click here for a sample letter to write to your insurance commisioner if ou wish to complain about not having coverage for lactation care.
What type of breast pump can I get?
Hospital grade rental pump, double or single electric personal-use pump, or manual pump?
Do I need to get the “recommended” pump or can I choose to purchase one & submit the receipt for reimbursement?
If yes, what amount will I be reimbursed? Is there a dollar limit on coverage for breast pumps?
If I have already obtained a breast pump, can I submit a claim for reimbursement?
When can I get my breast pump? Before giving birth? After the birth of my baby?
If I can’t get the breast pump until after the baby is born, does my eligibility for a pump expire when my baby reaches a certain age?
Where can I get my breast pump?
Does it need to be from a designated place (in-network provider) or can I choose where to get it?
If I need to use an in-network provider, how do I get a list of those companies & their contact information?
What do I do if the in-network providers do not have a breast pump available for me?
Will I be able to get services of an IBCLC if need assistance in proper use of the pump?
Does my insurance plan cover expenses related to breastfeeding?
What services & products do you cover? Are there any restrictions?
Do I need a written prescription for a pump from my physician?
Do I need to pay a copay?
Do I need to meet a deductible first?
What will I pay out of pocket? Is there a dollar limit for coverage for a breast pump and/or supplies?
You may be entitled to up to six visits from a professional Lactation Consultant (IBCLC). Each Insurance Provider may decide their own requirements and methods of reimbursement. If at first, you don't get the answer you want, call back. I've been told that if you talk to three different reps, you're likely to get three different answers. Know what you are entitled to, what you want, and then don't take no for an answer!
Are lactation consultant services covered?
If yes, do I need to have the consults approved first?
If yes, is there a certain level of consultant I can see? Only IBCLCs (International Board Certified Lactation Consultant) have the training and expertise regarding the mother, baby breastfeeding relationship. An IBCLC will spend the necessary time with you to fully assess your situation and help you develop a plan that is unique to you and your family.
Where can I receive lactation consultant services? If you prefer a home visit, tell them that. Insurance Companies are a business. Pleasing customers is how to keep your business.
Are there approved in-network providers?
Can I get reimbursed if I use a lactation consultant who is out-of-network?
Is there a limit on the number of visits I can have with a lactation consultant?
Do I need a prescription from a physician for a lactation consult or can I seek their services on my own?
If I receive services and pay for them, what information is needed on the receipt, so that I may apply for reimbursement.