Most insurance plans do not require pre-authorization or referrals for Lactation Services because lactation care is considered preventive primary care. Melissa is a part of Lactation Consultants of America and is an in-network provider with a wide range of commercial insurance plans to make quality lactation care affordable for more families.
Unless noted below, few plans require pre-authorization or referrals as Lactation is
Preventative Primary Care. Some plans may include cost sharing and there may be a non-medical travel fee for home visits separate from insurance costs.
Check to see if you have an eligible insurance plan from the list below.
If you are not sure if your plan is listed or marked as “check plan”, please email Patient.relations@lcsofamerica.com to inquire about coverage.
If your plan is listed, schedule your appointment now! Choose the “insurance covered appointment” option. If your plan is not covered, choose the “self pay” option.
After you book your appointment for an insurance covered appointment, you will receive an email from Lactation Consultants of American with intake forms.
This must be completed prior to being seen. Your appointment is not confirmed until the forms are completed. Your insurance will be verified within 24 hours of receiving the completed forms.*
*The benefits team is not able to confirm network status until forms are submitted.
Eligibility is checked Monday - Friday between 8am-4pm PST except on business holidays.
For plans that require benefits checked, please email Patient.relations@lcsofamerica.com and allow 24 business hours for a response from LCA.
Eligibility is checked Monday - Friday between 8am-4pm PST except on business holidays.
It is your responsibility to understand your insurance benefits. Insurance representatives often give enrollees incorrect information regarding lactation coverage and requirements. Even if it isn’t fully covered, part of your visit may be.
Call your plan and ask about coverage for:
Procedure code: S9443
Diagnosis code: Z39.1 (“care of lactating parent”)
Some plans include cost sharing; the best way to find out is to call your insurance company and also check with our patient’s relations team by emailing Patient.relations@lcsofamerica.com or calling (323) 870-1150 Monday-Friday from 7:30am-4pm PST.
If your insurance is not in network, you will be responsible for paying for your appointment in cash.
If your insurance plan is not in network, you will be required to pay in full at the time of booking. Choose the self pay appointment option when booking.
We do NOT accept Medicare plans currently and only accept Medicaid plans in CA at this time.
• PPO
• Point of service (POS)
• Open Access Plus (OAP)
• Select (local plans only) - check all plans
• Subsidiaries - check all plans
• HMO - not covered at this time
• PPO
• EPO
• HMO - only plans based in Oregon, other HMO plans not covered at this time
• Federal BCBS (Basic, Standard, & PPO)
*Plans that we can not work with:
• Blue Shield of CA Bronze, Silver, and Gold plans (will say the metal tier on the card)
• HMO (outside of Regence HMO)
• Regence Legacy
• All plans
• PPO
• POS
• OAP
• EPO - not covered at this time
• HMO - requires referral
• Allegiance Cigna - NO TELEHEALTH. Baby appointments will be charged $150. Lactating parent is covered without cost sharing.
• PPO
• Ambetter PPO
• Ambetter HMO
• HMO Fee-for-Service (No Assigned Medical Group)
• Other HMOs - not covered at this time, LOA possible for some plans email patient.relations@lcsofamerica.com
• Medi-Cal - not covered at this time
• All plans based in AZ
• PPO
• EPO
• HMO
• OHSU EPO/CCN, Legacy and MODA Select Plans - not covered at this time
• PPO
• EPO
• HMO
• Legacy
• PPO
• EPO
• HMO - Check all HMO’s
• Choice Plus
• Individual Exchange Plans - only in AZ
• Doctor’s Plan, Navigator, Core, Nexus - check all plans
• SignatureValue HMO, Oxford Metro, Heritage, and Neighborhood Health Plan, Community
• Health Plan - not covered at this time
