Paying for lactation care, or the story of my 289$ plumber visit.
Our shower was on the fritz. After 20 years, I guess it was due to crash and leak.
I paid my plumber $289 dollars for a tiny part and a half hours' work. And I was happy to do so. Well, my wallet wasn’t, but you get my drift. I looooove my shower, and I knew I had to pay someone professional to fix it. My fee covered his overhead, his parts, gas, and employees. His education, and his experience. I didn’t necessarily plan for a shower problem, but we all know that these problems don’t pop up at convenient moments, like winning-scratch-off-lottery-ticket times. They happen just…because. It IS better if you can at least plan for stuff, but we all know that is hard to do.
What does this have to do with IBCLC care? We all wish the insurance companies would comply with the Government ACA mandates, but the reality is, they aren’t making it easy. We want to help, but working for free isn’t feasible. For you, for me, for anyone.
About that plumber’s fee? Here’s a sample of what your IBCLC’s overhead looks like. Our professional education is expensive. Keeping current in lactation care is required by our certification, to the tune of many hundreds of dollars every year. We recertify every 5 years and by exam every 10 years. We don’t carry shower parts, but we have lots of other kinds of tubing! Nipple shields, syringes and hydrogel pads, advertising, written materials, insurance, gas and wear and tear on our vehicles… you get the picture.
Food=costs, for all of us. It’s life. Formula prices are outrageously high (I smell another blog post about THAT subject). And no kidding; it is a billion-dollar profit industry. You are your baby’s own grocery store and pharmacy all wrapped up into an awesome momma package! Although breastmilk is “free”, sometimes there are maintenance costs for the system that creates this awesome perfect food, food with baby-specific-super-vaccinations right in the mix! One lactation consult, or even a few, doesn’t nearly approach formula expenses, which can be thousands of dollars. Add a few extra trips to the Pediatrician for reducible health care issues for a non-breastfed infant; parents taking more time off work to get to the doctor, and whew, it’s looking like the cost outweighs the risk of NOT paying for help.
Insurance companies know what they need to do. The ACA mandates breastfeeding supplies and care to be covered. Do they WANT to? Despite the clear and overwhelming research telling them it makes sense to pay for the minimal cost of healthier moms and babies? Aetna has covered IBCLCs since 2012, recognizing we are the Gold Standard in lactation care. It’s kinda-sorta BS to me that other companies won’t do the same. So….What to do before, and when you need help?
* Health Savings Account plans cover lactation care. And lots of us have card readers to help make the payment easier.
* Baby shower gifts. Register for me! Factor in the LC care as something as needed as say, the crib, or the Boppy. Or the baby photographer. Tell your mom, grandmother, work peeps and college sisters to chip in. It's not as fun as a cutesy diaper cake (hey, I just saw one on Pinterest shaped like a motorcycle!) but it can get the “baby food” taken care of! PS; I'll even send a gift certificate in an adorable basket with some goodies to open at the shower.
* Save little bits throughout the pregnancy. If you don't need it, get a mani-pedi/massage. Pay a sitter for a night out. Or start that college savings account.
* Get a prenatal planning visit. Most insurers will cover this as a class fee. In my practice, we focus on preventing problems by learning about infant behavior and needs after birth, identifying barriers before problems occur. Hey, you might not need me at all after baby comes! I best be careful or I'll practice myself right out of practice.
* Pay a bit at a time over the pregnancy. Yes, we can work out a plan.
* After a visit, submit the superbill to your insurance company and take names, numbers and dates. Keep at it, get what you've paid for. The National Women's Center in Washington, DC is keeping track of these issues, as well as law firms considering class action suits for violation of the ACA. Every state has an insurance commissioner’s office to hear complaints. Don’t let them get away with shoddy practice over this important care.
Support IBCLC licensure in your state. Rhode Island and Georgia have gotten there, and it will help with insurance reimbursement.