Most insurance companies have not contracted with IBCLCs, do not have a list of out of network providers, or provide them with a list of non-existent providers or ones that do not have lactation experience. This leaves the mother thinking she has no recourse. Your best recourse is to hire an experience IBCLC to help you with any questions, concerns or challenges you have with breastfeeding. In other words, get help with breastfeeding and sooner, rather than later. Pay for this service out of pocket. When things settle down, request reimbursement from your insurance company. If you have problems getting reimbursed, you do have recourse as your insurance company is breaking the law.
Your first step is to refer them to the Department of Labor’s FAQ site for the ACA, submit an appeal, and submit a complaint to your state Department of Insurance.
Then contact the National Women’s Law Center CoverHerline to report the violation. The National Women’s Law Center also has a Toolkit with Phone Scripts and a ready made Appeal Letter.
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