Not necessarily. Here’s some helpful info from AAP’s statement on insurance and lactation
Recognizing the health benefits of breastfeeding, the Patient Protection and Affordable Care Act of 2010 (ACA) provides two major provisions to encourage mothers to achieve their breastfeeding goals: (1) reasonable break time to express milk and (2) health insurance benefits to defray the costs associated with providing breast milk to infants, including coverage of breastfeeding education and supplies in non-grandfathered health insurance plans. Prior to the ACA, the IRS agreed to include breastfeeding supplies as an eligible expense for health savings accounts (HSAs) and flexible spending accounts (FSAs).
While it is true that insurance companies are required to cover lactation visits, not many will contract directly with private practice IBCLCs, stating that care can be received at a pediatrician visit, which is covered by insurance. However, most pediatricians don’t receive more than a few hours of lactation education during their residency, meaning if you took a prenatal breastfeeding class, you likely know as much as they do!
The best thing to do is to call your insurance company and ask them who is in-network for your family that provides skilled lactation care. If there isn’t anyone qualified in-network, you can see an IBCLC and then ask for a receipt and superbill with all insurance billing info, and call your insurance company and inquire how you can submit it for reimbursement.
At Brave Birth, we most often work with Ashley Treadwell of Cascadia Lactation. Here’s what she says about working with insurance:
I am in network with both Aetna and BCBS, if you have either of these for insurance coverage, I can see you at your home with no additional cost sharing for you. If you have another insurance plan and are interested in using your insurance, this is something we can do - I work at a clinic in SW (Canyon Medical Center) - I can see you there and bill your insurance (assuming your insurance is accepted at the clinic) at little to no copay for you. -- Ashley
Learn more about the difference between hospital-based and private lactation consultants.
If my insurance doesn’t pay for a private IBCLC, what is the out-of-pocket cost?
There is a wide range in cost, which is dependent on the specific provider, the area you live in, and the type of visit. Some private IBCLC’s have an office where you can see them for a lower fee. Home visits often cost more. With all that is happening in the world now, many are doing virtual visits as well. Generally, you can expect to pay somewhere between $100 and $300 for an initial visit.
Ashley Treadwell of Cascadia Lactation charges an initial visit fee of $195. If you are a Brave Birth Family, you receive a $30 discount on your initial visit.
Learn more about what to expect at a private lactation visit.
To learn more: contact any of our doulas directly or email Brave Brith at hello@bravebirth.com.
All of our gorgeous photography is captured by birth photographer and doula Jen Berryman. Please take a moment to enjoy more of her work!
