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Subject:
From:
Kara Kaikini <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 3 Jan 2014 20:12:57 -0500
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Thank you for this helpful response, Liz! I will check out those links, and
"like" the National Breastfeeding Center FB page right now.

So, while the ACA requires/"mandates" insurance coverage for breast pumps,
lactation consults, etc. (no longer up to the insurance company to decide
whether to cover these anymore), breastfeeding classes are not considered
part of that mandate and are still considered optional based on what the
insurance company decides to cover?
I know that the law is vague which is why USBC and NBC did such a great job
writing the Model Payer Policy. Any idea of insurance companies are using
this model now?

Also, Felicia Henry, does Aetna only cover the breastfeeding classes and
support groups for contracted lactation consultants? (I ask because you
said "since I am contracted with Aetna...", otherwise I would assume this
is the same coverage for all Aetna holders.)

Thanks for all the responses so far on this topic. I will continue to
recommend expectant mothers call their insurance companies to ask if they
will cover prenatal classes, but it sure would be nice to be able to say
"your insurance company is mandated to cover these classes" (as they are
pumps and consults, unless plans are grandfathered or Medicaid at this
point).

~Kara



Date:    Fri, 3 Jan 2014 11:58:36 -0800
From:    Felicia Henry <[log in to unmask]>
Subject: Re: ACA and prenatal breastfeeding classes

It is included - since I am contracted with Aetna they pay for prenatal
education.  The ACA reads:



"Prenatal/postpartum breastfeeding classes - series up to a total of 18
class weeks, no referral or prior authorization required."  and
"Breastfeeding support groups - one monthly meeting up to a total of 12
meetings, no referral or prior authorization required."



I hope that helps!



Felicia L Henry, BCCE, IBCLC

Oxnard, CA
On Fri, Jan 3, 2014 at 6:12 AM, Elizabeth Brooks <[log in to unmask]> wrote:

> The question is asked whether group BFg classes would be covered under the
> Affordable Care Act (ACA) in the USA as part of the "comprehensive
> lactation support and counseling" that is now deemed to be an important
> part of preventive healthcare services for women.
>
> Well, ya'd think, right?  But it just depends on what kind of insurance
> the mother has (from a private insurance company? From "self-insurance"
> through her large corporate-type employer? From Medicaid?) and what
> individual features her particular policy allows.
>
> For general information about the ACA and its BFg-elements, poke around
> the United States Breastfeeding Committee (USBC) website,
> http://www.usbreastfeeding.org/, and review the Model Payer Policy
> co-authored by USBC and the National Breastfeeding Center, about services
> that *private* insurers are encouraged to cover for lactation services
> http://www.usbreastfeeding.org/NewsInfo/NewsRoom/201307ModelPayerPolicy/tabid/345/Default.aspx
>
> For specific questions about private insurance and lactation services, the
> National Breastfeeding Center's (http://www.nbfcenter.com/) Facebook page
> has an extensive series of Qs and As, and is worth reviewing:
> https://www.facebook.com/nbfcenter
>
> --
> Liz Brooks, JD, IBCLC, FILCA
> Wyndmoor, PA, USA (USBC Director 2012-14)
>
>

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