What’s Covered by Insurance?

Discover which lactation services, doula care, prenatal support, and birth education programs may be covered by your health plan.

Quality Care. Insurance Covered.

Many families qualify for insurance-covered lactation support, doula services, childbirth education, and prenatal wellness care with little to no out-of-pocket expense.

What's Covered by Insurance — Birthstone Women's Wellness

Insurance coverage in California

Your care is covered — here is what that means for you

Doula Support Lactation Consulting Childbirth Education

If you are pregnant or postpartum in California, doula care, lactation support, and childbirth education are now covered by all Medi-Cal plans and many major private insurance plans. At Birthstone Women's Wellness, we handle the billing so you can focus on your care.

Lower C-section rates

Continuous doula support is linked to fewer C-sections and less epidural use

Shorter labors

Birthing people with a doula consistently report shorter labor times

Better breastfeeding outcomes

Lactation support improves breastfeeding success and duration

Fewer complications

Lower rates of premature and low-birthweight births with supported care

Who qualifies

Who is eligible for covered care?

You do not need a referral. As of January 2023, a standing statewide recommendation from DHCS applies automatically to all qualifying Medi-Cal members. This benefit covers doula services, lactation consulting, and childbirth education.

Currently pregnant

Eligible from the moment you enroll in a qualifying plan — no referral or paperwork required.

Recently pregnant

Access services for up to one year after your pregnancy ends, regardless of outcome.

Postpartum only

You can begin care after delivery even if you did not receive prenatal support.

Loss or termination

Coverage applies even if the pregnancy ended in miscarriage, stillbirth, or termination.


Visit structure

How many visits are covered?

Most insurance plans follow the DHCS Medi-Cal visit structure. All services can be provided in person or virtually, including by phone, with no location restrictions.

1

Initial consultation

90-minute intake visit to establish care and begin your support plan.

8

Perinatal visits

Prenatal or postpartum visits used as needed throughout your journey.

2

Extended postpartum

Up to 3 hours each for in-depth postpartum support and recovery.

Labor and birth support

Continuous support through labor and delivery, including for miscarriage or termination.

If you have Medi-Cal, you may qualify for an additional 9 postpartum visits with a written recommendation from a second provider. Ask us about this at your first appointment.


What is included

Covered services

These are the services your insurance will reimburse when provided by a Birthstone provider.

Birth plan creation
Pregnancy education
Navigating your care team
Emotional support during labor
Physical comfort in labor
Miscarriage and loss support
Childbirth education
Postpartum recovery support
Newborn care education
Breastfeeding and latch support
Lactation consulting visits
Postpartum mental health follow-up
Community and resource referrals
Infant feeding education

What is not included

Not covered by insurance

These services may be offered separately or for an additional fee. You always have the right to opt in or out.

Belly binding
Birthing ceremonies
Babywearing classes
Massage
Birth photography
Placenta encapsulation
Shopping or errands
Vaginal steaming
Yoga sessions
Meal preparation

Doulas, lactation consultants, and educators are not medical professionals in this context. They will not diagnose conditions, provide medical advice, or perform clinical procedures.


Plans we accept

Insurance plans that cover these services

Birthstone Women's Wellness is contracted with the following plans. Coverage depends on your specific plan and county of residence.

Medi-Cal plans

Medi-Cal Direct
Inland Empire Health Plan (IEHP)
Anthem Blue Cross Medi-Cal
Blue Shield Promise
Health Net Medi-Cal
Community Health Group
Community Health Plan of Imperial Valley

Kaiser Permanente

Kaiser Permanente Southern California
Kaiser Permanente Northern California

Commercial plans

UnitedHealthcare
Additional plans as contracted

Northern California plans

Alameda Alliance for Health
Contra Costa Health Plan
Health Plan of San Joaquin
Health Plan of San Mateo
Partnership HealthPlan of California
San Francisco Health Plan
Santa Clara Family Health Plan
CalViva Health

Ready to find out what is covered for you? We verify your benefits before your first appointment — no surprises.

Verify my coverage