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Insurance

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What does my insurance cover?

At Just Natural we feel very strongly that Lactation Services should be covered by insurance just like any other health care service. Breastfeeding is at the very core of preventative care. The Affordable Health Care Act (AHCA) states Lactation Services will be covered by insurance as a preventive benefit not subject to co-pay or any out of pocket costs.  However, many insurance companies do not allow the IBCLC provider type in-network and some insurance companies do.  Some insurance companies grandfathered in before the AHCA was passed and do not have to provide Lactation Services. Most PPO plans cover Lactation Services but not as a preventative benefit making your coverage subject to deducible, co-pays and out of pocket maximums.  Despite all of these obstacles, in some cases, we can help you get your Lactation Services covered with minimal or no out of pocket costs. 

Insurance Companies we are In-Network with

   Aetna PPO, POS

   Meritain

   Multiplan

   Prime Health Care EPO

   TriCare West

   Blue Shield PPO, non-network provider

   Anthem PPO, non-network provider

   Cigna PPO, non-network provider

  

If we are not in network with your insurance company, we have several ways we can help you get covered! 

  

 1. Health Care spending account.  You can use you HSA/FSA card or we can provide you with a receipt you can               submit for reimbursement.

 2. PPO Plans: we can give you a super bill to submit to your insurance company and in some cases   

     we can directly bill the insurance for you after first determining coverage.  We recommend a free 

     telephone consultation to discuss & determine your benefits and any out of pocket costs you may incur. Use coupon         code FREEINFO when scheduling.

 3. HMO Plans: we can check your benefits for Lactation Services and in some cases are able to

     obtain a gap exception to cover our services.

 4. IEHP, Medical: If your OB or Pediatrician will allow the Lactation Consultant to see you in their office, we will be 

     able to bill the insurance "incident to" your doctor.  If this is an option you would like to discuss, 

     please schedule free telephone advice visit.  Use coupon Code FREEINFO when scheduling.

  

 

* You also can check with your insurance company to inquire about your coverage. In some cases, the insurance company can give you a referral to an IBCLC in our network that they will cover. If they do say the benefit is covered and refer you to an out of network provider, get a reference number for the call so your Lactation Consultant can use it when billing.  If they refer you to a free clinic, your insurance company is not providing you with the service allowed per the law.  

  

 

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