Besides the depths of sleep deprivation and the wild changes pregnancy and birth does to your body, figuring out insurance BS with a baby postpartum just might third on the list of awful things to deal with postpartum.

I am here to break it down simply so you have just the right amount of information you need to start, whether it is working with me or another lactation provider.

Under the Affordable Care Ace (ACA), the health care law requires all new insurance plans to cover breastfeeding supplies, and support and counseling without co-payments, deductibles, or co-insurance. This means you don’t HAVE to pay upfront for lactation support, but sometimes finding this in-network is very difficult.

Many insurance companies cover six lactation visits, including a prenatal one, but you likely won’t know until you inquire through them or submit them a superbill.

If you have your own insurance (not through an employer), you will be covered for lactation support since you have a new private plan.

If you have insurance through a job (from you or partner) chances are good lactation support will be covered, but not a guarantee.

If you have Medicaid, if it is through the expansion, yes you are covered. But traditional Medicaid, maybe.

Frustrating, I know. The law states all new plans, but there are some old plans out there that won’t cover it without you paying out of pocket first.

Now onto working with me as it relates to lactation support and your insurance. I am considered an in-network provider for many major insurance companies, and out-of-network for the rest. BUT out-of-network does not mean you won’t be reimbursed for the cost of the visit(s), you would just need to pay out of pocket first.

I am IN-NETWORK with:

• Blue Cross Blue Shield PPO, Anthem PPO, UnitedHealthcare PPO& HMO (not virtually, only in-person), VA CCN, PNOA, Multiplan and other select plans

• I use The Lactation Network to make it possible for me to be in-network with these plans with no out-of-pocket cost to you

• Book an in-network prenatal virtual consult with me here

I am OUT-OF-NETWORK with:

• Aetna and all other health plans not listed above

• Book an out-of-network prenatal virtual consult with me here

  ** working with me out-of-network has the out-of-pocket upfront cost, BUT many insurance companies will reimburse you once you submit a superbill that I will provide you with

Resources

• National Women’s Law Center Breastfeeding Toolkit

  • Scripting for contacting insurance, types of coverage, sample appeal letters