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Mothers, insurers navigating new benefits for breast-feeding in the Affordable Care Act

Some breast pump, lactation consultant costs are covered under the Affordable Care Act.
BY JENNIFER PALMER Modified: January 19, 2013 at 12:09 am •  Published: January 20, 2013
/articleid/3747409/1/pictures/1931128">Photo - A double-electric breast pump by Hygeia, which is now available to some insured women at no cost. PHOTO PROVIDED BY HYGEIA
A double-electric breast pump by Hygeia, which is now available to some insured women at no cost. PHOTO PROVIDED BY HYGEIA

Leah Lloyd, whose son is 8 months old, was able to receive a free breast pump through UnitedHealthcare with little hassle. She said she hit a few roadblocks with two medical suppliers but found one — Apria Healthcare — that accepted her insurance with a prescription from her doctor. She was able to pick up her new double-electric breast pump in Oklahoma City the next day.

“It was a lot easier than I thought it was going to be,” Lloyd said.

Breast pump maker Hygeia is offering mothers who were denied coverage of a breast pump or unable to obtain one through a medical supplier a coupon for $150 off one of its breast pumps, said Sheri Wallace, marketing director. She said the Fullerton, Calif., company's staff felt bad for all the mothers struggling to get a pump.

“I think moms have to be proactive and persistent and they have to keep going,” Wallace said. “For the most part, nobody wants to see them stop breast-feeding or lose (milk) supply because they don't have a pump.”

Hygeia posted information on its website to help mothers navigate the insurance system and locate a pump. Hygeia's products are sold through medical suppliers and available to UnitedHealthcare customers.

Other requirements

In addition to providing breast-feeding equipment, the Affordable Care Act requires insurers to provide “comprehensive lactation support and counseling by a trained provider during pregnancy and/or postpartum period.”

Blue Cross Blue Shield of Oklahoma said lactation consultants are available through in-network hospital facilities; breast-feeding support also can be provided through a registered nurse, said Hilarie Houghton, senior supervisor of public relations. The insurer will cover lactation counseling when billed by inpatient facilities or by licensed nurse practitioners.

However, when contacted by a customer, a Blue Cross Blue Shield representative said there weren't any in-network lactation consultants listed in its directory.

Aetna, on the other hand, sent letters to all board-certified lactation consultants in the country and asked them to become providers.

Mannel, lactation manager, said because insurance companies are new to covering lactation benefits, there are still wrinkles to be ironed out.

Historically, mothers have either had to pay out of pocket for these benefits or acquire them through Medicaid In Oklahoma, Medicaid doesn't provide a breast pump but WIC, the federal Women, Infants and Children nutrition program, often does.

That left middle-income mothers out of luck, Mannel said, and the benefits included in the Affordable Health Care Act help close the gap.

As moms are finding out about it (the provision), they are thrilled.”

Becky Mannel,
Lactation manager for The University of Oklahoma Health Sciences Center


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