Rooted Maternal Wellness is in-network with Aetna, UHC commercial plans, and Tri-care east which may cover lactation consultations. However, coverage varies based on your specific plan, and it’s important to verify your benefits before your visit.
In-Network
Key Coverage Information for Aetna & UHC
✔ Parent & Baby Must Be on the Same Plan: Both you and your baby must have the same Aetna or UHC commercial plan as your primary insurance for claims to be processed.
✔ Separate Billing for Parent & Baby: Each visit is billed separately for the lactating parent and baby, as required by insurance.
✔ Out-of-Network Baby Coverage: If your baby is on a different plan than you, I will bill your in-network insurance for your portion, but a $125 payment per visit will be required for the baby’s portion.
Aetna-Specific Coverage Details
- Billing Limits: Starting March 2024, Aetna covers six billing codes per year, not six full visits. Each consultation requires two codes (one for the parent, one for the baby), effectively covering three visits per year.
- Online Classes Count Toward Codes: If you've taken a "free" breastfeeding or pump class through Aetna, it may count toward your six allotted codes.
- Denial of Coverage: If Aetna denies coverage entirely, you will be responsible for the self-pay rate. A superbill can be provided for possible reimbursement.
- Exceeding Coverage: If you've used all six covered codes and need additional support, contact me to discuss further options.
- Medicaid Plans: I am not in-network with Aetna Medicaid plans at this time.
UHC-Specific Coverage Details
- Lactation visits are typically covered as preventive care under UHC commercial plans.
- Referral or preauthorization may be required for some plans—please check with UHC.
- Copays, coinsurance, or deductibles may apply depending on your plan.
- Medicaid Plans: I am not in-network with UHC Medicaid plans at this time.
Double check your covergae for lactation services and if you already used up some of you lactation benefits
Go ahead and book your appointment
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