If you’re caring for someone who is dying, or planning ahead for your own end of life, you may have come across end-of-life doulas: non-medical companions who help with emotional support, planning, vigil care and practical guidance in the final months, weeks and days of life. A common question follows almost immediately: who pays for this?

The honest answer is: mostly, you do. But there are some genuine funding pathways worth understanding, and a couple of promising but incomplete ones on the horizon. Here’s where things stand in Victoria right now.

Medicare: No, doulas aren’t a Medicare item

Medicare covers services delivered by registered health practitioners (GPs, specialists, nurses and allied health professionals) working under specific item numbers. End-of-life doulas are not a registered health profession in Australia. There is no Medicare Benefits Schedule item for doula support, and none is expected in the near term, since Medicare funds clinical care rather than the non-clinical, holistic companionship a doula provides.

This doesn’t mean the person you’re caring for misses out on funded care altogether: palliative care itself (delivered by doctors, nurses and allied health) is covered by Medicare and is usually free or low-cost with a Medicare card. A doula’s role sits alongside that clinical care, not instead of it, and is currently a privately arranged and privately paid service.

NDIS: Possible, but only if the person already has an NDIS plan for an eligible disability

The NDIS doesn’t fund doula support because someone is dying; it funds supports that relate to a participant’s disability and help them pursue their goals. So an end-of-life doula is really only fundable through the NDIS when:

• The dying person is already an NDIS participant (for example, living with a disability separate from their terminal diagnosis), and
• The support can be linked to their existing plan goals, and
• Their plan is self-managed or plan-managed, giving them flexibility to choose non-registered providers.

Where those conditions line up, some families have used NDIS core supports or capacity-building funding to engage a doula in the same way they’d engage any other support worker. It isn’t a standing entitlement, though: it depends entirely on individual plan wording and approval, and a person who becomes eligible for NDIS only because they are terminally ill won’t automatically get doula support included.

Home Care Package: the program has changed, and doulas still aren’t on the list

If you’ve been researching this for a while, you may have last read that Home Care Packages could sometimes stretch to cover a doula through flexible, client-directed funding. That’s now out of date in an important way: Home Care Packages no longer exist. On 1 November 2025, the federal government replaced the Home Care Packages Program (and the Short-Term Restorative Care Programme) with the new Support at Home program.

Under Support at Home:

• Funding is delivered through quarterly budgets across eight assessed classification levels, rather than one flexible annual package.
• Spending is tied to a defined service list across three categories: clinical care, independence support, and everyday living.
• There’s a specific short-term pathway for end-of-life care, reflecting government recognition that dying-at-home needs are different from general aged care needs.
• If someone has a terminal diagnosis with three months or less to live, they may be eligible for a dedicated end-of-life funding boost (commonly reported at around $25,000) on top of their regular support.

Here’s the catch: end-of-life doulas are not currently on the approved Support at Home service list, and the Department of Health and Aged Care has indicated that doula and end-of-life consultant services are expected to be funded privately. Advocacy groups, including the doula training organisation Preparing the Way, are actively pushing for doulas to be added to the approved provider list so this dedicated funding can be used more flexibly. As things stand, though, you cannot draw on a Support at Home budget to pay for a doula.

If someone was already receiving a Home Care Package before the changeover, their existing funding and provider arrangements carried across automatically, but the same service-list restrictions now apply.

So how are people in Victoria actually paying for doula support?

• Privately, out of pocket. This remains the default. Victorian doulas typically charge on an hourly or package basis (commonly in the $80–$150+ per hour range, with vigil, respite and legacy-work packages priced separately), and payment is made directly to the doula as an independent provider.
• Through an NDIS plan, where the person is already a participant and the support fits their approved goals.
• Through philanthropic or subsidised programs, where they exist: some community organisations and charitable funds occasionally support doula access for people who can’t afford it, though these are limited and not guaranteed to operate in every area of Victoria.
• Through informal in-kind arrangements, such as a doula donating time, though this isn’t something to rely on when planning care.

What this means if you’re planning ahead

• Don’t assume your Home Care Package (or its Support at Home replacement) will stretch to cover a doula: check the current approved service list with your provider, but expect the answer to be no for now.
• If the dying person has an NDIS plan for an unrelated disability, it’s worth asking their plan manager or Local Area Coordinator whether doula support could be linked to an existing goal.
• Budget for doula care as a private expense, and ask prospective doulas directly about their fees, package structures, and whether they offer any sliding-scale or subsidised support.
• Keep an eye on reform in this space: the push to add doulas to the Support at Home approved provider list is active, and funding rules can change. If this matters to you, it’s worth checking Services Australia or My Aged Care for updates before assuming the current gap is permanent.