What's *really* going on with
health insurance covering
expert breastfeeding services in San Antonio??
Despite the Affordable Healthcare Act of 2010 (the Act) mandating that women's preventative services be covered by health insurance companies (breastfeeding is a preventative service mentioned in the Act, btw), the Act did not specify that the IBCLC (the gold-standard in in clinical breastfeeding support) be the actual provider who offers these preventative services to families. What this means is that other providers who were already traditionally in-network with insurance companies (like doctors, etc.) can be paid to discuss breastfeeding with you despite not being trained breastfeeding experts.
Some insurance companies, however, have realized the cost-savings of paying for breastfeeding guidance that comes from a breastfeeding expert (the IBCLC) vs. the eventual emotional and financial costs of paying for their members to receive non-expert breastfeeding care. Aetna, in most markets, has been one of the companies who acknowledged the importance of accepting IBCLCs in their network, and after *five* years of trying to bring covered-breastfeeding care to SA, Breastfeeding Housecalls (BH) has finally received in-network status. This means that most families who are members of Aetna can receive BH's expert services at no or little cost to them now.
These bullet points may answer your question better:
Some insurance companies, however, have realized the cost-savings of paying for breastfeeding guidance that comes from a breastfeeding expert (the IBCLC) vs. the eventual emotional and financial costs of paying for their members to receive non-expert breastfeeding care. Aetna, in most markets, has been one of the companies who acknowledged the importance of accepting IBCLCs in their network, and after *five* years of trying to bring covered-breastfeeding care to SA, Breastfeeding Housecalls (BH) has finally received in-network status. This means that most families who are members of Aetna can receive BH's expert services at no or little cost to them now.
These bullet points may answer your question better:
• Families with BCBS/UNITED HEALTH/HUMANA, etc. will continue to be scheduled as usual on a private-pay basis, and will be given a claim to attempt reimbursement by health insurance. Though no guarantees, many insurance companies do reimburse for IBCLC consultations! Ironically, the likelihood of parents being reimbursed for services are much higher than of lactation consultants being accepted in-network with most insurance companies.
Need more perspective? Check out this blog about why hiring a private-practice lactation consultant is worth your baby's weight in liquid gold.
• Families with CIGNA, call for special instructions about coverage of services.
• Families who receive non-insurance coverage such as MEDICAID OR TRICARE are not covered with BH but special prices can be discussed for services based on income. Please call first to discuss.
All families can schedule themselves for our next available appointment here:
Need more perspective? Check out this blog about why hiring a private-practice lactation consultant is worth your baby's weight in liquid gold.
• Families with CIGNA, call for special instructions about coverage of services.
• Families who receive non-insurance coverage such as MEDICAID OR TRICARE are not covered with BH but special prices can be discussed for services based on income. Please call first to discuss.
All families can schedule themselves for our next available appointment here:
