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Insurance May Cover Lactation Consults
| Posted on August 6, 2013 at 8:23 AM |
I am happy to share information about lactation care as it relates to the Affordable Care Act with you today. Desiree, a friend of mine from Phoenix, has been kind enough to share her vast knowledge on the topic. She has spent countless hours on the phone with the insurance companies learning how to best use the law in favor of nursing mothers. This is the first in a three-part series on how you, as a lactating mama, can use the Affordable Care Act to your advantage. What a relief, to know that you might be able
to use insurance to cover Lactation Consults in the early days after you
deliver your baby. This is the first in
a series of articles on the Affordable Healthcare Act as it relates to
breastfeeding:
I am an
International Board Certified Lactation Consultant in private practice and I share
this material for informational purposes only.
Each insurance plan is a little different and it is best to call and
request the specifics from your individual plans. Copied from the Health Services Administration
website: “Non-grandfathered plans and issuers are
required to provide coverage without cost sharing consistent with these
guidelines in the first plan year (in the individual market, policy year) that
begins on or after August 1, 2012” http://www.hrsa.gov/womensguidelines/  At first glance the law seems
pretty straightforward. Breastfeeding
support, supplies and counseling by a trained provider is covered for
non-grandfathered plans renewing 08/01/2012.
It is included in Women’s
Expanded Preventive Services
Benefits. If you qualify for the breast
pump or free contraception, you likely have the coverage, but call first. It is supposed to cover services without
applying to your copay or your deductible.
Here is where it becomes less
straightforward: the law does not define who exactly is the trained provider,
how long the services must be rendered, and that it apply to both in-network
and out-of-network benefits. The US Surgeon
General, in her Breastfeeding Call to Action in 2011, explained the provider of choice for the services is
an IBCLC. IBCLC credentialing is
essential for Lactation Consultants providing Lactation Services to
breastfeeding mothers. The credentialing
process entails coursework, 2000+ counseling hours with mothers, following a
code of ethics, and an international board exam. We recertify every 5 years with 75 hours of
CERPS and take the board exam every 10 years.
It is considered the gold standard of Lactation Care and is equivalent
to a Physical Therapist, Speech & Language Pathologist, or Occupational
Therapist in years of study, counseling, assessment, and intervention
skills. Insurance companies often
assume it is the OBGYN, Pediatrician, or hospital IBCLCs who provide the
service. What they don’t realize is
OBGYNs and Pediatricians often refer to IBCLCs and that most women need
additional help after leaving the hospital when her milk comes in. Insurance companies may confirm you have the
benefits, but neglect to inform you that it is only available with an
in-network provider. Confirm whether you
company contracts with an IBCLC and if not clarify whom it feels is a trained
provider. If, you are given a pump
rental company, and they are not a trained provider, then push for an IBCLC. Currently there are two insurance companies
in AZ contracting with IBCLCs- Aetna and BCBSAZ. United Health Care is exploring the
possibility, but no contracts yet and CIGNA will not contract with IBCLCs. I imagine this is all clear
as mud to you right now. What I often
recommend to my clients is that you call your insurance company to clarify
benefits and policies while you are pregnant, between 28 weeks-36 weeks of pregnancy, that way
if you need the services once your baby is born, you can have peace of mind
preparing for birth and breastfeeding.
If you can, get their responses in writing. My next article will cover how to request
coverage from your insurance company.  Desiree Allison, IBCLC602.903.0002 I am an Aetna contracted
provider and am negotiating with several other insurance companies for
contracts. I have a passion to help
mothers and babies thrive. I have been an
IBCLC for 3 years and have over 8years experience as a breastfeeding volunteer
with an international organization. Most
importantly, I am a mother of three incredibly inquisitive and independent
children. Please leave us a comment - it will be moderated and
posted. In an effort to keep the spam
to a minimum, I am taking the time to moderate comments now. The material included on this site is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®. |
Categories: Breast Pumps, Breastfeeding, Breastfeeding support, IBCLC, Lactation Consult, Lactation Consultation
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http://dentalimplantcostguide.blogspot.com
7:31 AM on June 7, 2014
The material included on this site is for informational purposes only.
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ramfry
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chaiaalfo
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chaiaalfo
7:36 AM on December 18, 2021
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viviemelod
5:50 PM on December 18, 2021
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kalhaber
1:12 AM on December 19, 2021
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itzelise
1:36 AM on December 19, 2021
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jaidliss
3:27 AM on December 19, 2021
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dorelar
7:13 PM on December 20, 2021
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mardawni
4:40 PM on December 21, 2021
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wendald
8:57 PM on December 22, 2021
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waitammi
7:48 AM on December 23, 2021
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bernzenph
8:38 PM on December 23, 2021
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odeademman
9:33 PM on December 26, 2021
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rassax
10:15 PM on December 26, 2021
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atllar
11:26 AM on December 27, 2021
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