When Insurance Companies Refuse to Cover Lactation Care: The Impact on Kentucky Families

As an International Board Certified Lactation Consultant (IBCLC) practicing in Kentucky, I am deeply concerned about a growing and harmful trend: health insurance companies, such as Anthem (the largest provider in KY) are refusing to cover lactation services.

An insurance representative might tell you, “Of course we cover lactation care. We comply with the Affordable Care Act (ACA), which requires coverage for breastfeeding support.” But here’s the reality: many insurance companies do not recognize the IBCLC credential.

That means the very professionals who hold the highest, most rigorous credential in lactation care are excluded from insurance networks. IBCLCs—who undergo more education, supervised training, and examination in lactation than any other health professional—are shut out. Insurance companies may point parents toward providers with far less training, while leaving out the experts.

The Consequences for Families

1. Out-of-Pocket Expenses
   Families often pay $150–$250+ per visit for IBCLC services, and breastfeeding challenges often require multiple follow-ups. This creates a financial barrier, especially for new parents already facing medical bills, childcare costs, and unpaid leave.

2. Discontinuation of Care
   Many parents stop seeking lactation help after one or two visits—not because their issues are resolved, but because they simply cannot afford continued care. This leaves problems like low milk supply, pain, or poor infant weight gain unresolved.

3. Impact on Baby’s Health
   Without proper lactation support, babies may face preventable issues: inadequate weight gain, dehydration, early formula supplementation, and in some cases, early weaning. Breastfeeding protects against infections, allergies, obesity, and chronic disease later in life. Cutting families off from IBCLC care is a direct hit to infant health.

4. Impact on Small Lactation Businesses
   Independent IBCLCs are small business owners serving their communities. By excluding us from insurance networks, insurers are not only making care unaffordable for families but also threatening the survival of the very practices that provide this specialized service.

In short: Kentucky families lose when insurers refuse to recognize IBCLCs.

What You Can Do: Contact Your Insurance Company

Here’s a script you can use to call your insurance company and advocate for coverage:

Step 1: Ask Clearly

“I would like to know how I can access lactation services covered under my plan. Specifically, do you reimburse for care provided by an International Board Certified Lactation Consultant (IBCLC)?”

Step 2: When They Say “We Cover Lactation Services With No Limits”
This is a common half-truth. You can respond with:

“The problem is that in Kentucky, insurance companies do not recognize the IBCLC credential and therefore will not contract with them. IBCLCs are the gold standard in lactation care, with more education and training in breastfeeding than any other provider. By excluding them, your coverage is functionally meaningless. Can you provide me with the names of IBCLCs who are in-network with my plan in Kentucky?”

(They won’t be able to.)

Step 3: Push Further

“If there are no IBCLCs in-network, then your plan is not actually providing meaningful access to lactation care as required under the Affordable Care Act. I request that you begin contracting with IBCLCs so families can receive the care they are entitled to without unreasonable out-of-pocket costs.”

Or here’s an email script:

Subject: Request for Coverage of IBCLC Lactation Services

Dear [Insurance Company Representative],

I am writing as a member of your health plan to request meaningful access to lactation support, as required under the Affordable Care Act (ACA).

While your company states that you “cover lactation services with no limits,” the reality in Kentucky is that you do not recognize or contract with International Board Certified Lactation Consultants (IBCLCs). This is a serious problem, because:

• IBCLCs are the gold standard in lactation care, with more training and expertise in breastfeeding than any other healthcare provider.

• Without coverage for IBCLCs, families like mine are forced to pay out-of-pocket for lactation care—or forego care entirely.

• This creates financial hardship, worsens health outcomes for babies, and undermines the ACA’s requirement for comprehensive breastfeeding support.

I am requesting the following:

1. That [Insurance Company Name] begin recognizing the IBCLC credential as eligible for reimbursement.

2. That IBCLCs be allowed to contract with [Insurance Company Name] so they may provide services at a reasonable and customary rate.

3. That you provide me with a list of in-network IBCLCs available in Kentucky.

If there are no IBCLCs in-network, then your current system does not provide meaningful access to lactation care, and I ask that you take immediate steps to correct this.

Thank you for your prompt attention to this matter. I look forward to your response.

Sincerely,
[Your Full Name]
[Your Insurance ID #]
[Your Contact Information]

Why This Matters

Lactation care is health care. When insurance companies cut off access to IBCLCs, they force families to choose between financial strain and their baby’s health. That is unacceptable.

Please take a few minutes to call your insurer and demand better. If you are a community member, share this post to spread awareness. And if you are a policymaker or advocate, we need your voice to hold insurance companies accountable.

Kentucky families deserve better. Babies deserve better. And IBCLCs deserve to be recognized for the essential health care services we provide.