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Sunday, September 22, 2013

Insurance companies may cover breast pumps, supplies and consults

Healthcare Insurers Graded on Support for Breastfeeding Moms: Anthem and Aetna Score Highly National Breastfeeding Center has released a scorecard of healthcare insurance companies based on coverage policies for breastfeeding support. Share on TwitterShare on FacebookShare on Google+Share on LinkedInEmail a friend . . Insurers are now tasked with making sure that healthcare dollars are spent more wisely and invested in long-term preventive care. To do less than their best for their littlest members is simply not good enough. New York, NY (PRWEB) September 06, 2013 Anthem and Aetna both score highly out of 100 healthcare insurance companies graded by the National Breastfeeding Center (NBfC). Research was conducted to see how the insurance industry is responding to the Patient Protection and Affordable Health Care Act (PPACA), specifically the part of the law concerning coverage of breastfeeding support, a provision which went into effect on August 1, 2012. “It has been a year since the mandate went into effect," says Susanne Madden, COO, of the National Breastfeeding Center, "so there has been plenty of time for insurers to adjust to the law. We wanted to see how insurance companies are performing when it comes to supporting nursing mothers and their babies." Madden says that the NBfC research uncovered a wide range of insurance company policies and compliance. "We were encouraged to find that some insurers really recognize the importance of improving breastfeeding and support the intent of the mandate by covering fully qualified lactation care providers and effective breastfeeding equipment. But many more provide only the bare minimum required by law, such as a manual hand-operated breastpump and advice given during a well care exam by providers that may have little lactation care experience." "We weren't surprised to see Aetna near the top of the score card," says Beverly Curtis, the Executive Director of NBfC. Aetna was quick to open its network to lactation care providers who have certification as International Board Certified Lactation Consultants (a designation awarded by an independently-accredited program). Curtis points out, "it is important that insurance companies support care delivered by independently certified professionals as these are the providers best qualified to address and improve lactation care." Madden said that the Anthem Group of companies came to the top of the list due to such provisions as covering home visits and allowing pumps to be dispensed from both providers and medical supply companies. "Companies should see our score card as a helpful tool for evaluating their breastfeeding support policies," Curtis says, "and like Aetna and Anthem, aspire to be the best in this critical area of mother and infant healthcare insurance coverage.” NBfC assessed commercial insurance companies’ published policies and guidelines and assigned a grade based on the adequacy of coverage provided. Using The Verden Group’s Policy Search tool to locate official Medical Policies and Google to search insurers’ member and public domains for guidelines and newsletters that contained information about each company’s breastfeeding coverage, “we believe we’ve conducted a comprehensive review of the information available,” says Madden. Why grade insurance companies on their breastfeeding support policies at all? "The purpose of the mandate is to improve breastfeeding initiation and duration rates," Curtis replies. "It follows that mothers should receive lactation counseling support from a provider educated in lactation care.” Madden agrees and says "It's the best way to insure that the care provided is appropriate to each mother’s concern or issue and that each has access to breast pumps that perform appropriately according to her medical or societal needs. Insurers are now tasked with making sure that happens, and that healthcare dollars are spent more wisely and invested in preventive care. To do less than their best for their littlest members is simply not good enough. We want to bring attention to that," Madden concludes, "and prompt insurers to do even better going forward." ****** National Breastfeeding Center (NBfC) The National Breastfeeding Center (NBfC) provides expertise to corporations/employers, hospitals/health systems, healthcare providers and organizations to improve breastfeeding promotion and support. Our unparalleled experience in the business of medicine, blended with our broad insurance experience and deep clinical knowledge, delivers powerful insights and innovative solutions. For more information on the NBfC, visit http://www.NBfCenter.com. Share on TwitterShare on FacebookShare on Google+Share on LinkedInEmail a friend PDF Version PDF Printer Friendly VersionPrint Contact Susanne Madden, COO National Breastfeeding Center +1 855-777-6232 1 Email .Beverly Curtis, Executive Director National Breastfeeding Center 855-777-6232 2 Email . Attachments Insurers Breastfeeding Policy Scorecard Insurers Breastfeeding Policy Scorecard Healthcare Insurers Scorecard for Breastfeeding Support Model Policy Model Policy Guidelines for Insurance Company Coverage of Breastfeeding Support and Counseling Services, Pumps and Supplies .

Sunday, September 8, 2013

Health Insurance Lactation Assistance

Many Breast-Feeding Moms Unaware Of Health Law Help By Lisa Stiffler and Seattle Times | Kaiser Health News, Published: August 27 . New moms crave information, whether it’s car-seat safety ratings, the pros and cons of pacifiers or how best to sooth a colicky infant. So it’s a little surprising that many moms aren’t up to speed on how the Affordable Care Act could benefit them. The law has specific requirements targeting moms, including coverage for breast pumps and consultants to help breast-feeding mothers. “So many moms don’t know about the benefit,” said Cary Seely, director of provider relations at Pumping Essentials, a California-based company selling supplies and services to assist in breast-feeding. While many of the changes mandated by the Affordable Care Act will benefit low-income Americans by expanding access to health insurance, the Obama administration has tried to build support among a wide swath of the public. Officials routinely tout reforms included in the new law that are designed to help the middle class. Among them are provisions that mandate insurance coverage regardless of pre-existing conditions; allow adult kids to stay on their parents’ insurance plans until they’re 26; require free preventive services such as mammograms, colonoscopies and flu shots — and institute the breast-feeding provisions. But in a recent poll, only 36 percent of Americans surveyed said the law “will make things better” for the middle class. When Whitney Courson, of Seattle, was pregnant earlier this year with her first son, a friend advised her that her insurance might pay for a breast pump, which generally costs $200 to $400 for an electric model. She forgot about the tip, even putting the pump on her baby-gift registry, hoping someone would buy it for her. Then another parent mentioned the benefit at a childbirth class. This time, Courson called a representative at Premera Blue Cross, her insurance provider through her husband’s job at Amazon.com, and learned it would cover the cost of a breast pump. She bought one and had her baby, Nicholas, in July. She loves the ability to pump and store milk so that she can bottle-feed her son when she needs to, or so that someone else can feed him in her absence. “Now I’m telling everybody I know, ‘Call your insurance, this is amazing,’ ” she said. The Affordable Care Act provision supporting breast-feeding went into effect for new health-insurance plans a year ago, but many plans didn’t incorporate the benefit until January 2013, when they were renewed. One hurdle to more widespread use of the provision is the vague language used to describe it, leaving insurance companies to come up with their own interpretations of what it means. Many plans require women to purchase their supplies from an approved medical-device provider, while other others will allow a mom to get reimbursed for a purchase made anywhere. Some will pay only for a handheld, nonelectric device, while others cover more premium pumps. The rule is even more unclear on the lactation-support provision, with no definition of who is qualified to assist a woman trying to breast-feed. When Courson initially found breast-feeding difficult, she again turned to her insurance provider. “I had so many questions and concerns. I wanted to see a lactation consultant so I called insurance just to see.” Courson learned that she had coverage for counseling, and found a provider who would visit her home. Now more than a month after delivering Nicholas, breast-feeding is going well. “Knowing this kind of care is available and covered … that is huge,” she said. Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communications organization not affiliated with Kaiser Permanente. Reprints