed for you to seek reimbursement directly from your insurance carrier. At this time we do not participate in TRICARE or Medicaid programs.
How to Verify Your Insurance Benefits
Before your baby arrives, we recommend calling the member services number on the back of your insurance card and asking these three questions:
"Does my plan cover out-of-network reimbursement for CPT code 99499 (Doula/Labor Support)?"
"Do I need to provide a Letter of Medical Necessity from my OB/GYN or Midwife to qualify for reimbursement?"
"What is the specific mailing address or portal for submitting an out-of-network maternity claim?"
Your Reimbursement Success Checklist ✔️
Follow these steps to maximize your chances of a successful claim.
Verify Your Benefits: Call your insurance provider and ask if "out-of-network doula care" is a covered benefit under CPT Code 99499.
If needed, get Your Letter of Medical Necessity (LMN): Have your OB/GYN or Midwife sign it during a prenatal visit.
Keep Your Receipts: Save your initial deposit and balance payment confirmations.
Request Your Superbill: Once your baby is born (or your postpartum care is complete), email us to request your official Superbill.
Submit the Claim: Mail or upload the following three items to your insurance portal:
The completed Claim Form (from your insurer's website).
The Superbill provided by Great Expectations Dallas.
The signed Letter of Medical Necessity.
Follow Up: If you haven’t heard back within 30 days, call your provider to check the status of your claim. If denied, ask for the specific reason—often it is just a missing signature or a simple data entry error!