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Navigating company health insurance when having a baby can be a confusing process, particularly if the mother and baby need additional medical support. Do your employees know what your company insurance covers regarding breastpumps and lactation services? Do they know how to submit a claim? For many mothers, needing to rent a hospital grade pump and lactation consultations are a must. Many employees may not actually know what their insurance covers until after the fact. We suggest helping your employees understand what is covered and how to submit a claim before they go on maternity leave. Here are some ways to help your employees understand their insurance coverage for lactation and breastfeeding needs.
Prenatal Breastfeeding/CPR Classes
Let your employees know if prenatal breastfeeding classes, breastfeeding back-to-work classes, or CPR classes can be reimbursed through their insurance or if your company offers them as an employee perk. These classes help promote breastfeeding and benefit companies by preparing employees who are nursing for a smooth transition back-to-work. If you would like to offer these classes at your company, they are available through Healthy Horizons, contact us for more information.
Breastpumps For Going Back-to-Work
Many companies offer hospital-grade breastpumps for mothers to use at work. Although, moms need something to use at home as well! Insurance may reimburse the cost of renting a hospital-grade pump or a personal use breastpump for the mother. Keep in mind, that if your company insurance provides an insurance pump, it typically does not come with the rest of the pumping attachment kit and carrying bag. To help your employees, review with them how your insurance covers a personal breastpump or renting a hospital-grade breastpump and if you will provide a kit, or if they can pay for it through a health savings account.
Hospital-Grade Pumps and Lactation Consultations
Your employee and their baby may have a medical need to rent a hospital-grade pump and have visits with a lactation consultant. It is good for your employee to know what authorizations are needed for insurance to cover this before having the baby. It is stressful enough for a mother to deal with breastfeeding issues without having to find out if the breastpump and consultations are reimbursed under insurance. Make sure that your employees know what their coverage is and what they will need to pay out-of-pocket.
How To File An Insurance Claim
Before having the baby, employees should be familiar with the process to get reimbursed for their claim. Discuss with your employees how they can request an insurance pump or file for reimbursement. Review what authorizations and paperwork are needed to submit a claim. Make sure they know what Prior Authorizations are needed from the physician for a service or medical equipment. Go through an example of submitting a claim so they understand what they need and how to submit it. Provide insurance contact numbers, fax numbers, and emails for additional questions and support. It’s important to note, that even if these services are covered many insurance companies may deny a reimbursement! If it occurs, Healthy Horizons has an insurance information page to help employees dispute a claim denial at https://www.healthyhorizonsonline.com/insurance
There are many ways to help your employees navigate the insurance process. Consider giving them this information before they go on leave, or offering a corporate back-to-work class for mothers. Have a corporate website that outlines what is covered and reimbursed with a step-by-step guide on filing claims. Some employees may find that they have a special circumstance where it is not clear what is covered; therefore it is important to have a person as a contact for employees to reach out to discuss their situation. Healthy Horizons can help you set up classes and communications for your employees to help them navigate their insurance so they can focus on their baby and be prepared to return to work.