Expert guidance for inducing lactation, relactation, and co-lactation now covered by insurance

I am now working with The Lactation Network (TLN) to cover many major insurance providers. Use this link to determine whether your plan is included and to get started with lactation consultations covered by insurance!

I have also been working directly with Aetna for many years. Their coverage for lactation has recently decreased significantly and there may be co-pays. If your Aetna plan is not covered by TLN, use this link to request a phone script to use when contacting Aetna regarding your coverage.

When your insurance plan covers my services, the first consultation regarding each parent/baby dyad includes a modest administrative fee to be paid upfront out-of-pocket. Subsequent consultations for a parent/baby dyad should not require any additional out-of-pocket costs.

 

Frequently Asked Questions

The only way to know for sure if your plan is covered is to check using the TLN link above. At the time of this writing, covered plans include most Blue Cross Blue Shield PPO, Anthem PPO, VA CCN, PNOA (logo on card), and Multiplan (logo on card).

United does not cover telehealth through TLN.

Some Aetna plans do not cover telehealth through TLN. However, you may have telehealth covered directly through Aetna.

Although I am always delighted to meet with St. Louis clients in-person, I work with most of my clients via telehealth using HIPAA-compliant Zoom. Some insurance providers are covered through TLN for in-person only, but most TLN providers cover both in-person and telehealth.

When meeting via telehealth, please plan to meet in a private place. A breast assessment will be part of our first consultation.

So far, the only difficulty covering non-birthing parents has been when there is no due date. The only time this may be an issue is for prospective adoptive parents not yet matched. If this is your circumstance, we can discuss your options during a free mini consultation.

The administrative fee helps me to get compensated at the same level for my clients covered by insurance as those who are self-pay. But it also benefits you, the parent. One concern holding me back from extending my coverage with insurance was that my past clients covered by insurance often had poorer outcomes than my self-pay clients. I believe this is because my self-pay clients were required to make a higher level of commitment to their lactation plan by making an upfront financial investment -- they had more skin in the game, so to speak.

The  administrative fee is $195. This covers at least six consultations per parent/baby dyad.

If parents plan to co-lactate, I can accept insurance from either parent as long as the insured parent attends the consultation. If both parents are covered, then I do request insurance information for both.

If baby is arriving via surrogacy and the gestational carrier will be providing milk for baby, I can meet with her to discuss establishing lactation and pumping, storing, and shipping milk. Although I would not charge an additional administrative fee, the GC would have to be covered under her insurance unless the intended parent choses to self-pay for her consultations.

In either case, each parent/parent/baby or intended parent/gestational carrier/baby triad will be charged a single administrative fee. 

If you are approved with TLN, they will send both you and me an email letting us know. I will follow up by sending you a scheduling link.

Any additional questions? Feel free to email me or schedule a free mini consultation!

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