Milkalicious is an in-network provider for Aetna PPO plans. We also accept Tricare (Standard AND Prime) with no out of pocket costs to the patient.
Most PPO insurance plans/companies (including Tricare) will reimburse Milkalicious as an out-of-network provider. We require all our patients to pay the price listed on our "services" page at the time of service (our discounted "cash" price). The up-front cost of your consult today is YOUR PORTION DUE; the remaining balance will be billed to your insurance. If they cover THEIR PORTION, you may be eligible for a refund. This all depends on your insurance plan, policy, and deductible.
Please be aware that this process takes a minimum of 6-8 weeks. If your insurance does NOT cover the claim submitted, we will NOT contact you to pay any additional amounts above the fees paid at the time of service (even if the EOB states that the patient is responsible for a certain amount).
Unfortunately, we do not accept any HMO plans or government provided insurance (Medicare/Medi-Cal/CalOptima, etc.).
If you'd like more information about insurance coverage for breastfeeding services, denial from you insurance company for services, or additional information on women's health and the Affordable Care Act, please visit http://nwlc.org/resources/breastfeeding-and-health-care-law/. To read the National Women's Law Center's report on health plan violations of the ACA (and what you can do about it), please visit http://nwlc.org/wp-content/uploads/2015/08/final_nwlc_breastfeedingreport2015.pdf
If your insurance company denied your claim for lactation services, required you to pay a co-pay, or applied the claim to your deductible, click here to view a template for a letter you can send your state's insurance commissioner. California residents can file a complaint online at the California Department of Insurance website. These claims often get reversed and paid.