Yes! You are so right, Marsha.  It is a dream of mine that employers, and
health plans will begin negotiating at the contracts level for reimbursement
of Lactation Consultant services.  This is where the real changes in
reimbursement will take place.  If you, or anyone on Lactnet, wants to
modify my "insurance letter" for this purpose, I would be thrilled.  I also
think we'd be smart to draft a letter to hospital and clinic administrators,
describing the benefits of professional lactation support.  In this way we
can gain the support of administrators in our workplaces who may not be
familiar with what we do. When they learn how our work contributes to public
health and customer satisfaction, our programs will grow!
Martha Johnson RN IBCLC
Eugene Oregon

-----Original Message-----
From: [log in to unmask] [mailto:[log in to unmask]]
Sent: Sunday, December 23, 2001 6:49 AM
Subject: Coverage for LC Services


Martha has written a great letter to insurance carriers to help thedm
understand the need to cover lactation care and services. However, we should
also consider another letter to employers. Close to 70% of mothers in the US
received health insurance from their employer or their spouse's employer.
Employers are not required to offer health coverage at all, but do so as a
benefit of working at the company. Employers negotiate contracts with health
insurers for what they wish to offer to employees. Some insurance carriers
cover lactation services but if the employer has not chosen this as part of
the health benefits then it is NOT covered. If the employer is self insured,
they still may not offer lactation services as they perceive it as an added
benefit.

Women need to request that their employer include lactation services as a
covered benefit. We as health care professionals need to contact employers
also to help them understand the importance of offering this as a benefit.
Until employers include lactation services in their benefits package,
insurance companies remain unable to cover this service under negotiated
contracts.

Marsha Walker, RN, IBCLC
Weston, MA

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