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Insurance & Fees

We are happy to report that many of our families get their visits covered. In addition to being in-network with Aetna, we work with two lactation billing companies- The Lactation Network and Wildflower Health- so we are able to cover most United and Cigna plans. For Anthem or other non-covered plans, we have options for you too. See More 

We are in-network providers with Aetna, but every plan is different. It is your responsibility to call before our appointment to confirm coverage with our practice. You might find us under our legal name Central CT Lactation Services, LLC or by our individual provider names. 

 

*Home Visit Concierge Fees Apply

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SEE MORE ON AETNA 

Newborn Baby
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Newborn Baby
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cigna healthcare lactation consulting

Virtually all Cigna plans will be covered by Wildflower Health. To check eligibility, fill out this form.​

If you have United Health Care,  The Lactation Network (TLN), a lactation billing company, will check your plan, and if eligible, TLN will cover your in-office visits at 100%. To determine coverage, please fill out the form at the link below.

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*Home Visit Concierge Fees Apply​

Mother Holding Baby Finger
Lactation Network Logo
Baby's Grasp

No Coverage?

Unfortunately, some insurance plans, such as Anthem, are not eligible for coverage. However, you may be able to petition for pre-authorization for our consults. If not, you can always use your HSA, FSA, cash or check to pay and we will provide you with an official receipt, called a “superbill” that you can submit to your insurance company.

Click here if you have Anthem for steps on how to petition your insurance company if your plan isn’t covered by The Lactation Network, Wildflower Healthcare or Aetna insurance.

No Cover/Self Pay

Click here for self-pay rates.

 

Discount for Husky & Tricare clients, in-office only. Please contact us directly before booking consult.

Mother Holding Baby Finger

Visit Rates

Newborn Baby

Home Visit & Travel Fees

We are always pleased to do your consult in the comfort of your home. Extra fees may apply.

 

Home Concierge Fee:  $90

If your consult is covered by Aetna, Cigna/Wildflower Health or The Lactation Network, and your prefer a home visit, there will be an out-of-pocket additional $90 fee for the convenience of doing the visit in your home. 

 

* Self-pay clients: This $90 fee does not apply to self-pay clients because this fee is already built into their at-home visit cost.

 

Travel Fees: 

Please be aware that home visits may incur an additional fee if you are over 25 miles away and/or it takes longer than 30 minutes to drive to your home. When we do home visits, it’s time out of the office, so if you prefer to not have the extra cost, please feel free to come to us.

  • Less than 25 miles away and under 30 mins: $0

  • Greater than 25 miles or longer than 30 mins: $55

  • 25-35 miles or 35 minutes: $55 

  • 35-45 miles or 45 minutes: $85 

  • 45-55 miles or 60 minutes: $125

  • Over 55 miles: $200, but availability is limited

Anthem Insurance & Pre-authorization Instruction for Self-Pay Clients

 

Unfortunately, Anthem will not allow IBCLCs to be in-network providers. However, you may be able to petition for reimbursement. If you have a Care Coordinator at your work (many CT state employees do), then reach out to them for assistance. The Affordable Care Act says that you are entitled to lactation coverage, but unfortunately, it’s never that easy. Your insurance company may provide you with a name of a physician who also an IBCLC, but they do not do private lactation consults, or a local pediatric practice may have a lactation counselor or consultant (very different credentials) but if you are not at that practice, they will not see you. 

 

Here are some things to try:

 

  1. You can try to get a pre-authorization for our consults, but you must do this beforehand. Request an “in-for-out” which means that even though we are out-of-network we can be considered as if we were in-network providers. 

  2. Request that this be expedited. Write everything down -- who you spoke with, the date, the case number and the very important authorization number. Ask that you be sent the confirmation in writing.

  3. Ask for unlimited visits but if they need a number, request 8 visits.

  4. Make sure they understand we are not medical doctors.

  5. You will be required to pay up-front for our services and we will provide you with an official receipt called a “super bill” to submit for reimbursement.

  6. Get directions for how to apply for reimbursement. We will not bill your insurance directly on your behalf even if you get approval because they never end up paying us directly. Checks are always sent to you, the subscriber.

  7. The typical procedure codes we use are s9443 or 99404 so find out which is acceptable.  The diagnosis code used is z39.1 (Maternal Lactation Care).

  8. Our tax ID/EIN #87-0890714 associated with our legal name: Central CT Lactation Services, LLC

  9. Our Group NPI #1891361127

  10. Our individual NPI numbers: Susan Forrester #1710201942, Lauren Akers #1740820521 and Brittany White #1477314375.

 

If you need any other information, please reach out to us.

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