Navigating Insurance

UCSD HMO

We are in-network with UCSD HMO/UCSD Managed Care, and therefore can bill them directly for a fully covered visit. They have a universal referral, which covers the first 3 visits with us. It is covered under the lactating parent. Home visits will be charged a travel fee, which insurance does not cover. Once you know you are in our service area, here are your next steps:

1. Contact us to schedule a visit:

   • You can book Office Visits via our online scheduler HERE. Choose the UCSD version of the appointment you would like to schedule.

   • For Home or Office Visits, text or call us at 858-218-6455 and let us know you have a referral from UCSD

   • Submit a request for a Home or an Office Visit via email HERE

Aetna PPO

We are in-network with Aetna PPOs, and therefore can bill them directly for your visit. Although they say they fully cover visits, they often require a patient responsibility, which varies depending on how many lactation visits you have had in a calendar year. They do not require a referral or preauthorization. Home visits will be charged a travel fee, which insurance does not cover. Once you know you are in our service area, here are your next steps:

Contact us to schedule a visit:

• You can book Office Visits via our online scheduler HERE. Choose the Aetna version of the appointment you would like to schedule.

• For Home or Office Visits, text or call us at 858-218-6455 and let us know you have a Aetna PPO as your insurance

• Submit a request for a Home or an Office Visit via email HERE

Cigna through Wildflower

If you have Cigna Health Insurance, Wildflower is a healthcare company that works and bills Cigna to provide lactation services through their contracted providers. We are contracted to provide lactation services with prior eligibility check from Wildflower. Home visits will be charged a travel fee, which insurance does not cover. Your next steps:

1. Contact us to make sure you are in our service area, and that we have availability to see you.

2. Check to verify your eligibility with Wildflower Health HERE. You should get a reply (we get one, too!) when you are approved for your first visit (it is a very quick response time!)

3. If you have not already, contact us to schedule a visit:

   • You can book Office Visits via our online scheduler HERE. Choose the Cigna/Wildflower version of the appointment you would like to schedule.

   • For Home or Office Visits, text or call us at 858-218-6455 and let us know you have been approved with The Lactation Network

   • Submit a request for a Home or an Office Visit via email HERE

Blue Cross PPO, Blue Shield PPO, Anthem PPO, Multiplan, United Healthcare, and PNOA via The Lactation Network (TLN)

The Lactation Network is a DME (Durable Medical Equipment Provider) that bills multiple insurance companies. We are contracted with TLN to provide lactation services with prior approval from TLN. Home visits will be charged a travel fee, which insurance does not cover. Your next steps:

1. Contact us to make sure you are in our service area, and that we have availability to see you. You can always schedule an appointment pending insurance approval.

2. Check to see if your insurance is covered through The Lactation Network HERE. You should get a reply (we get one, too!) when you are approved for your first visit. It sometimes takes upwards of 24 hours for a reply, depending on the day of the week. If you select the Urgent Visit option, you should get a faster response.

3. If you have not already, contact us to schedule a visit:

   • You can book Office Visits via our online scheduler HERE. Choose the Blue Cross PPO, Blue Shield PPO, Anthem PPO version of the appointment you would like to schedule.

   • For Home or Office Visits, text or call us at 858-218-6455 and let us know you have been approved with The Lactation Network

   • Submit a request for a Home or an Office Visit via email HERE