Breastfeeding Support and Supplies: Coverage Under the ACA as a Preventive Service

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Chimicles & Tikellis LLP is investigating a potential class action lawsuit on behalf of women with individual health insurance or employer sponsored coverage that were either denied coverage for mandatory breastfeeding support, supplies or counseling, or were required to pay, out-of-pocket, a portion of such costs.

Under the Affordable Care Act (ACA), all new health plans must provide certain preventive services, including coverage for breastfeeding support, supplies and counseling, without any cost-sharing, which means plans may not apply any co-payments, deductibles, or co-insurance. The ACA requires all new health plans to cover “comprehensive prenatal and postnatal lactation support [and] counseling” and cover breastfeeding equipment and supplies, such as breast pumps, for the duration of breastfeeding. The aim is to encourage more women to breastfeed.

Click here to view the landmark class action lawsuits that C&T has already filed against insurance carriers for failing to provide, cover, and administer Comprehensive Lactation Benefits.

C&T is investigating whether violations of the ACA have occurred due to, among other things:

  • denial of insurance coverage for lactation counseling or breastfeeding equipment;
  • having paid any portion or the full cost for lactation counseling or breastfeeding equipment;
  • insurance companies not having any lactation consultants or breast pump providers in-network, but refusing to cover the out-of-network service or item at all, or without cost-sharing; and
  • insurance companies imposing an unallowable waiting period or limit on breastfeeding equipment, or refusing to provide lactation counseling, or limiting the benefit to a hospital setting.

If you or someone you know has experienced any of the above or similar issues on or after August 1, 2012 please contact the attorneys below.

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Attorneys for this case:

Kimberly Donaldson Smith
Stephanie E. Saunders