How to Get Insurance to Cover my Night Nanny or Doula

July 6, 2024

The newborn and postpartum care industry is unregulated but growing. There are many reasons why your family might need overnight care, so understanding payment options becomes crucial. How to Get Insurance to Cover my Night Nanny or Doula explores insurance coverage for postpartum doula and night nurse care.

The Role of a Night Nurse or Doula for Newborns

A night nanny, also known as a newborn care provider or postpartum doula plays a vital role in providing specialized care during the nighttime hours. Responsibilities typically include:

1. Feeding and Nutrition: Whether through breastfeeding assistance or bottle feeding.
2. Healthy Sleep: Supporting healthy sleep patterns and routines for the newborns, twins and parents.
3. Monitoring and Documentation: Keeping track of the newborn’s feeding patterns, diapers and overall health.
4. Support for New Parents: Evidence-based education and reassurance to new parents on infant care.
5. Medical Need: Infants with medical conditions require specialized care and monitoring.

It’s important to pause here and note that the term “nurse” is still used coloquially, but is a legally protected term. It’s correct to refer to Licensed Practical Nurses (LPN), Licensed Vocational Nurses (LVN) or Registered Nurses (RN) as “baby nurses” or “night nurses” . When insurance coverage includes Night Nurse care, care must be executed by a clinically licensed Nurse.

Here’s the thing- when a newborn has medical need, health insurance overwhelmingly covers the cost of pediatric night nurse care. When a parent has medical need however, the chance of insurance stepping in is rare. But not impossible! Here’s how to answer the question, how to get insurance to cover my night nanny:

Situations Where Health Insurance Might Step in for Night Nanny Care:

Pre-Existing Conditions: Again, if your newborn or twins (or higher order multiples) are in need of medical care, insurance will almost always cover care provided by a licensed nurse. For you though, coverage typically hinges on medical necessity. If you have a pre-existing condition, and sleep is a necessary means to control that condition, insurance may step in. For example, the frequency of seizures in a person with certain type of epilepsy may be triggered by lack of sleep. For this reason, overnight newborn care could be “prescribed” by the parent’s physician before baby arrives.

Doctor Directed Care: Similar to if there is a pre-existing condition, postpartum doula or night nurse care may be directed by a healthcare provider after birth. An example of this is if postpartum psychosis or anxiety presents in a parent with a documented history of mental health issues. In this instance the doctor may advocate for health insurance coverage on behalf of the patient.

Both of these situations depend heavily on the parents’ doctor advocating on their behalf. The first step is to discuss your need for night nurse services with your primary care physician or obstetrician. They can provide documentation and medical justification for why such care is necessary, which is crucial for obtaining insurance approval.

What about Employee Benefits like Carrot or Maven?

If insurance coverage is unavailable your company might offer employee funded benefits. These are corporate benefit programs which pay for overnight postpartum doulas.

• Carrot Fertility– Carrot helps cover fertility treatments, labor doulas and postpartum doula help for the first 6 weeks after baby arrives. Let Mommy Sleep provides Carrot-approved doulas.
• Maven – Maven offers comprehensive Maternity and Family Benefits: from preconception through postpartum all the way up to menopause. Let Mommy Sleep caregivers are Maven approved.

• Flexible spending accounts (FSAs) or health savings accounts (HSAs) can also help. If using Let Mommy Sleep postpartum night doulas, you might also consider paying with Affirm, a pay over time option. Lastly, if insurance isn’t an option you can start a shared-funding account where loved ones can contribute to a monetary baby registry.