“Will my insurance cover my visit? Are you in network with my insurance?” are understandably among the first questions many patients ask me.
It is very difficult for IBCLCs to become in network with most insurances. A limited number of insurances will credential lactation consultants, although reimbursement rates may be challenging. Some IBCLCs contract with outside organizations that seek reimbursement on their behalf, although this does not mean they are “in network”. For this reason, I am not in network with any insurance plans at this time.
However, many insurance plans will reimburse, in full or in part, the fees my patients pay for care. The Affordable Care Act (Obamacare) mandates lactation coverage be offered to patients at no out-of-pocket cost; how well your insurance company complies with that can really vary. I have had the most success locally with Empire Plan and Aetna, and other plans regionally and nationally also reimburse well.
To schedule with me, you pay the out of network fee at the time of booking.; I then submit directly to your insurance for you to be reimbursed, no extra steps needed on your part. From there your insurance company should communicate directly with you, including sending any reimbursement check directly to you.
Please ask if you have further questions. I continue to seek ways to make lactation care more accessible and affordable for all.