The Affordable Care Act states that breastfeeding support, supplies and equipment should be covered with no co-pay, no deductible, for the duration of breastfeeding. Lactation consulting is provided as a “Women’s Preventive Service.”
Currently, Aetna is the only company that covers lactation support, meaning no out of pocket cost to you. The Aetna preferred providers In our group are Shelly Taft, Heather Bingham and Christine Fisher Rothman. They will bil insurance directly. We can help you find other Aetna providers if need be.
In our experience, clients with Harvard Pilgrim, Blue Cross/Blue Shield of Massachusetts and some Tufts health plans have been reliably reimbursed. You will pay the IBCLC directly. She will provide you with a receipt that has the necessary information for your insurance company. We suggest that you call your insurance company to confirm what they provide for breast-feeding support.
Some insurance companies will give an exception for an out-of-network provider if they do not have in-network providers. Sometimes the providers they offer are not IBCLC Lactation Consultants. To be clear, an IBCLC is a lactation specialist. The IBCLC is an internationally recognized certification, considered the most rigorous standard for lactation education, requiring the most background in lactation education and clinical, one-on-one experience.
Breastfeeding help is a healthy investment for the whole family and even for the planet! The longer a mother breastfeeds, the more long-term health benefits for her and her baby. In addition. you’ll save money on formula, bottles and likely less doctor visits. You also reduce the amount of trash and plastics. It’s a win win situation for everyone.
Here are some helpful resource in advocating for these benefits, It's always a good idea to document all your calls and correspondences with your insurance company so it’s clear what you’ve been told.
• You can file a complaint with the Commissioner of Insurance in Massachusetts.
Donald Judson, the Commissioner of Insurance in Massachusetts, issued a bulletin on July 6, 2016 that clarifies the benefits. "Federal Requirement that Carriers Cover Certain Lactation Services Without Any Consumer Cost-Sharing".
• The National Womens Law Center has a helpful booklet that explains your benefits under the Affordable Care Act.