Does Insurance Cover Breastfeeding Services?

Insurance Coverage Of Lactation Services
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Insurance coverage of breastfeeding practitioners and services depends on your insurance company, your individual health plan, the kind of breastfeeding service you need, and the type of specialist you want to see. You should contact your health insurance company directly, talk to the benefits coordinator where you or partner work, and ask your doctor or breastfeeding specialist about covered services. Some health professionals have staff members in their office who will call your insurance company to get a preauthorization of services for you.

Health Insurance and the Types of Breastfeeding Practitioners

Your OB/GYN: Your health insurance should cover visits to your obstetrician/gynecologist (OB/GYN) for breast-related issues. Common breastfeeding problems such as plugged milk ducts, sore nipples, thrush, and mastitis may require medical treatment and should be covered by your insurance plan.

Your Baby's Doctor: Most insurance plans cover well-child health visits. At these appointments, your child's pediatrician examines your child, checks his weight, and makes sure that your baby is healthy, growing, and getting enough breast milk. If your baby is not breastfeeding well, losing weight, or having any other health problems, your insurance company should cover those medical issues, as well.

Lactation Consultants In The Hospital: If your insurance covers your delivery and your hospital stay, it should include any lactation services that you receive while you're in the hospital for the birth of your child.

Lactation Consultants In A Doctor's Office: If there's a lactation consultant that works with your doctor or your baby's doctor, those services may be covered by your insurance.

Lactation Consultants In Private Practice: Some insurances cover private lactation consultants, and others do not. Some lactation consultants accept insurance, and others do not. Your insurance is more likely to pay for a visit with a lactation consultant who is also a physician, nurse-midwife, or nurse practitioner. When you are choosing a lactation professional, check with your insurance company and the individual lactation consultant to find out what you need to know about fees and the payment process.

Other Types Of Breastfeeding Services

The WIC Program: In the US, The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a government program that provides breastfeeding information and supplies such as breast pumps and breast shells to women who qualify.

Visiting Nurses: Some hospitals send nurses to visit a mother and her child at home in the first few days after they leave the hospital. Visiting nurse services and insurance reimbursement are typically arranged by the hospital or the visiting nurse agency.

Doulas and Baby Nurses: Postpartum Doulas or Baby Nurses can be hired and paid a fee for their services. Some health insurance companies may cover these services. You should contact your individual insurance company for specific coverage information.

Free Breastfeeding Services

You can also find free breastfeeding assistance, support, and guidance from groups of other women all over the world. Organizations such as La Leche League International, The Association Of Breastfeeding Mothers, Breastfeeding USA, Nursing Mothers Counsel, and Australia Breastfeeding Association conduct in-person group gatherings or provide telephone and email breastfeeding support.

However, if you have a medical issue, you need to see a medical professional. These breastfeeding support associations cannot provide medical care and treatment. 

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Article Sources
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  • American Academy of Pediatrics. New Mother’s Guide To Breastfeeding. Bantam Books. New York. 2011.
  • Lawrence, Ruth A., MD, Lawrence, Robert M., MD. Breastfeeding A Guide For The Medical Profession Seventh Edition.  Mosby. 2011.
  • Riordan, J., and Wambach, K. Breastfeeding and Human Lactation Fourth Edition. Jones and Bartlett Learning. 2014.