Told your marketplace plan means self-pay? Check with us first.

Ambetter plans cover lactation support as preventive care under the Affordable Care Act, the same as any other ACA-compliant plan. The catch has never been the coverage; it is that very few lactation providers join marketplace plan networks, so Ambetter families get quoted self-pay rates almost everywhere they call, and out-of-network claims on these plans are routinely denied. Breastfeed Atlanta is in network with Ambetter. Your visits are billed to your plan by our own team, the way in-network care is supposed to work.

Ambetter or Peach State? Either way, you're covered here.

Georgia families often carry one of two similarly named plans: Ambetter from Peach State Health Plan, the marketplace plan bought through Georgia Access, and Peach State Health Plan, the Georgia Medicaid plan. They are different products under the same parent company, and it is easy to be unsure which one your card is. The good news is that it does not matter here. We are in network with Ambetter and with every Georgia Medicaid CMO, including Peach State. Send our billing team a photo of your card when you book and we will verify the right plan.

Covered visits, and care that can continue when you need more

Preventive lactation coverage typically means minimal out-of-pocket cost depending on health coverage, and the preventive benefit is commonly described as six visits. Feeding challenges do not always fit inside that number. Because Breastfeed Atlanta is a multi-specialty lactation practice with nurse practitioners on our collaborative team, we can often continue your care through your plan's medical benefits after the preventive benefit is used. Our billing team verifies how your specific Ambetter plan handles this before your first appointment.

Classes, support groups, and your breast pump benefit

Ambetter covers our prenatal breastfeeding classes and support groups for most members, and most plans include a breast pump benefit. Our IBCLCs have advanced pump training, will help you choose a pump that fits your body and feeding plan, and our team handles the benefit paperwork. Start at our pump store and we will take it from there.

Billing stays in our office, start to finish

Our in-house billing team verifies your Ambetter benefits before you arrive, files every claim directly with your plan, and answers coverage questions themselves. We never route patients through third-party billing networks such as The Lactation Network. More detail is on our insurance and billing page, and if your family carries a different plan, see our Anthem and BCBS, UnitedHealthcare and UMR, Aetna, or Cigna pages.

Sandy Springs office visits, telehealth across Georgia

Visit us at our Glenridge Breastfeeding Center in Sandy Springs, or ask about a telehealth lactation visit from anywhere in Georgia. Marketplace plans differ in how they cover telehealth lactation care, so our billing team will confirm how your plan handles it when we verify your benefits.

Ambetter questions, answered