Does Insurance Cover Certified Lactation Counselor (CLC)?

Pregnancy and Postpartum Care for Everyone

The short answer is Yes! Coverage for services provided by a Certified Lactation Counselor (CLC) can vary widely depending on the insurance plan and where you are located. In the United States, for example, many health insurance plans are required to cover lactation support and counseling as part of the essential health benefits under the Affordable Care Act. This typically includes coverage for lactation consultations without cost-sharing for the duration of breastfeeding.

However, the specifics, such as the extent of coverage, whether a CLC is considered a qualified provider, and if pre-authorization is needed, can differ between insurance providers and plans. It's also important to check if there are limitations regarding the number of covered visits or specific circumstances under which the coverage applies.

To get the most accurate information:

  1. Review your insurance policy details, particularly under sections related to maternity care and preventive services.
  2. Contact your insurance provider directly to inquire about coverage specifics for lactation counseling services.
  3. Ask the CLC if they have experience with billing insurance and if they can assist you in understanding what is covered under your plan.

If you have specific concerns or need detailed information about your insurance plan, it may be helpful to speak directly with your insurance company.