Blog

In-home newborn care is not usually covered by traditional health insurance. There are many reasons why your family might need overnight care however, so understanding payment options becomes crucial. How to Get Insurance to Cover my Night Nanny or Doula explores insurance coverage for overnight doula and night nanny care.

Situations Where Health Insurance Might Cover a Night Nanny or Doula:

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. Typically one or both of these conditions needs to be met:

• Pre-Existing Condition: 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 as a parent 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 help. For example, the frequency of seizures in a person with certain type of epilepsy may be triggered by lack of sleep. For this reason, the primary care physician could recommend overnight doula care as an appropriate treatment in the postpartum phase.

• Doctor Directed Care after Birth: Similar to having a pre-existing condition, postpartum doula or night nurse care may be directed by a healthcare provider after birth. An example might be 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. They can provide the documentation and medical justification for why overnight newborn care is necessary. Doctor advocacy is a critical piece of obtaining insurance approval.

That Said, Here’s How to Get Insurance to Cover my Night Nanny or Doula

1. Talk with your Primary Care Provider before the birth: If you have a pre-existing condition or think you may encounter a postnatal situation where night doula care is needed, have those conversations early and often. This way if you *do* need overnight care, it can be scheduled before baby arrives, or can be coordinated quickly.
2. Contact your insurer: Health insurance benefits vary widely by state and carrier. While one may cover birth doula care and several postpartum doula visits, another may not. Contact your provider and ask what postpartum coverage you have. Specifically you can ask if they will cover all or part of medical billing code 99501 or 99502. There may be other codes relevant to your situation; but these are the common in-home postpartum codes.
3. Coordinate Appropriate Care: When insurance covers overnight newborn care, typically it’s required that care be rendered by a clinically licensed Nurse or in some cases only by a Registered Nurse (RN). This means the caregiver must be: a Licensed Practical Nurses (LPN), a Licensed Vocational Nurse (LVN) or an RN. Be sure to clarify which level of care is covered. It’s important to note that the terms “night nurse” or “baby nurse” are often used colloquially, but “nurse” is a legally protected term in most states. For insurance purposes “night nurse” will be used in the legal way.

What about Employee Benefits like Carrot or Maven?

Get insurance to cover my night nanny or doula through work – your company might offer employee funded benefits. These are corporate benefit programs which pay for overnight postpartum doulas.

• Carrot– Carrot is a corporate benefit that 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 whose experience and certificates can be verified on the NAPS Night Doula Registry.
• Maven – Maven offers comprehensive Maternity and Family Benefits: from preconception through postpartum all the way up to menopause. Let Mommy Sleep staff are Maven approved.
• Flexible spending accounts (FSAs) or health savings accounts (HSAs) can also help. Benefits differ between card issuers so check with your HSA provider to see if Let Mommy Sleep postpartum night doulas are an accepted expense.

The Role of a Night Nurse or Night Doula

A night nanny, also called a newborn care provider or postpartum doula plays a vital role in providing specialized care during the nighttime hours. If you want to answer the question how can I get insurance to cover my night nanny or doula, first you can see if the role fits into your needs.

Responsibilities of the Night Nurse or Night Doula typically include:

1. Breastfeeding assistance or bottle feeding support and education.
2. Supporting healthy sleep and soothing for the newborns and twins
3. Keeping track of the newborn’s feeding patterns, diapers and overall health.
4. Allowing parents to receive deep, restorative blocks of sleep to aid recuperation, strengthen the immune system and receive better mental health outcomes.
5. Ensuring the home is ready for the day; tidy nursery, prepared bottles or pump and a calm, clean baby.

If insurance still does not cover your night nanny, you can try to offset the cost by financing, accepting gift certificates from loved ones or using a postpartum baby registry. If you have more questions about how to get insurance to cover my night nanny or doula, please contact us!

And if you’re expecting and want more tips, sign up to receive our free newborn and postpartum support guide!