Insurance; 
Will my insurance company cover/reimburse lactation consultation by an IBCLC 

                According to the Affordable Care Act of 2012 most health insurance companies require covering breastfeeding support, supplies and counselling that relates to the new baby(ies).  The law says, most insurance companies should cover a home visit from an IBCLC. But as with any kind of insurance reimbursement, this may not be the case for one of the many reasons.  So please call them ahead of time (we can even give you the CPT codes that we use for both in-home and clinic consults) and learn about their policies and what they will and what they will not cover. Make sure to record the time and date of the call, who did you speak to and what they told you (I usually ask them to repeat and take notes) they usually have a recorded  copy of the conversation if there is any dispute happens but being prepared with this information makes thing much easier for you if you need to "remind" them what they told you previously.


In-home Consults;


We will provide each client with an insurance reimbursement superbill. This will have all appropriate codes for submitting a request for reimbursement for services rendered or necessary lactation products, directly to insurance companies. Alas at this time we do not submit any insurance claims on your behalf after the in-home consults. You may find the article at the bottom of this page useful before you call your insurance company.  


Office visits:


After your initial* payment ($105.00 for singletons $170.00 for multiples), the rest is billed to your insurance. For the follow-up office visits, you only pay your normal co-pay to see a specialist. The rest is billed to your insurance company. 

   *If you are a registered patient with Dr Beam's Medical Home please click here for your pay scale. 


Even within the same insurance company, the policies are very varied, therefore if you want to get further information about their lactation coverage please contact your insurance company directly.


The client is responsible for paying for any consultation services or products, on the day services are rendered,
regardless of the insurance policy or likelihood of.


Here is an article from Women's law centre it may be useful to read before calling your insurance company for reimbursements.
Another one from Healthcare.gov





If you are low income or having financial difficulties please do not let this to be a barrier to getting the services you deserve.

A sliding scale consultation may be available to you, to ensure lactation help and information is accessible to all who need them.


Last updated on the 03/02/2018