Lactation support is not a luxury;
it’s a medical need.
MoCo Lactation is proud to offer in-network and out-of-network care to our patients.
If you are a Cigna patient, please check your eligibility for coverage here.
If you are a patient with Blue Cross PPO, Blue Shield PPO, United Healthcare, Anthem PPO, or Multiplan/PNOA plans, please check your eligibility here.
Most insurance companies will cover up to 6 lactation consults with $0 out-of-pocket costs.
If you are denied coverage by your insurance, please contact us and read below for tips on gaining insurance coverage for lactation services.
Tips for Insurance Coverage
If MoCo Lactation is out of network for you, please read below to understand insurance exceptions that may cover our services. Please contact your insurance carrier directly, as I cannot guarantee that these exceptions will be approved.
Out of Network Exception
Unfortunately many insurance companies do not have enough (or any) lactation professionals in-network to serve their customers in a timely manner. Federal guidance makes clear that “if a plan or issuer does not have in its network a provider who can provide the particular service, then the plan or issuer must cover the item or service when performed by an out-of-network provider and not impose cost-sharing with respect to the item or service.” If you have called your insurance company and they do not have any LCs in-network, the insurance company must cover services from an out-of-network provider without cost-sharing. This means they should reimburse you. This is called an Out-of-Network Exception.
Geographic Gap Exception
What if your insurance company has a lactation consultant, but they can’t see you for days or the person they send you is a two-hour drive away? Call again and ask for a Geographic Gap Exception. This is a legitimate tool health insurance companies use to compensate for gaps in their network of contracted healthcare providers. You are entitled to ask for your insurer to cover care you get from an out-of-network provider at the in-network rate.
*Information compiled from National Women’s Law Center’s Breastfeeding Toolkit.