Payment for IBCLCs (International Board

 

 

 

 

 

 

 

 

 

By reading this, you would think that lactation counseling will be covered by your insurance company, right? Unfortunately, it is not the case here in Hawai'i.

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Here is why.

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Insurance companies will say,

"We will cover any lactation counseling provided by a licensed consultant."

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Currently, an IBCLC (International Board Certified Lactation Consultant) is not a licensed provider in the States of Hawai'i.

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An IBCLC holds the highest qualification in breastfeeding support, yet, a system to offer a license to IBCLCs are not in place.

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thatI will provide you with a documentation called the superbill to start the process. Click here for more information on insurance reimbursement from National Women's Law Center.

Insurance Payment for IBCLCs (International Board Certified Lactation Consultant)

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Here is what "The Affordable Care Act (ACA) of 2010" states:

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By reading this, you would think that lactation counseling will be covered by your insurance companies, right? Unfortunately, it is not the case, here in Hawai'i.

​

Here is why.

​

Insurance companies will say,

"We will cover for any lactation counseling provided by a licensed lactation consultant."

​

An IBCLC holds the highest qualification in breastfeeding support, yet, Hawai'i does not offer licensure to IBCLCs.

 

Currently, there are only 4 states in the US that provides licensure to IBCLCs. Unfortunately, Hawaii is not one of them.

 

For the rest of the 46 states, insurance companies can get away from reimbursing for lactation counseling saying that there is no licensed lactation consultants in the state.

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You might say, "then what about the ACA of 2010?". The law clearly states that insurance companies must cover for breastfeeding counseling.  

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This is why a superbill (detailed receipt) is provided to you at the end of the visit.

You can submit this superbill to your insurance company and if they deny payment, please appeal.

The National Women's Law Center has a toolkit that includes a sample appeal letter.

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*Health plans that existed before the health care law are considered “grandfathered” into the new system, therefore, not obligated to follow the ACA. It is important to call your insurance company to find out if they are grandfathered in or not.

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Click here for easy-to-read blog article that explains how insurance reimbursement works under the Affordable Care Act.