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
Virtually all Cigna plans will be covered by Wildflower Health. To check eligibility, fill out this form.
If you have United Healthcare, please check to ensure we are in-network with your plan.
*Home Visit Concierge Fees Apply
We are able to bill for most Anthem & BCBS plans by working with Women’s Healthcare Associates. If you have an HMO whose plan begins with X6G please read the information at the bottom of this page for directions as to how to get pre-approval. You can also find the information on our FAQs page.
Unfortunately, some insurance companies will not allow us to be in-network providers. For plans not covered, 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. Please read the information below for how to request reimbursement from your insurance company.
No Coverage?
Visit Rates
Click here for self-pay rates.
Discount for Husky & Tricare clients, in-office only. Please contact us directly before booking consult.
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.
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Less than 25 miles away and under 30 mins: $0
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Greater than 25 miles or longer than 30 mins: $55
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25-35 miles or 35 minutes: $55
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35-45 miles or 45 minutes: $85
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45-55 miles or 60 minutes: $125
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Over 55 miles: $200, but availability is limited
Pre-authorization Instructions for non-covered plans or Anthem/BCBS State Blue Care Prime X6G Plans
Below is information if you have an insurance plan that we cannot bill through or you have the above-mentioned HMO plan. You will need to contact your insurance company directly and ask for either a "gap exception" or for an "in for out" (they will treat us as if we were in-network.) 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.
Anthem HMO State Blue Care Prime "X6G" Plans or Other Non-Covered Plans
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You can try to get a pre-authorization for our consults, but you must do this beforehand. Request an “in-for-out” or "gap exception" which means that even though we are out-of-network, we will be considered as if we were in-network providers.
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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.
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Ask for unlimited visits but if they need a number, request 8 visits.
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Make sure they understand we are not medical doctors.
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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.
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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.
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The typical procedure codes we use are s9443 or 99404 so find out what codes they want us to use. The diagnosis code used is Z39.1 (Maternal Lactation Care).
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Our tax ID/EIN #87-0890714 associated with our legal name: Central CT Lactation Services, LLC
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Our Group NPI #1891361127
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Our individual NPI numbers: Susan Forrester #1710201942, Lauren Akers #1740820521.
If you need any other information, please reach out to us.