The 2012 Affordable Care Act requires Insurance plans to provide trained lactation support at no cost to the member. (Exceptions include self funded and grandfathered plans)
Many insurance companies cover the costs of lactation visits. (If you ask me, ALL should!) I use The Lactation Network (TLN) to cover your visits with me! They act as the primary provider for Cigna, Blue Cross Blue Shield, Anthem PPO, and other insurance plans. Check your coverage HERE. If your insurance does not cover visits, my self-pay rate is: $165 initial office visit$135 follow up office visits $195 initial home visit $145 follow up home visit
IF your Insurance Company is not in network with The Lactation Network (TLN), that's okay, I'll provide you with an itemized receipt that can be submitted for reimbursement. Most insurance companies do have a process for granting this access on a case by case basis called a Waiver or GAP coverage IF they don't have a listed IBCLC within their network (& many don't!) Steps for Filing for GAP Coverage or a Waiver can be found HERE
The Lactation Network/Ashland Health (TLN)
I am a sub-contracted IBCLC through The Lactation Network/Ashland Health. (TLN) TLN acts as the primary provider for many Cigna, Blue Cross Blue Shield and Anthem PPO insurance plans.
You can submit an inquiry for coverage HERE. Approved inquiries will receive an email with a request to sign an Assignment of Benefits (AOB) form which allows them to bill your insurance company. IF not signed prior to our appointment, payments due will be your responsibility and due at time of service. If approved, your email will indicate the number of approved appointments (usually 6 though we can request more if needed) and there will be no out of pocket costs for the pre-approved visits regardless of what your insurance company does/ does not pay. If additional visits are not approved, TLN will bill you directly. (historically the maximum cost has been capped at $175 but is subject to TLN policy changes)
Tricare East / Humana Healthcare
I am an approved NON network provider for Tricare East/ Humana Healthcare.
You can submit a referral request via Tricare for an appointment with me. You may be asked to provide my name and NPI number (Heather Martin/1952649311)
Approved inquiries will receive an email or phone call prior to your ability to schedule directly. This may take 24- 72 hrs at a minimum.
For appointments, payments will need to be paid at time of service or prior. I will provide a Superbill for reimbursement purposes at the end of our appointment in addition to copies of your Care Plan.