Under the Affordable Care Act of 2012. one of the biggest victories for breastfeeding individuals was the coverage provided to them. The ACA covers breastfeeding education, counseling and equipment at no cost to beneficiaries. However, as anyone who has spent hours on the phone with their insurance company knows, sometimes receiving those benefits is easier said than done.
Insurance Coverage For Lactation Support
Currently, Carolina Birth and Wellness and our two International Board Certified Lactation Consultants (IBCLCs) are not in network with any insurance companies. However, that just means we cannot directly bill the insurance company for you. We can provide the information you need to receive reimbursement.
We can provide a Superbill for you to provide to your insurance company for reimbursement of our services. While we cannot guarantee full reimbursement, that is strictly dictated by your individual plan and insurance company as a whole, we can provide the information needed to hopefully have you receive full reimbursement. We are also happy to add to the Superbill if at first coverage is denied.
How To Tell If Insurance Covers Breastfeeding Support
As if you need another thing to do when you are preparing for a new baby, or when you baby is newly born, we do recommend that you contact your individual insurance company prior to your lactation appointment to see any rules they may have with lactation support and submitting the Superbill for reimbursement. You can tell them that our IBCLCs provide the following on each Superbill:
CBW’s EIN (employer identification number for tax reasons)
The IBCLCs NPI (National Provider Identity number, this will be specific to the IBCLC that you see)
The license number of the IBCLC
Applicable codes related to the information covered in your lactation appointment in regards to both your and your baby, as well as codes related to any equipment used
Once you have the information from you insurance company, please pass that on to your IBCLC during their in-home consultation so they can provide a Superbill specific to your needs.
More Insurance Coverage for Lactation Support
The Superbill is a great benefit for many families, however, only you (the consumer, the voter, the parent, the breastfeeding person, the breastfeeding advocate, etc) can facilitate real change. We encourage everyone to call their elected officials and demand more insurance coverage for breastfeeding support and counseling.
