No, doula services are not universally eligible for reimbursement with a Flexible Spending Account (FSA) or Health Savings Account (HSA). However, portions of a doula’s services may be eligible if they are medically necessary and supported by a Letter of Medical Necessity (LMN) from your healthcare provider.
Why Are Doula Services Sometimes FSA/HSA Eligible?
Doulas are non-medical professionals who provide physical, emotional, and informational support during pregnancy, labor, and the postpartum period. While this support is valuable, it is not typically considered medical care under IRS Code Section 213(d), which is required for FSA and HSA eligibility.
However, if a doula performs tasks that qualify as medical care—such as assisting with labor pain management or postnatal recovery—and these services are prescribed as medically necessary, they may be reimbursed with an LMN.
Eligible Doula Services (with a Letter of Medical Necessity)
To be eligible, the following conditions must be met:
Services must be clearly itemized and only include care directly tied to a medical condition (e.g., labor support, physical recovery support)
The doula must be a certified provider
You must obtain a Letter of Medical Necessity from your doctor describing the medical condition being treated and the specific services being recommended
Examples of potentially eligible services with an LMN:
Physical labor support during childbirth (pain coping, breathing guidance)
Postpartum recovery support related to a diagnosed medical condition (e.g., perineal trauma, postnatal depression)
- Assistance prescribed as part of a high-risk pregnancy management plan
What’s Not Covered?
The following doula-related services are not eligible, even with a Letter of Medical Necessity:
Emotional support services
General parenting or infant care education
Housekeeping or childcare assistance
Services not itemized or linked to specific medical treatment
Care from non-certified or unlicensed providers
How to Use Your FSA or HSA for Eligible Doula Services
If you plan to seek reimbursement for doula services:
Request a Letter of Medical Necessity from your healthcare provider outlining the diagnosis and required care
Work with a certified doula who can provide a detailed, itemized receipt
Submit both the LMN and the receipt to your FSA or HSA administrator for approval and reimbursement
For more details, refer to IRS Publication 502.
