Wednesday, February 27, 2013

Breast Pump Insurance Coverage & Reimbursement

   As the Affordable Care Act is enacted and more and more moms are becoming aware of the benefits of it, we are learning more and more about getting insurance to cover your breast pump.
 First, don't take "no" for an answer.  Call your insurance company.  If the representative tells you that a breast pump is not covered ask why.  Some insurance companies are still classifying breast pumps as "personal comfort" items.  According to the US Government Department of Health & Human Services, " Non-grandfathered plans and issuers are required to provide coverage without cost sharing consistent with these guidelines in the first plan year (in the individual market, policy year) that begins on or after August 1, 2012."
     The Affordable Care Act covers Breastfeeding support, supplies, and counseling.  Some insurance companies are covering hospital grade breast pump rentals, but others are covering quality personal use pumps sold by DME supplies like Lactation Connection.  We found the United Health Care policies buried in a table entitled Expanded Women's Preventative Health and it states that these items are required coverage for plans beginning after 8/1/12.
     Make sure to get prior approval from your insurance company before purchasing from an out of network supplier, especially if you are on an HMO.  But it is always a good idea to call your insurance company first for information on how to get reimbursement.  Take down the name of the person you spoke to.   If the answer is "we don't cover that"  ask why and if the answer is not that you have to buy "in network" or that your plan is grandfathered.  Call back and speak to someone else until you get a knowledgeable helpful representative.  Finally, ask what paperwork you need to submit for reimbursement.  Lactation Connection provides you a receipt with the appropriate insurance codes attached for your convenience when you purchase at http://www.lactationconnection.com


http://www.hrsa.gov/womensguidelines/
http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-list.html#CoveredPreventiveServicesforWomenIncludingPregnantWomen
https://www.unitedhealthcareonline.com/ccmcontent/ProviderII/UHC/en-US/Assets/ProviderStaticFiles/ProviderStaticFilesPdf/Tools%20and%20Resources/Policies%20and%20Protocols/Medical%20Policies/Medical%20Policies/Preventive_Care_Services_CD.pdf

Saturday, February 16, 2013

Breastfeeding Herbs: Is it all Fenugreek to You?

Herbs can be confusing because not all herbs are created equal. Cheaper herbs can loose their efficacy quickly.  For increasing milk supply you want a high quality brand Fenugreek in a trusted brand  like Nature's Way Fenugreek for maximum freshness and potency if taking in capsule form. You also need to take the appropriate dosage for your weight.  If you are an average weight and taking  610-626 mg capsules, you should take three capsules three times daily which is a total of 9 capsules per day.  If you are a plus sized mom, you should take 5 capsules three times daily for a total of 15 capsules per day.  Below is a height and weight chart for the average women 18-34 for the purposes of dosage:
4'10"-5' 90-128 lbs
5'1"-5'3" 101-141 lbs
5'4"-5'6" 111-155 lbs
5'7"-5'9" 111-169 lbs
5'10"-6'   132-184 lbs
Fenugreek can also be taken in the form of tea.   Traditional Medicinals Organic Mother's Milk Tea company recommends drinking three cups per day.  There is no recomendation for plus size moms.   Some moms like to use capsules when they are on the go and coffee or tea when they are relaxing with a beverage.  You can also use the tea as a cold beverage once steeped.  It is easier to get the appropriate dosage from capsules.  Fenugreek capsules also work well when combined with another herb such as combining 3 capsules of Fenugreek and two capsules of Blessed Thistle three times daily.  When taking the appropriate dosage in a quality herb, you should see results in just 48-72 hours.
May your cups run over!
Tanya

Sunday, February 10, 2013

Comparing Hygeia Breast Pump Models

     The Hygeia EnJoye Breast Pump has become our most requested pump of 2013, but the different models can be confusing.  First, all EnJoye pumps have the same motor with the same three year warranty. All three are "green" pump so they are approved by the FDA for multi-person uses so can be resold.  If you are purchasing a used Hygeia EnJoye you will need your own sanitary double pumping kit which includes the tubing, filters bottles and valves. And all three have the CARE function witch is an audio recording device to record your baby's coos or cries and play them back to assist with let down while pumping.  The distinctions are below:
Hygeia EnJoye EPS Breast Pump has an external power supply (AC adapter) only and can be purchased on our site with or without a tote.
Hygeia EnJoye EXT Breast Pump has both the AC adapter and an external AA battery pack.  You can purchase these with a brown or black tote which makes a very nice diaper bag as well.
Hygeia EnJoye LBI Breast Pump has both the AC adapter and includes an internal lithium ion rechargeable battery for moms who don't have access to an outlet and reply on a battery to pump.

The Hygeia EnJoye Breast Pump is an excellent purchase and is covered under your insurance plan if purchased from either a network provider or a DME supplier like Lactation Connection in most cases.  Always check with your insurance company for details on breast pump insurance coverage, but know that in 2013 a breast pump is covered as preventative care under the Affordable Care Act so don't take no for an answer.  Breastpumps and breastfeeding supplies are covered. 
     If your insurance company pays for breast pump rental, the Hygeia EnDeare is an excellent choice.



Thursday, February 7, 2013

The Breastfeeding Baby and Smoking



I recently had a grandmother ask this question, "Unfortunately my daughter has smoked during her entire pregnancy. She wants to breastfeed and continue smoking. She will not quit spite the potential problems. How can you smoke and breastfeed safely?" 
This is a difficult issue and I thought it best to arm her with the facts.  There are many studies on nicotine in breast milk, but I am referring below two helpful articles.  The first shows that while nicotine is harmful, it may be less harmful to breastfeed and smoke than to bottle-feed and smoke since the baby will most likely be getting the passive second hand smoke.  The second shows the effects of sleep patterns on infants due to nicotine intake.  These babies have difficult sleep patterns and increase risk of respiratory infection.  The Nicotine patches are a much reduced risk to the baby, so I would encourage the mother in that direction.  Also, when dealing with someone who is self-involved, make it more about her benefit than the babies.  For example, tell the mother that she will get more sleep when her baby sleeps better.  Tell her that she will spend less money and time at the doctor when her baby does not have a respiratory infection.  Tell her that she will not have to buy or mix formula when her milk supply is not decreased by nicotine. 
If the mother continues to refuse to stop smoking, make her aware that the nicotine peaks at 60-90 minutes so avoiding nursing during that peak, will help somewhat.  As I said, this is a difficult issue when you care so much, but it is ultimately the mother who will have to come to terms with her decisions.
Best Wishes,
Tanya

References


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2277470/