Blue Cross Blue Shield Lactation Coverage

Important Update: Changes to Blue Cross Blue Shield Lactation Coverage

Dear Prospective Patient,

We want to share some important updates about your insurance coverage and how it may impact your ability to access lactation support.

**If you have Blue Cross Blue Shield of Illinois and Rhode Island please follow this link to begin the process for checking lactation coverage through our third party billing company, TLN.

Blue Cross Blue Shield of Texas Has Made Major Changes
Recent decisions by Blue Cross Blue Shield of Texas (BCBSTX) have significantly altered how lactation services are covered:

• They’ve redefined lactation care to include brief 20-minute visits—despite the fact that real breastfeeding support takes time, skill, and connection.

• Reimbursement rates have been drastically reduced, making it difficult for providers to offer care under these terms.

The Lactation Network (TLN) Is No Longer Accepting BCBS Plans in Texas

Due to this instability, TLN has announced they will no longer process out-of-network claims for any Blue Cross Blue Shield plans in Texas. As a result, Milk Diva is no longer considered in-network with BCBS, Anthem, or Blue Cross Blue Shield plans.

What This Means for You

We’re still here to support you—and here’s how we’ll continue to help:

• We are happy to submit an out-of-network claim to BCBS, Anthem or Cigna on your behalf.

• However, full payment is required at the time of service. Please select “Self-Pay” when booking your appointment.

Before your visit, it is recommended to:

• Verify your out-of-network benefits with your insurance plan.

  • Insider Tip: If you recently delivered your baby at a hospital, you may have already met your insurance deductible. This means your out-of-network reimbursement could be higher than expected—but it’s crucial to discuss this directly with your insurance company, as we cannot guarantee coverage or reimbursement.

• If your insurance plan does not reimburse our full fee, you may be responsible for the remaining balance.

  • Office Visits Range from $220-200 (singleton)

  • Home Visits Range $289-$239 (singleton)

• All of our services are HSA/FSA eligible

You Have a Right to Lactation Care
Lactation care is a health right—not a luxury.

We encourage you to contact your insurance provider directly to:

• Express your concern about the lack of in-network access.

• Insist that they honor out-of-network lactation claims as required by the Affordable Care Act.

We understand this is a big shift, and we’re here to answer your questions, support your goals, and continue delivering exceptional care to you and your baby—no matter what.

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Building Healthier Futures with Mom and Baby.