Affordable Care Act Expands Benefits for Breastfeeding Families

Q: I have heard that insurance companies are now required to provide more benefits for breastfeeding mothers. What does this include?

A: Many studies have proven that breastfeeding an infant is a significant intervention in disease prevention, which has been a big topic in the medical community.  The Affordable Care Act (ACA) recently expanded its benefits for breastfeeding families by requiring health plans to cover breastfeeding support services, such as lactation consultant visits, and breastfeeding supplies, which include the buying or renting of breast pumps. Breastfeeding advocates say these changes will likely be a great positive for breastfeeding moms and babies, since it helps eliminate the cost hurdle for getting help with nursing.

Many health plans began implementing this coverage on or after Aug. 1, 2012. Because changes to coverage vary among insurance plans, contact your insurance company prior to the birth of your baby to understand the coverage benefits available to you.

Some questions you should ask your insurance company include:

What kind of breast pump can I get?

  • When and where can I get a breast pump?

  • Can I submit a reimbursement claim for a breast pump I have already purchased?

  • Do I have to get a breast pump or lactation visit approved first?

  • Where can I receive lactation counseling services?

  • Is there a limit to the number of lactation consultant visits I may have?

By Jill Nettekoven, RN, lactation consultant, Theda Clark Birth Center and Appleton Medical Center Birth Center.