Insurance Coverage Survey

Survey of Massachusetts parents' experiences with insurance coverage for lactation consultant (IBCLC) services.

The Affordable Care Act of 2012 requires coverage of lactation consulting as a “Women’s Preventive Service.” This questionaire is an anonymous survey about the kinds of experiences, both positive and negative, that parents are having as this provision goes into effect. It is not meant to be a scientific poll, but rather a qualitative gathering of information. The results will be used to inform the healthcare community, policy makers, and the general public, with the goal of eliminating barriers to parents' access to lactation support.

Please take this survey if you:

1) Live in Massachusetts

2) Sought insurance coverage for lactation help outside of the hospital since Jan 1, 2013

3) You can take the survey if you saw a lactation consultant and were not covered by insurance.

4) You can take the survey if you did not see a lactation consultant because you were not covered by insurance.

Please take the survey only once!

This survey is for Massachusetts residents. Do you live in Massachusetts? *

Yes

No

This survey is for parents who sought insurance coverage since Jan 1 2013. In what year did you first contact your insurance company or submit a claim for lactation support? *

When you sought breastfeeding/lactation help outside of the hospital, what was the reason? (check all that apply) *

In what setting, outside of the hospital, did you see a lactation consultant (IBCLC)? (check all that apply) *

Which insurance company do you have? *

Other

Did you contact your insurance company prior to seeing a lactation consultant to ask about your coverage for lactation support? *

Yes

No

When you contacted your insurance, what were you told? (Check all that apply)

Were you able to find a lactation consultant (IBCLC) who met your insurance company's requirements?

Yes, the IBCLC I preferred was covered

Yes, but the IBCLC I preferred was not covered

Yes, my insurance provided a list, and I chose from it

No, I could not find an IBCLC that my insurance would cover

Other Other

Did you delay seeing a lactation consultant, or not see one at all, because of issues with insurance? *

No

Yes, delayed because I had trouble finding a provider who would be covered

Yes, delayed by waiting for my insurance to approve coverage

Yes, I ended up not seeing a lactation consultant because I could not arrange insurance coverage

Other Other

When you saw a lactation consultant, how was billing handled?

The IBCLC was associated with a doctor's office or clinic, and they billed my insurance

The IBCLC billed insurance directly

I paid the IBCLC, and filed a claim for reimbursement

I paid the IBCLC, but never filed a claim for reimbursement

NA - Did not see a lactation consultant

Other Other

What was the outcome of your insurance claim for IBCLC services?

The service was fully covered

The service was covered minus a copay or partial payment

Claim was denied - I did not appeal

Claim was denied, but I received coverage when I appealed

Claim was denied, and I appealed but still did not receive coverage

NA - Did not see a lactation consultant

Other Other

If a claim was denied, was the reason given (check all that apply):

My IBCLC was not in network

My IBCLC did not have another credential required

The type of service (e.g. home visit) was not covered

The diagnosis code (ICD-9) or CPT code was not covered

My plan did not cover IBCLC services

Other Other

Anything else you would like to tell about your experience with insurance coverage for lactation support?

Thank you for completing this survey!

Nipple pain	Breast pain
Mastitis/thrush/Infection of nipple or breasts	Baby not latching
Baby not gaining enough weight	Not sure if baby was getting enough milk
Baby was fussy or uncomfortable	Concerns about feeding pattern or schedule
Concerns about allergies	Problems breastfeeding a previous baby
Twins/multiples	Premature baby
Baby with special needs or medical concerns	Maternal medical history, such as breast reduction surgery
Maternal medical problems or medications	Concerned about milk supply
Concerns about lactation when returning to work or school	Recommendation of my pediatrician
Recommendation of my obgyn/midwife	Recommendation of another healthcare provider
Other Other

Doctor's office	Clinic
IBCLC's office (not part of another medical practice)	IBCLC came to my home
NA - did not see a lactation consultant	Other Other