Starting January 1, 2025, Kaiser Permanente has expanded doula coverage access to its 9.4 million+ members in California. This exciting development is the result of California’s AB904 legislation, which mandates “a health care service plan or health insurer, on or before January 1, 2025, to develop a maternal and infant health equity program that addresses racial health disparities in maternal and infant health outcomes through the use of doulas.”
While this initiative is undoubtedly a step in the right direction, barriers to access still remain. These include low reimbursement rates, which are currently on par with existing Medi-Cal levels, and difficulties in finding available doulas. In this blog, we aim to address these issues and provide clear information for families and doulas navigating this new benefit.
What are doulas and why are they important?
Doulas are trained professionals who provide emotional, physical, and informational support to families during pregnancy, childbirth, and the postpartum period. Unlike medical professionals, doulas do not provide clinical care but instead focus on helping families feel informed, empowered, and supported. This is particularly important in addressing racial health disparities, as doulas can advocate for families who might otherwise face systemic inequities in healthcare settings.
Various randomized controlled trials have suggested that the involvement of doulas in continuous labor support leads to:
- Lower cesarean delivery rates
- Lower rates of epidural administration
- Better 5-minute Apgar scores
- Improved rates of breast-feeding initiation
- Higher rates of positive childbirth experiences
- Lower postpartum depression rates
- Improved adoption of infant safety including back-sleeping for infants and appropriate car seat use
While most doulas provide both birth and postpartum support, some specialize in specific areas. For example, certain doulas may focus on the birth and early recovery period, offering comfort measures, lactation support, and guidance immediately after delivery. Others may specialize in postpartum care, providing newborn support and assisting mothers with physical and emotional recovery. Finding the right type of support tailored to your family’s unique needs is essential. To learn more about choosing the best fit for you, check out our blog: Finding the Perfect Fit Doula.
I am an expecting parent, what doula benefits are covered?
Under Kaiser’s doula program, current coverage is aligned with the existing Medi-Cal levels. This includes the following support from a doula:
- An initial extended visit of 90 minutes
- Up to 8 prenatal visits of 60 minutes (some of the 8 sessions can also be used towards postpartum support)
- Support during vaginal delivery or support during a cesarean section
- Up to 2 extended postpartum visits of 180 minutes
- Support for pregnancy that ends in stillbirth, miscarriage, or abortion
These prenatal and postpartum visits can address a wide range of needs, including perinatal support and guidance, health navigation, evidence-based education on prenatal, postpartum, childbirth, and newborn/infant care, lactation support, birth plan development, and connections to community-based resources. Coverage also extends to comfort measures and physical, emotional, and nonmedical support provided during labor and delivery, as well as for miscarriage and abortion.
However, some services commonly offered by doulas to clients paying out of pocket are not insurance-billable. These include belly binding (traditional or ceremonial), birthing ceremonies (such as sealing or closing the bones), group classes on childbirth education or babywearing, maternal or infant massage, still and video photography, placenta encapsulation, shopping assistance, vaginal steams, yoga, and hypnotherapy.
I’m a parent - How can I access these benefits?
If you are a Kaiser member and expecting, you are eligible for these benefits. Doula services are self-referred, meaning no prior approval or prescription from your care provider is required.
As of January 2025, doulas must bill Kaiser directly for services. Families cannot be charged directly or asked to pay any additional fees beyond the reimbursement rates set by the health plan.
Identifying doulas who accept Kaiser benefits can be challenging, and availability is often limited. In Northern California, for example, many doulas are booked 3–4 months in advance.
To find a doula, you can ask for referrals from family and friends, search for doulas in your area by ZIP code, or reach out to Cradle and Coos. Our team will work with you to identify available doulas within our network, understand your preferences, and match you with one who offers the best care tailored to your needs.
I’m a Doula—how can I start accepting Kaiser clients?
To serve Kaiser clients, doulas must:
- Be Medi-Cal approved and provide proof of enrollment (enrollment letter required). For details on the Medi-Cal enrollment process, visit this link.
- Submit the following documents to Kaiser:
For additional support or questions about enrolling, contact our team at info@cradleandcoos.com.
Under Kaiser’s doula program, current coverage is aligned with the existing Medi-Cal levels. This includes the following:
- A total of 11 doula visits for up to 12 months after pregnancy, which include the following:some text
- 1 extended initial visit of 90 minutes (reimbursement rate: $197.98)
- 8 prenatal or postpartum visits of 60 minutes (reimbursement rate: $162.11)
- 2 extended postpartum visits of 180 minutes (reimbursement rate: $486.36)
- In addition, support during vaginal delivery (reimbursement rate: $685.07) or support during a cesarean section (reimbursement rate: $795.73)
Addressing challenges to expand access
The expansion of doula coverage for commercial members is a significant step forward, but challenges such as low reimbursement rates and a limited network of available doulas remain barriers to full access. Advocacy for fair compensation and initiatives to grow the doula workforce, especially in underserved areas, will be essential for the success of this initiative. By working collaboratively, families, doulas, and healthcare providers can help ensure this benefit effectively improves maternal and infant health outcomes across California.
We will continue to monitor and share updates as this policy is implemented. If you have questions, need guidance, or have updates to this document, please don’t hesitate to contact us at info@cradleandcoos.com
