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Is Your Lactation Consultant and Other Breastfeeding Support Covered by Insurance?

Is Your Lactation Consultant and Other Breastfeeding Support Covered by Insurance?

Aug 22, 2019

There are two types of moms: The nursery is primped and ready, your hospital bag is packed, and you’ve got your lash extensions done so you look slightly put together in your birthing photos.

Orrrr maybe you have a crib that needs to be assembled, you have yet to pack a hospital bag, you could care less about your lashes, and every day you (semi-firmly) whisper and point to your belly, “Ready whenever you are, Sparky.”

If you’re either mom (or a delightful blend of the two), we SO get it. Either way, the baby is on the way and you’ve got so many things buzzing through your mind.

Lactation consultant insurance coverage FAQs

We know a lot of you wonder — is a lactation consultant and lactation support covered by my health insurance? — which is exactly what this post is about. Let’s get into it...

But First...A Little Breastfeeding History

Back in 2010, the ACA (or the Affordable Care Act) passed two laws that applied to breastfeeding mothers. The first was in relation to work. Employers were now expected to provide a break and a private area for women to pump during work hours. The second law was that insurers were now required to cover breastfeeding support services and any breastfeeding equipment. With the rise of working mothers and more conversation around the fifth trimester, these were two much-needed laws that needed to be passed. However, having a space to pump and breastfeeding supply coverage are only two pieces of the lactation spectrum.

So, when it comes to health insurance coverage for lactation support services, what exactly do we get coverage for?

What Kind of Lactation and Breastfeeding Support does Health Insurance Cover?

  • Prenatal breastfeeding support and counseling provided by a professional
  • Postnatal breastfeeding support and counseling provided by a professional (this support is covered during the entirety of the breastfeeding period)
  • Breastfeeding equipment (ie. a breast pump) that is either rented or purchased

 

As with most things, these overarching categories come with a sprinkling of caveats. So, here’s what you should know.

Talk To Your Insurance About Lactation Support

The coverage you receive for lactation support — both prenatal and postnatal — heavily depend on your insurance company, the specific plan you have through them, and the type of lactation support service you need. You can Google questions until your fingers turn blue, but the best way to learn about your lactation support coverage is by directly talking to your insurance about your benefits. Websites and articles may have information that is no longer up to date or applicable, so speaking with someone who can give you a straight answer is the best way to get information about what services will be covered through your insurance plan along with how much coverage you’ll be receiving.

Mom tips: Lactation Consultant

Ask Your Insurance Provider about these Lactation Tools

  • Lactation Consultants: If you are delivering at a hospital and your insurance is covering your hospital stay, you may be covered for a lactation consultant during your stay. Coverage for lactation consultants working in conjunction with your doctor, your baby’s doctor, or a private practice varies depending on your insurance company. Some insurance companies may be more likely to cover the fees of a lactation consultant who is also a nurse practitioner, physician, or midwife, so be sure to clarify any details. You may be required to copay if you are requesting lactation consultant services at home or in a doctor’s office. Coverage may also vary depending on if your healthcare provider and/or lactation consultant is within your network of providers.  
  • Breast Pump Coverage: Your specific insurance plan may have rules about the type of breast pump it covers (manual or electric), how long they will cover the duration of the rental period, and when you will receive the pump (prenatal or postnatal).
  • Doctor Authorization: Some health insurance companies will provide varying amounts of coverage depending on the authorization and recommendation of your healthcare provider. Speak with your doctor about your options and what type of support services they have available to you.

Insurance and breastfeeding

The "Milky" Bottom Line

Lactation support can be covered by your health insurance, but what type of services and how much coverage you receive depends on your insurance company. Talk with your insurance about your options for coverage and speak with your healthcare provider to see what they recommend is best for you and your birth plan.

For more lactation support help, read our blog for helpful articles like our Breastfeeding Guide for New Moms or browse other free resources like La Leche League International to find lactation support groups near you.

Sources:

Have you tried Majka’s Unsweetened Nourishing Lactation Booster or Majka’s Vanilla Chai Nourishing Lactation BoosterEach one has its own unique flavor that can heighten any recipe's taste and nutritional content! Our Nourishing Lactation Boosters give new moms an all-natural source of galactagogues, antioxidants, and good fats to support you and your milk supply postpartum.

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