Insurance Coverage & Pricing Information

So do you take my insurance?

For prenatal or breastmilk feeding clients with United, BCBS PPO, Anthem PPO, Unicare PPO, Optum VA CCN, some Cigna & Harvard Pilgrim, any PPO subsidiary of any of these companies, and many cards with a PNOA or MultiPlan logo on the back- insurance coverage should be available at no cost to you through The Lactation Network (TLN). The Lactation Network bills your insurance company, and then uses a portion of what they collect to pay me. For clients with these insurance plans, or for anybody who wants to double check, please click here to to check coverage. You will hear back from TLN with confirmation of coverage usually within 1 day. You must receive approval prior to your appointment in order to use this service. There is no copay and no deductible. As long as your insurance policy does not change, you will never receive a bill- even if your insurance company denies the claims- TLN will cover the cost. The only cost that is not covered by TLN is the travel fee* portion of home visits. Office visits and telehealth visits are covered at 100%.

If you choose not to use TLN, if you are formula feeding & not lactating at all, or if your insurance company is not an affiliate, 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, but not all will. If reimbursement is important to you, please check in with your insurance company about your plan's coverage prior to scheduling- requesting GAP coverage may help. I can not guarantee reimbursement and I will not refund non-reimbursed fees. I will provide a special 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 an exclusively formula feeding baby as the patient.

I accept FSA & HSA cards, cash, check, Visa, Mastercard, Discover Card, American Express, and Venmo. If private lactation or infant feeding assistance is needed, but private 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. Financial limitations should not inhibit your access to quality care.

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*for TLN home visits there is a $45 house call fee per appointment up to 30 minutes away, or $60 for appointments 31 to 45 minutes away