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Insurance and Fees

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We make sure all our families feel welcome, safe, and taken care of. 

 

We provide all services- before baby arrives & after- in office, in home or via tele-health and most families don't have to pay out of pocket for our services. 

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Insurance

Insurance Coverage

We are an in network provider with Aetna. It is your responsibility to make sure we are an approved provider with your specific Aetna plan as some plans have coverage and service restrictions. Please ensure that your baby is also covered by your plan. If your baby is not covered at time of service, there will be an additional $50 fee.  *Home Visit Concierge Fees Apply

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We are affiliated with The Lactation Network (TLN) which will check your plan's eligibility. If you have a PPO plan with Cigna, Anthem BlueCross Blue Shield, United Health Care or you have coverage with Multiplan or PNOA, you may get complete coverage for our services.* 

 

To determine coverage fill out this form. We will both receive an email response confirming or denying coverage for services. 

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*If the above clickable link does not open for you, please copy this link into your browser: 

https://go.lactationnetwork.com/ForresterLactation

 

*If covered by TLN, office visits will not incur any extra fee, but a home visit will incur a Home Concierge Fee

Other Insurance

Some companies such as Cigna and BCBS may provide you with reimbursement.  For BCBS state employees you need to contact your "care coordinator" who will help you through the process of getting prior authorization for "out of network as if in-network". Basically if BCBS (and Cigna) don't have any private practice IBCLCs in-network they need to cover someone as if they were in-network. Some plans have a $500 out of network deductible, though others do not, so it's important to clarify this with your care coordinator. 

You will need to pay something out of pocket and we will issue a "superbill" (official receipt) and then they should reimburse you. You may not be reimbursed in full -- for example, they may deduct $25 for an out of network co-pay. It is important to get the prior authorization in writing. Sometimes calling BCBS will get you no where so it is advised to go through your care coordinator and request multiple or unlimited visits. The CPT or procedure code they will want is "99404". 

Home Visit

Home Visit & Travel Fees

Concierge Fee:  

If your services are covered by Aetna or The Lactation Network, and your prefer a home visit, there will be an out-of-pocket additional $85 fee and possibly a travel fee - see below. This $85 fee does not apply to self-pay clients (but there may be an additional mileage fee). 

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Travel Fees:

Travel of up to 25 miles/30 minutes from the office address is included in home visit fees.

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Click to check mileage

Other

What If Services Aren't Covered? 

If none of the other options covered here apply to you OR your receive reply that you are not covered by your insurance plan please look at the following options: 

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  • Click here for steps on how to petition your insurance company for coverage

  • Click here for self-pay costs

  • Husky and TriCare families please contact us to discuss payment options if needed

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