AETNA:
We are in network with Aetna.

On September 1, 2024, Aetna changed its longstanding policy from covering 6 lactation visits to covering 6 lactation codes. This means that, as an Aetna-covered patient, you will now only be covered for 3 lactation visits per child, not 6. Aetna’s reimbursement for a single code barely covers half the cost of a lactation appointment, which is why all lactation consultants contracted with Aetna have historically billed for 2 codes per visit.

This policy change is infuriating. We, along with dozens of lactation consultants nationwide, have sent letters to Aetna explaining how this negatively impacts access to affordable lactation support for families. Unfortunately, Aetna has refused to revert to their original policy.

Going forward:

1. Please know that Lactation Services of Southington will do everything we can to provide you with the lactation support you need and deserve.

Lactation Services of Southington New Aetna Policy (Effective 10/14/24)

• If you have had more than 3 appointments with our lactation consultants prior to 10/14/24, you will not be billed for any visits beyond the first 3. Lactation Services of Southington will absorb the cost of those additional appointments.
• For any future appointments beyond the first 3, you will need to pay our cash rate. If this rate is not within your family’s budget, please reach out to discuss your options.
• Aetna no longer covers virtual appointments, so all visits must take place either in our clinic or at your home.
• We will continue to bill Aetna for all appointments. If we happen to receive payment for any visits beyond the first 3, we will refund that amount directly to you. *If the reimbursement exceeds the amount you paid for the appointment, you will be refunded up to the amount you paid.

Prior to our appointment we ask that you call Aetna to confirm the coverage you are have for lactation care.

CONNECTICARE:
Connecticare also usually covers at least 1 visit. However, you are still responsible for the fees at the time of the visit but we are happy to submit your bill to them for you for a small fee.

ALL OTHER INSURANCES:

We now partner with The Lactation Network and visits are often covered in full for UHC, BCBS.  Click here to see if your visits can be covered in full.

We partner with Wildflower Health to cover our CIGNA clients.  Click here to check your coverage.

While the Affordable Health Care Act states that coverage for lactation care in or out of network is the law unfortunately it is not an easy task for families. Calling to confirm and check with your insurance carrier about their coverage is recommended. As well this link will take you to the National Women’s Law Center and their toolkit which has very helpful information in speaking with your insurance company.

You may also find this link helpful to learn more about breastfeeding benefits under the Affordable Care Act.

We recommend you call your insurance company to discuss your coverage and your ability to work with us for your lactation care.  If your insurance company tells you that we are not in network (which is because they don’t allow us to join their network) please request a “gap exception” or an expedited “in for out” request. Also, please ask them to expedite this request so that you can have lactation care quickly. As well this link will take you to the National Women’s Law Center and their toolkit which has very helpful information in speaking with your insurance company.

You may also find this link helpful to learn more about breastfeeding benefits under the Affordable Care Act.