Self-Pay
If the lactating person is covered by BCBS of Massachusetts, Mass General Brigham, Harvard Pilgrim, or Tufts, I am an out-of-network provider and you should book a consult as a Self-Pay client. Typically, these major plans will reimburse you 100% for an unlimited number of consults, see Reimbursement Information, below, for details. If you are covered by Aetna, United, or Cigna, I am likely in-network with your plan, please follow the appropriate link for details.
If you are covered by ANY other insurance plan not listed above, you should also book as a Self-Pay client; reimbursement rates vary.
-
Typically, the 4 major Massachusetts insurance companies (BCBS of Massachusetts, Mass General Brigham, or Harvard Pilgrim, or Tufts) will reimburse families 100%. You self-pay for the consult and then request reimbursement using a superbill. As a complimentary service for my clients with one of these 4 companies, I will file your reimbursement request to your insurance payer on your behalf.
Lactation care is mandated to be covered under most insurance plans per the Affordable Care Act but the companies vary in terms of how they approach the mandate. I encourage you to call your insurance company and ask about their policy and process regarding reimbursement (not coverage) of lactation support for an out-of-network provider; this is especially recommended if you have a plan that’s not listed above. I cannot guarantee reimbursement.
I also accept HSA/FSA cards; contact your HSA/FSA company directly to verify coverage.
-
MassHealth plans are usually NOT eligible for reimbursement. Discounted services available for families participating in WIC or covered by Medicaid/MassHealth (please contact me directly to use this service).