Holistic Lactation & Infant Feeding Support
Sara Alanis RN, IBCLC, IFS
Lactation Consultant, Feeding Specialist, Registered Nurse
Insurance Coverage & Pricing Information
Appointments with Board Certified Lactation Consultants are, by law, expected to be covered by health insurance with no deductible, no copay, no coinsurance, and no other out of pocket costs.
...unfortunately, its not that easy.
More information is below.
Aetna
Cigna
First Health
Multiplan
PNOA
Unicare
United
VA CCN
So do you take my insurance?
For prenatal or breastmilk feeding parents or babies with United/UHC/UMR, Unicare, Wellpoint, Aetna, Harvard Pilgrim Multiplan, VA CCN, Imagine Health, Meridian; any subsidiary of any of these companies; and some groups with a PNOA or MultiPlan logo on the back of the card- up front insurance coverage may be available to you through The Lactation Network (TLN). Except for pump flange fittings, there is a one time $40 administrative fee for use of this third party biller. With some plans a cost-share billed by TLN may apply. For families who choose this option the overall cost of care should be significantly reduced- especially if you plan on follow-up visits, but please read this before deciding.
For parents or babies with Cigna, regardless of feeding modality (breastmilk or formula), insurance coverage is available to you though Wildflower, prenatally and postnatally. Except for pump flange fittings, there is a one time $40 administrative fee for use of this third party biller, but no cost-share applies, so the maximum out of pocket expense is only that one time fee*.
The Lactation Network and Wildflower are medical billers who will bill your insurance company, and then use a portion of what they collect to pay me. You must receive approval prior to your appointment in order to use this service, and your policy must remain active for coverage to continue. With TLN, there may be a maximum number of visits allowable; and 5% of plans may be subject to paying a cost-share, which is very small plan-specific percentage of the insurance allowable amount billed. You can contact your plan to find out if this is you, and if so, what your cost share of the allowable amount would be. With Wildflower there is no limit on the number of visits covered and the coverage is always one hundred percent. *Home visit travel fees do still apply with TLN and WF if you select to have home visits.
If you choose not to use a third party biller, or if your insurance company is not listed above, then detailed pricing information is available on the Appointments page. Payment is due in full at the time of service, and you may seek reimbursement afterwards. Many insurance companies will reimburse (Blue Cross PPO plans, Tufts, Harvard Pilgrim, Tricare), but not all will (NH state plans, Blue Cross federal plans, Anthem HMO plans). If reimbursement is important to you, please check with your insurance company about coverage prior to scheduling. I can not guarantee reimbursement and I will not refund non-reimbursed fees. I will provide an invoice to submit to insurance following your appointment with me. The procedure codes generally are S9443 for a prenatal; 99404 and 99203 for a lactating parent as the patient; and S9444 for a formula feeding baby as the patient.
I accept FSA & HSA cards, cash, check, Visa, Mastercard, Discover, American Express, and Venmo. If lactation or feeding assistance is needed, but care is not covered by your insurance, and is out of reach financially, please let me know and we can work something out- whether it is a reduced fee, a payment plan, or a barter. Everybody deserves care.
