Insurance and Fees
You're in great hands!
We make sure all our families feel welcome, safe, and taken care of. For all questions related to insurance and fees, please read the following information first because it should answer all your questions so that you can get moving with scheduling your initial appointment.
Do you accept insurance?
If you have Cigna, Anthem & United Health Care you may be eligible for full coverage for multiple visits. To explore this option, you will need to fill out a simple form through the Lactation Network which will do the billing on behalf of Forrester Lactation. No need for the frustrating call to your insurance company! The Lactation Network will run your coverage, and if eligible, you'll have 6 covered visits. If you are not eligible, payment in full is due at the time of the visit. See more information below.
If you have Aetna, you are likely covered. See information below.
ConnectiCare will cover one home visit in the first two months of baby's life. See information below.
Please keep in mind that even if you have to pay out of pocket for lactation support, it is well worth it. Good lactation help can ultimately save you money, help you achieve your breastfeeding goals and keep you and your baby healthy and happy.
We are an in-network practice with Aetna. Aetna families typically get 6 visits but it remains your responsibility to confirm your specific coverage prior to initiating service with us. Please be aware that despite what Aetna tells you, telehealth visits may entail a co-pay. Home visits will incur an extra cost. (See below)
**If you have Meritain, a subsidiary of Aetna, do not assume coverage. Please call your insurance company to confirm.
ConnectiCare families usually get 1 home visit within the first two months postpartum but you are require to call to confirm your plan's breastfeeding benefits and inquire if there is a cap on how much they will reimburse you. You will be responsible for the consultation fees at the time of service but will be provided the necessary forms to submit for reimbursement.
If you have Cigna, Anthem or United Health Care, you may be able get insurance coverage for our consults. Keep reading.
The first thing you should do is apply to the Lactation Network because you might be eligible for full coverage. But if you aren't eligible through them you can try to petition your insurance carrier (see below):
Forrester Lactation has partnered with the Lactation Network to provide families with lactation coverage both prenatally and postpartum. If eligible, the Lactation Network will cover the cost of of 6 lactation consults. They handle the paperwork and bill your insurance directly. To find out if you are eligible for coverage, click here.
Home visits with Lactation Network or Aetna coverage will incur a separate $65 concierge home fee. This is paid out-of-pocket and not reimbursable by either Lactation Network or Aetna.
Travel Fees: Beyond 25 miles from the office (270 Farmington Ave, Farmington on Google Maps), a fee will be charged to account for the extra travel time and gas:
25-35 miles will be charged $50
35-45 miles will be charged $85
45-55+ miles will be charged $135
Over 55 miles will be charged $200
Pre-authorization: If you are not eligible for insurance coverage or coverage through the Lactation Network, you can try to get a pre-authorization for a consult beforehand by requesting a "gap exception" or an "in for out". If your insurance carrier has no in-network lactation consultant (IBCLC), they are supposed to cover an out-of- network provider. Request that this be expedited, write everything down -- who you spoke with, case number and the authorization number. If denied, I encourage you to file a complaint with the State Commissioner of Insurance. Make some noise!
For more information about what the Affordable Care Act says you are entitled to, please take a look at this Insurance Toolkit. If your request is denied you can also file a complaint with the Connecticut Insurance Department. Fight the good fight!
In-office initial consult: $225
In-office follow-up consult: $100
In-office twins: $275
In-office twins follow-up: $150
In-office prenatal: $150
Home initial consult: $330
Home follow-up consult: $220
Home twins initial: $375
Home twins follow-up: $270
Home prenatal: $250
TriCare, Husky and Medicaid Plans will not reimburse for lactation services unfortunately. If you need breastfeeding help, but have financial constraints, please contact me directly to discuss your situation. There are some breastfeeding practices in the Greater Hartford area that can bill these plans or I would be happy to work out a payment plan so that you can work directly with me.