As of the first of 2013, many insurance plans began covering the purchase of breastpumps for expectant or lactating mothers under the Affordable Healthcare Act (ACA). What’s more, the law allows new purchases “in conjunction with each new pregnancy,” meaning all your children receive the same healthy benefits. But since ACA laws for breastpumps and breastfeeding accessories are still new, many providers may still be trying to understand these laws themselves. Coverage can vary by insurance company and policy type. The only way to verify your specific plan coverage is to complete the Qualify Through Insurance form. Then Lehan's will contact your insurance provider for you and inform you of your coverage. That way you can focus on the most important thing in your life: your family.
Depending on your insurance company, you may be eligible to receive a breastpump before your baby is born under your preventative care clause and up to a year after delivery. Typically, Lehans is able to dispense your breastpump between 30-60 before your due date. Once you complete the Breast Pump Insurance form, we will contact insurance for you to find out the exact details of your coverage.
Lehan's currently offers breastpump upgrade options for Medela, Hygeia and Ameda brestpumps. Breastpump coverage all depends on your particular insurance and plan; there is no one-cost-fits all regarding insurance-grade breastpumps or upgrade pumps. If you are interested in an upgrade option pump, you will need to complete the Breast Pump Insurance form before we are able to determine any costs. Don't worry Lehans takes care of all the phone calls with your insurance and will notify you of your specific coverage details. Lehan's does accept HSA and FSA spending accounts as payment for upgrade pump charges.
Coverage and reimbursement depends on health insurance type, plan and network. Not only does private/commercial insurance versus Medicaid play a role, but your deductible and reimbursement timing do too. Whether or not you are in-network is evaluated once your information is submitted to Lehan's. If for any reason you do not qualify for a breastpump through insurance, Lehan's has pumps available for purchase.
Of course—that’s why we’re here! We let you know exactly what is needed from both your insurance and your doctor, and do as much of the filing and phone calls as possible. You can submit signed prescriptions via email; include it as an attachment and send to email@example.com.
The following is a list (subject to change based on contracts) of current in and out of network insurance providers. We are able to bill any major insurance, but coverage will vary based on network status. In-Network Benefits (Durable Medical Equipment)* Aetna/Coventry Blue Cross Blue Shield PPO ECOH First Health Net Health Alliance Health Link HFN Illinicare Medicaid Medicare Meridian Molina Multiplan Personal Care Insurance of IL Quartz/Chartwell The Alliance Tricare United Healthcare (Medicare Advantage Only) Out of Network Benefits (typically poor coverage) BCBS Medicaid Managed Care Cigna Humana United Health Care (non-Medicare Advantage) UHC Medicare Advantage Complete (HMO) *There may be individual groups within an in-network insurance plan that utilize a narrow network which may exclude Lehan’s. As such, Lehan’s will contact any insurance company on behalf of all patients and determine their coverage/benefits. We will work with all patients regardless of insurance or financial status to ensure the best patient care possible. Please call Lehan’s at 815-758-0911 with any questions.
The coverage for all medical items depends on your specific insurance policy. Any time you need a medical item, service, or see a new doctor, you should contact your insurance policy for specific coverage details. The phone number for most insurances can be found on the back of your insurance card. Our customer service specialists are also happy to assist in contacting your insurance company for coverage details. Your policy will give the most accurate information regarding coverage. Most insurances require a prescription from a doctor in order to bill a claim and often require additional documentation from your healthcare providers including office visit notes. If you haven’t already received a prescription from your doctor, you can schedule an appointment or contact their office to have them send one to the pharmacy or medical equipment company of your choice.
Once the order for your items is reviewed by our billing staff, it is sent to your insurance company for processing. Once they’ve determined the final decision on your claim, they will send an explanation of benefits to you and an explanation of benefits with any payment required to Lehan's. The amount of time that it takes an insurance to process and pay a claim depends on the insurance company, and can vary greatly. This process can take one month or it can take several months. If there is any remaining patient balance on a claim, we will send out an invoice to the patient once the insurance company has processed and paid the claim. You can contact your insurance company to discuss where they are at in their claims process. If you have any further questions, you can contact our billing department at 815-766-3459.
For an up-to-date patient balance, please visit our patient portal (link to our Home Medical Bill Pay). You can view your balance, past payments, and invoices at your convenience. If there are any further questions, you can contact our billing department at 815-766-3459.