How to Use Your HSA or FSA to Pay for Doula Services: A Step-by-Step Guide
One of the most common questions families ask is: “Can I use my HSA or FSA to pay for a doula?” The answer is often yes — if you follow the right process. While coverage is not guaranteed under every plan, many families have successfully used their pre-tax healthcare dollars to cover birth or postpartum doula care.
Here’s a clear, step-by-step guide to help you navigate the process.
Step 1: Check Your Plan Documents
Start by reviewing the eligible expenses list in your HSA or FSA plan. Doulas may not be listed directly, but don’t be discouraged — plans often allow services that can be justified with a medical necessity letter.
Step 2: Ask for a Letter of Medical Necessity
Request a Letter of Medical Necessity (LMN) from your provider (OB, midwife, or nurse practitioner). This letter should explain why doula care is beneficial for you. For example:
Reducing the risk of complications during birth
Supporting postpartum recovery and mental health
Providing continuity of care during a high-risk pregnancy
Step 3: Keep Clear Records and Receipts
Your doula should provide a detailed invoice that includes:
The type of service (birth doula, postpartum doula, education sessions)
Dates of service
Total amount paid
You’ll submit these receipts along with the LMN to your HSA/FSA administrator.
Step 4: Submit Your Claim
Each plan has its own process, but typically you’ll log into your HSA/FSA portal, upload your documentation, and submit for reimbursement.
💡 Pro tip: If your claim is denied, appeal. Many families get approval the second time with clearer documentation.
Step 5: Follow Up and Advocate
If your plan pushes back, follow up by pointing to research showing doulas lower intervention rates and improve maternal outcomes. Every request adds to the growing pressure for broader coverage.
Why It’s Worth the Effort
Using HSA or FSA funds can save you hundreds of dollars on doula care. More importantly, it makes this support accessible to families who might otherwise hesitate because of cost.
Even if your request isn’t approved, you’ve planted a seed — the more families ask, the more likely insurers will expand coverage in the future.
Final Thoughts
Navigating insurance and benefits can feel intimidating, but you don’t have to do it alone. As a doula, I regularly provide the documentation families need to submit claims and am happy to guide you through the process.
Investing in doula care is investing in peace of mind, confidence, and support for your family’s unique journey.
👉 Contact me today to learn more about using your HSA or FSA for doula support
Frequently Asked Questions About Using HSA/FSA for Doula Care
Can I use my FSA for postpartum doula care?
Yes, in many cases. If your provider writes a Letter of Medical Necessity (LMN) explaining why postpartum support is medically beneficial (for example, supporting recovery, breastfeeding, or mental health), you may be reimbursed.
What if my HSA/FSA claim for doula services is denied?
Don’t give up. Many families are successful on appeal, especially if they provide additional documentation or a more detailed LMN.
Do all insurance plans cover doula services with HSA or FSA?
No — coverage varies by employer and plan. Some are more flexible than others, but asking shows there is demand, and that pressure can encourage broader acceptance over time.
What documents do I need to submit?
At minimum: an invoice from your doula and a Letter of Medical Necessity from your provider. Be sure the receipts are itemized and include dates of service.
Is it worth the effort even if my claim is denied?
Absolutely. Trying costs nothing, and you may save hundreds if approved. Even if denied, you’ve added your voice to the movement pushing for wider recognition of doulas as essential care.
You are not alone, and support is available. If you’d like to learn more, take a look at my Doula Packages or Fertility Coaching Services — I’d be honored to walk with you.