Insurance Coverage for Breastfeeding Support and Equipment
With the passage of the healthcare law (Affordable Care Act) came the requirement for new insurance policies to provide breastfeeding support, supplies and counseling without cost sharing, meaning there should be no co-pays or charges, "for the duration of breastfeeding." Insurance companies are meeting this legal obligation in a variety of ways, so it is best to check with your individual insurance company for the most current information.
Where do I start?
Here are two links that provide important information that will help you access care in Oklahoma:
SoonerCare coverage for IBCLC care
Breastfeeding Benefits Coverage in the Affordable Care Act Toolkit from National Women’s Law Center (pdf,11 pages) includes:
Where do I start?
- Call your healthcare insurance company to make sure lactation services are covered. Insurance plans that were in place before 2010 may be grandfathered in and deny services.
- Contact your healthcare insurance company member services (number is usually on the back of your insurance card), or if your insurance is through your employer, your benefits administrator may have information on accessing lactation services. You will want to ask about:
- Lactation consults - location? in-network services? provider referral needed? is there a limit on the number of visits?
- Breast pumps - when can you obtain one, before or after baby's birth? where do you obtain a pump, many require you to work through an approved durable medical equipment company, do you need a prescription or referral from your provider to obtain a breast pump?
- When you talk with your insurance company representative be sure to write down the date and time of the call as well as the name of the person that you talked with. If possible, ask them to send you a confirmation of the conversation including the information that they provided on your coverage. For scripts and more information on contacting your insurance provider, check the Toolkit link below.
Here are two links that provide important information that will help you access care in Oklahoma:
SoonerCare coverage for IBCLC care
Breastfeeding Benefits Coverage in the Affordable Care Act Toolkit from National Women’s Law Center (pdf,11 pages) includes:
- An explanation of the law
- Sample scripts & letters for contacting insurers about coverage of breastfeeding equipment (including pumps) and lactation care
- Q & A section
This page last updated 5/28/20 by CC
