Insurance and Fees
You're in great hands!
We make sure all our families feel welcome, safe, and taken care of. Please contact us with your questions, but if you are ready to book an appointment, it's simple and best to do it yourself.
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 full visit in the first three 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.
Susan is an in-network provider 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. (please reach out to us for more info) **If you have Meritain, a subsidiary of Aetna, do not assume coverage. Please call your insurance company to confirm.
ConnectiCare families usually get 1 visit within the first three months post-partum but you need to call to confirm your plan's breastfeeding benefits. 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.
Any home visits with Lactation Network coverage will incur a separate $90 travel fee.
Travel Fees: Travel fees cannot be charged to insurance and must be paid at the time of service. All costs are to cover the extra travel time as measured from our office location:
0-25 miles is included - $0
25-35 miles will be charged $40
35-55 miles will be charged $75
55+ miles will be charged $150
Any home visits through Lactation Network will incur a non-covered $90 travel fee which will be invoiced & paid separately to day of the consult.
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!
To see what fees are, go through the process of scheduling an appointment (either in-office or telehealth), choose "self pay" and the fees will be listed next to each appointment type. You can easily browse appointment types without committing to anything.
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.