Insurance Reimbursement Update

It has been almost 3 years since I wrote about insurance coverage for lactation services. A lot has changed in that time.  Most insurances will now provide new mothers with an electric breast pump as soon as the baby is born, if not before, at no cost to her.  The insurance plans now comply with the Affordable Care Act when it comes to breast pumps.  However, coverage for lactation help is still spotty.

Insurances which otherwise must abide by the Affordable Care Act are required to cover lactation services as well.  Some of my clients have found, though, that when they inquire about this coverage, they are given several excuses of why they will not be reimbursed for a lactation consultation.  The most common excuses are

1.  We only cover lactation services while you are in the hospital

2.  We only cover services provided by a licensed provider

3.  We only cover services provided by in-network providers

Luckily, the Federal government has gotten wind of these excuses and is putting a halt to them!  In October of 2015, the US Department of Labor published a document that addressed these excuses and other concerns about preventive services covered by the Affordable Care Act.  You can read the document yourself at http://www.dol.gov/ebsa/faqs/faq-aca29.html

If you don’t want to read the whole thing, however, then here are the most important facts to know when you discuss this with your insurance company.

1.  Insurers must provide coverage for lactation services for THE DURATION OF BREASTFEEDING.  That means they must cover it if you need help at any point while you are breastfeeding, not just in the hospital.

2.  There is only one state in the United States which currently offers licensing for lactation consultants.  Insurers may not refuse to cover for an unlicensed provider, so you should be covered to see an IBCLC (International Board Certified Lactation Consultant).

3.  Insurers must provide coverage for out-of-network providers if they have no in-network providers in your area.  This is usually the case as there are very few in-network lactation consultants around the country, and, currently,  none in Southern Maryland.

This is all good news, but it doesn’t mean that dealing with the insurance company is always easy.  You still need to pay up front and then submit for reimbursement from your insurance company.  I’m sure you will agree, though, that that is a small price to pay for expert help in your home when you most need it!

The Affordable Care Act has definitely changed insurance company involvement in breastfeeding, but one thing remains the same.  Expert lactation help is worth the investment.  Even if you have to pay for it, it will more than pay for itself as you save on formula and doctor’s visits.  And who can put a price on peace of mind?

 

 

 

Breastfeeding: Making Us Better Mothers

There has been a lot of discussion in the media recently about the mother who left her baby in the carseat all day while she was at work. Sadly, the baby died. The mother reported that she simply forgot about him. Stories like this are always shocking, and, as mothers, we like to think we could never do any such thing. Deep down, though, we know that we often get overwhelmed, overtired, and distracted. At that point, we have to admit that anything is possible.

As a lactation consultant I can’t help thinking that a breastfeeding mother simply cannot forget her baby for 8+ hours. Her full breasts will remind her long before that. Even a mother away at work is reminded of her baby every time she pumps.

This is just one of the many ways that breastfeeding helps us to be the best mothers we can be. We all wish we could be perfect mothers, but, face it: That is never going to happen. We are going to make mistakes, some minor, some big. We are going to sometimes ignore what we know to be the better choice. We will lose our tempers and our composure. We will all disappoint ourselves from time to time.

As breastfeeding mothers, though, we won’t forget about our babies for very long. We won’t fail to give them a lot of physical contact. We won’t forget to take a little time to sit and hold our little ones—biology simply won’t allow it.

Nature has ways of making sure to protect our offspring. Human babies need to be kept close to their mothers and they need to eat frequently. Mothers need to be reminded to take a break and focus on their babies when their lives become harried. This was not only true for “cave” mothers and babies. It is equally true today, as the reports of numerous babies left in carseats reminds us. Breastfeeding is nature’s way of protecting our children from some of our inevitable failures as mothers.

Breastfeeding–Naturally!

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iStock_000005607524XSmallWe offer individual consultations, private and group classes, and assistance with choosing a breastpump. Home visits in the La Plata and Waldorf areas are available.

We sell only the highest quality products which have been carefully evaluated for their convenience and usefulness. If you are looking for a breastpump or other breastfeeding product, why not choose Milky Way where you can get expert advice along with superior prices?