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INSURANCE & PAYMENTS

Insurances we work with, self pay information, and payment policies

Anthem PPO, Humana, Multiplan, PNOA: Check Coverage with Lactation Network

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Star Lactation is an independent contractor with Lactation Network, an insurance billing company. Lactation Network contracts with the insurance plans listed above, and if your plan works with Lactation Network, you can get coverage for any lactation visits you need. You can see whether your plan works with Lactation Network, and select Star Lactation as your provider, by entering your insurance information at the underlined link above. Lactation Network will bill your insurance company directly for any services that Star Lactation provides. After your visit(s), you will receive an Explanation of Benefits (EOB) from your insurer indicating that Lactation Network has billed for services provided by Star Lactation. Lactation Network states that it will not collect any deductibles or copays, nor will Star Lactation. Note that if at the time of your visit, your insurance policy has lapsed and Lactation Network does not cover the visit, you will be responsible for Star Lactation's cash rate.

Aetna - Most plans, except Medicaid

Star Lactation is a contracted provider with Aetna (except medicaid plans). Most, but not all, Aetna plans provide some coverage for lactation care. It is always prudent to call Aetna to ensure Star Lactation is in network with your plan, and that your plan covers lactation services.  Some HMO Aetna plans require OB/PCP referral. Provider details: Havener Ventures DBA Star Lactation, NPI # 1710510045, EIN # 842943443. Aetna commonly requires "cost sharing" for lactation visits. Cost sharing includes copays, coinsurance, and amounts applied to deductibles.  Historically, cost shares have averaged $50 a visit.  Usually, cost shares start at your fourth visit, but we can not guarantee this. We do our best with coding to reduce cost shares, but only book a visit if you are comfortable with cost sharing.​  NOTE: If you were told by Aetna that you have 6 free visits, please note this is not accurate.  Aetna covers 6 uses of the billing code S9443 in a 12 month period.  In order for us to be paid appropriately for our expertise and long visit times, when billing for your visits, we use S9443 for parent and baby per visit, in addition to a counseling code. This means the S9443 code will be used up after your 3rd visit.  If you did prenatal visits through Aeroflow or another company, you will have less of these codes available, and will likely have more cost sharing.

Star lactation is an independent contractor with Wildflower, an insurance billing company that works exclusively with Cigna to provide lactation coverage for its members. If your plan works with Wildflower, you can receive at least 6 covered visits at no cost to you (no cost sharing).  Wildflower will bill Cigna directly for any services that Star Lactation provides. After your visit(s), Cigna will send you an Explanation of Benefits (EOB).  Note that if at the time of your visit, your insurance policy has lapsed and Wildflower does not cover the visit, you will be responsible for Star Lactation's cash rate.

Tricare

Star Lactation is a Tricare East Certified Provider.  Tricare covers 6 lactation visits for mothers with no cost sharing.  It does not cover infant(s).  If both mother and baby are at a visit, Star Lactation will bill Tricare for the mother, and mother will be covered, but you will be responsible for a $50 fee per visit for infant. Star Lactation will send an invoice, due before your visit, for the infant portion of your visit(s). 

 United Health Care

Star Lactation participates with United Healthcare. We have found that most, but not all, UHC plans are covered. Gate HMO and Freedom Plans are not typically covered. It is always prudent to call UHC to ensure Star Lactation is in network with your plan, and that your plan covers lactation services. Historically, UHC pays visits without requiring any cost sharing (copays, coinsurance, deductibles), however we can not guarantee this. Should you have a visit and your plan is not covered, you will be responsible for the cash pay rate and will be invoiced accordingly.  Provider details: Havener Ventures DBA Star Lactation, NPI # 1710510045, EIN # 842943443.

Self Pay

If your insurance is not listed above, you can pay for your visit via cash, check, credit card or HSA card.  If paying by card, your payment is due prior to visit. Cash or checks will be accepted at visit. After your visit, we can provide you with a superbill to submit to your insurance company for reimbursement.  Self pay fees for visits with Katherine Havener IBCLC are listed below.

  • 60-75 minute initial consultations (one baby) are $150; twin initial visits are $200.

  • 45-60 minute follow ups (one baby) are $100; twin follow up visits are $150.

  • 60 minute prenatal consultations are $100

  • 45-60 minute online consultations are $80

  • 30 minute flange fittings are $60 (two Medela, Spectra/Ameda flanges included with price)​

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REDUCED COST VISITS WITH ADVANCED STUDENT EMILY MORRIS:

Limited appointment spots available on Thursday mornings with Emily Morris.  Visit cost is $40, prepaid.  For families on WIC/Medicaid, the rate is $20.

Appointment availability is visible when you click BOOK NOW below.   

If your situation is URGENT, and there are not any available appointments the next day,

reach out to us at 540-253-1984 and we will do our best to open up time to see you.  

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