Does Your Medical Insurance or FSA Cover the Cost of a Sleep Consultant?

Sep 10, 2024

So, you just had a baby. The hospital makes sure they are strapped into the car seat properly and then off you go, launching into parenthood. Reality hits. 2:00 am, 3:12 am, 4:16 am…. why do you sleep all day and not sleep at night? I thought after a few weeks things would level off?

Maybe it’s time to seek help – but where should I start?

Is Sleep Coaching and Sleep Consulting Covered by Insurance?

It MIGHT JUST BE COVERED! More and more people are speaking out about the harmful impact to our body that chronic sleep deprivation causes and so helping families fix this issue can actually curb other costly medical treatments outside of sleep coaching. This year alone, countless studies on parental burnout have come to light & the impact is real.  

Helping your baby or toddler to sleep through the night is just one way to manage the burnout, which often starts here, in addition to workplace pressure, the management of sports, activities and our aging relatives all can lead to exhaustion and overwhelm. We speak to new & expecting parents or seasoned parents looking for sleep every day and many are surprised to find out that your medical insurance might just pay for our baby & toddler sleep consulting services {or our Adult Sleep Coaching services too.} 

To begin understand what you can get covered and what you can’t, it’s best to start with calling your insurance and asking about newborn care services, behavioral insomnia, or sleep deprivation coverage. Many insurance providers will actually talk you through filing a claim after the service for reimbursement and what paperwork you need to do that. 

A medical letter of necessity from your Pediatrician can’t hurt either to submit with our paid receipt for Tiny Transitions Sleep Coaching Services. Don’t have that, make it easy on your Pediatrician and download our template here, add the details you need for your family and provider, print it and have them complete the paperwork. Then, submit with our detailed invoice provided upon request to your insurance. 

A Medical Letter of Necessity is a document written by a healthcare provider that explains why a specific medical treatment, service, or equipment is essential for a patient’s health. This letter is often required by insurance companies to approve coverage for treatments that may not be typically covered under standard policies. It outlines the patient’s condition, the recommended treatment, and why it is necessary for their health and well-being. For parents, this letter can be crucial in ensuring that their child receives the necessary care and support.

However, if you medical insurance does not yet cover it, did you know the your FSA {AKA – Flexible Spending Account} might cover it? 👇

Will Your FSA or Flexible Spending Account Pick Up the Cost?

In many cases YES – they do! So you have to do a little work first on your end to validate this, as I have clients get reimbursed for our services all the time. So where do you start:

1. Pick up the phone and call you FSA provider. {Note: FSA (not your actual insurance) and an HSA (your actual insurance) are two different things and it’s the FSA where you can typically get reimbursed.} They will let you know what the requirements are for reimbursement, which typically involves an itemized invoice from us here at Tiny Transitions, which you will get for the package you move forward with.

The services can be “newborn care services”, or just recently a member of my team shared that in her insurance called it “sleep deprivation services”, just to share a few examples. If you aren’t sure, take the invoice and submit for reimbursement, the worst they can say is no, but you tried and needed the help anyway, it’s just a bonus that you don’t have to pay for it with the FSA.

2. Speak to your Pediatrician. It’s important to have open lines of communication with your child’s doctor about things that are happening with your baby. You are with them enough to know if something is off. For example, a baby/child snoring can actually be something else going on, that needs to be assessed by a medical professional.

However, they can also write a letter of medical need to share with insurance / FSA for reimbursement purposes alongside our invoice. {I just had the parents of twins do this in January and they had their whole program covered and they were 9 months old – and a super fun couple to work with who had success with us….um on night 2 of implementation with minimal tears!}

3. Understand Your Options. The sleep consulting space is tricky and unregulated. Many sleep coaches offer the same 1 package, for the same cost, with the same support. Do you know why? That’s because they all went to the same Sleep Coaching Online Training and all stamped out the same product offerings, as they were trained to.

So whether you need to full package or not, that’s what you are getting with them. Not here, we meet you where you are.

Don’t purchase what you don’t need.

Speak to a member of the team here on a discovery call, and we will help you get setup with the right program and right tools and can also direct you on reimbursement for the FSA submission.

 

Sleep can be a challenge and we are always here to help with great free training, downloads, and resources. Join my free Slumber Made Simple Facebook Group. Also, check out my Instagram where you can get even more tips and tricks for successful sleep!
My name is Courtney Zentz, a Pediatric Sleep Consultant from Philadelphia, PA, Postpartum Doula, Lactation Counselor and founder of Tiny Transitions. As an award-winning sleep consultant, I help exhausted parents teach their infants & toddlers to sleep well every night with gentle, customized solutions and both group and private coaching options, so your family can all be at their best.