Private Pay

 

Private payment is due at the time of service.  We accept major credit cards, debit cards, cash, and HSA/FSA.  The Affordable Care Act mandated insurance payers to cover lactation services and supplies.  You may request a superbill to submit to your insurance for possible reimbursement of any out of pocket fees.  It is always advisable to call your insurance company and ask their policy on covering lactation services. 

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Self-set ​​payment plans are available.  Please inquire for further information.

 

Amaryllis Lactation Support LLC is proud to offer First Responder and Military Family discounts of 20% for out of pocket/private pay.  

First responders include: Police, Firefighter, EMT, Paramedic, and Line Workers.

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Understanding how insurance works for lactation care can feel complex. This page is designed to clearly explain how billing works based on your insurance plan so you know what to expect before your visit.

In-Network Insurance Plans

 

Amaryllis Lactation Support is in-network with:

• Aetna

• Meritain Health (a subsidiary of Aetna)

• TRICARE East/Humana Military

For these plans:

• We bill your insurance directly

• You are responsible only for copayments, coinsurance, or deductibles as determined by your plan

• We accept contracted insurance rates

• No additional balance billing applies beyond your insurance-defined cost-sharing

 

Out-of-Network Insurance (UnitedHealthcare)

We are currently out-of-network with:

• UnitedHealthcare (UHC)

For these visits:

• We will bill your insurance directly as an out-of-network provider

• Your insurance company will process the claim based on your out-of-network benefits

• After your insurance processes the claim, you will be responsible for any remaining balance not covered by your plan

Important to know:

• Your insurance determines the allowed amount and reimbursement

• Depending on your benefits, insurance may pay a portion of the visit directly to you or to the provider

• Any difference between our fee and the insurance payment may result in a patient balance

• Balance amounts vary based on your specific out-of-network coverage

**We are actively working toward in-network participation with UnitedHealthcare.

 

Blue Cross Blue Shield Plans (Superbill Only)

For:

• Blue Cross Blue Shield of Connecticut

• Blue Cross Blue Shield of Rhode Island

We are not in-network and do not bill insurance directly.

For these visits:

• Payment is due at the time of service

• A detailed superbill is provided for insurance submission

• Reimbursement depends on your individual plan benefits

*A note with regard to Anthem/BCBS plans:  Anthem/BCBS has thus far refused to partner with IBCLSs for coverage of lactation visits, despite multiple attempts and advocacy.  You may contact your insurance to demand coverage options,

as described by the Affordable Care Act.

 

Specialty Insurance Pathways (Care Coordination Plans)

Some insurance plans require additional steps before care can begin.

This applies most commonly to:

Cigna (via Wildflower)

For these plans:

You may verify your coverage here:  https://portal.wildflowerhealth.net/affiliate-care/f1c20ef 

• Coverage is determined by your insurance, not by Amaryllis Lactation Support, LLC

 

Payment & Financial Responsibility

Payment is due at the time of service unless otherwise specified by your insurance plan.

You are responsible for:

• Copays and deductibles for in-network services

• Any non-covered or out-of-network portions of care

• Any remaining balance after insurance reimbursement

 

Out-of-Network Transparency 

If you are using out-of-network benefits, your insurance company may pay directly based on your plan’s allowed amounts.

This means:

You may be responsible for the difference between your insurance reimbursement and the provider’s fee

This is known as balance billing and applies only to out-of-network services.

 

Good Faith Estimate

You have the right to request a Good Faith Estimate of expected charges prior to your visit.  This provides transparency into anticipated costs based on your selected services.

 

Insurance Disclaimer

Insurance coverage varies widely between plans and is never guaranteed.

Your insurance company determines:

• Whether a service is covered

• Whether it is in-network or out-of-network

• The amount they will reimburse

• We do not control insurance benefit decisions.

 

Our Commitment to You

We believe lactation care should be clinically excellent, accessible, and transparent.

If you have questions about insurance or billing, we are happy to help you understand your options before your visit so you can make informed decisions.

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The Affordable Care Act (ACA) requires health insurance support for breastfeeding equipment and breastfeeding educational services within Section 2713, which outlines the health insurance benefits under the Women’s Preventive Health Services provision.  Find more information at https://downloads.aap.org/AAP/PDF/FederalSupportforBreastfeedingResource.pdf