What is an ACA (Affordable Care Act) Breast Pump?

All of the dust has settled and now we all, healthcare professionals and families, are asking,

"What is this affordable care act stuff and what is my coverage?"

For Women's preventative services the Affordable Care Act (ACA) covers multiple items. The article found at ACA coverage  sums everything up nicely and summarizes your coverage as a breastfeeding mom with "Breastfeeding support, supplies, and counseling: Pregnant and postpartum women have access to comprehensive lactation support and counseling from trained providers, as well as breastfeeding equipment. Breastfeeding is one of the most effective preventive measures mothers can take to protect their health and that of their children. One of the barriers for breastfeeding is the cost of purchasing or renting breast pumps and nursing related supplies." 

So, how do you take advantage of this? It really is an easy process.

1. Get your insurance card out. Look on the back and call the customer service number. Give them your ID and other information they request and ask: "What is my coverage for a personal ELECTRIC pump? "

2. The next questions is: "Where can I get this pump from?" The insurance company should be able to give you list of providers or DME offices they are working with.

3. The pump you receive will be a special ACA pump. It will more than likely come in a brown box with the company name on it- Medela, Ameda, Hygeia - and should contain a personal electric pump with a pump kit for your personal use.

Now I have my pump, but what if I need follow up with breastfeeding challenges?

Again, this is covered under ACA. To find out your coverage follow these steps.

1. Get your insurance card out. Look on the back and call the customer service number. Give them your ID and other information they request and ask: "What is my coverage for lactation consultation with an IBCLC?"

2. Find out what your coverage is specifically: Is it prior to deductible, after deductible? Is it different in network vs out of network? What is your copay amount? How many visits do you have at this rate?

3. The next questions is: "Who do you have as listed Lactation Consultants that I may see?" The insurance company should be able to give you list of providers and their direct contact information as well as their websites. These providers have been credentialed by the insurance company and carry an NPI so they may bill insurance.

4. Make sure to do your homework! Just because a provider is listed doesn't mean they are the best available. Like many do for other healthcare professionals be diligent. Check YELP, Yahoo, etc.  for reviews and go to the providers website if provided. References should be available in one or both of these locations. You can also check the providers licensure status at the IBCLE site at IBCLC registry

Other hints to help you navigate this process:

1. DO this work prior to delivery. KNOW your benefits before the pump or consult is needed. It is always easier to deal with this preventatively rather than reactively.

2. CALL your hospital and find out who their IBCLC is and how long they typically spend with a patient in L&D and on Postapartum. If the answer is 15 min or less and that their hours are Mon-Fri 8-5 then make contact with your insurance company's IBCLC ahead of time. When the time comes you will be glad that all you needed to do was let them know you have delivered and could they come and guide you through to your successful path.

3. DON'T be afraid to ask questions. ACA has included coverage for breastfeeding moms for a reason. The AAP as well as the Surgeon General as well as your government are making this a priority and they want you  to do the same.

Best wishes and if you are in the Las Vegas area and need guidance please feel free to look us up at http://Breastfeeding and Babies, Yeah!  .

-Lisa Weinshenker, RN, IBCLC

The Cost of NOT Breastfeeding?

Yes, there is a cost of not breastfeeding. It comes in many forms from the cost of formula, to the cost of sickness to the baby and to the mom, to the cost to your company or the medicaid system for the illnesses caused by not providing what your baby needs through breastmilk,  to the cost of emotionally feeling like you did not achieve your desired path.

First, the cost of formula.
1. The cost of a consult without insurance can be anywhere from $80-400 depending on where you live and the standard cost of a consult with an IBCLC in the area where you live. The cost of formula at 3 months of age for one week with a standard formula (not a high cost organic formula or one with special antifussiness pricetags) can be calculated by using a site like babycenter.Formula Calculator or on theKellymom calculator 

Or you can do the math yourself. At about $25-27 for one formula container which should yield about 150 ounces of formula (8.7 grams powder yields one 2 ounce bottle, 657 grams in a container) your 3 month old who is consuming probably 30-40 ounces a day will eat their way through at least 2 of these a week. So in a matter of 1.5 weeks you have paid for at least one consultation by an IBCLC to solve your breastfeeding challenge.

At $50 a week for formula (or probably more) you could have rented at least 3 hospital grade pumps for that month to maintain your supply for a baby who is not latching well. (general cost of hospital grade pump rentals for supply maintenance for the exclusive pumper or full time working mom is between 45-80 a month) .

At $50 a week for formula you could buy multiple packages of lactation cookies by Milkin' Cookies  orMilkmakers .

At $50 a week for formula you could have multiple pill form galactagogues from companies like golacta   or Motherlove .

Second, the cost of healthcare for a formula fed infant with no formula intolerance reaches far beyond the cost of a consult. First one must consider health risk to the infant. Infant's who are not breastfed are at risk for multiple childhood illnesses that include obesity, diabetes, autism, and ear infections to just name a few. Third one must consider the health risk to mom by not breastfeeding. By breastfeeding mom reduces her risk of breast cancer, ovarian cancer, and postpartum depression.  A more indepth list can be found in these articles. Reviews in Obstetrics and Gynecology    and From Canada,   WIC easy to read article and  A great review of the res .

I could also review the risks to mom separately but I think they are laid out pretty well in the articles mentioned above. Overall, I think anyone can clearly see the value in a lactation consultation either prenatally, within a few days postpartum, or when trouble arises. I also think it is pretty clear what the cost of not asking for help or searching out your local breastfeeding resources is both short term and long term to both your wallet, your health, and more importantly your infant's health. Yes, there are some who can not breastfeed whether for physical, anatomica, or psycho-social reasons, but in general almost everyone can make the attempt and have some level of success even if it is only for the first few weeks or months.

Get out, get help, and don't hide behind your front door!! 

Your local IBCLC or La Leche League is waiting for your call and is more than willing to help you overcome your challenges!

For more info in the Las Vegas area please contact Lisa at Breastfeeding and Babies, Yeah! or your local Breastfeeding Coalition or your local La Leche League at llli.org