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Re: ACA - BCBS

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I noticed they specified a helper with a state-recognized certification. That would seem to allow them to *not* cover any private practice consultations at this time, since there is no licensing yet, so no state-recognized certification, unless they are defining that some other way. Would seem to only cover RN and MD consultations, such as in hospital or at the ped's office. And what about non-RN IBCLCs working in hospital? Would that also be disallowed? Hmmmm.

Dee Kassing

To: Sent: Tue, August 7, 2012 10:00:21 AMSubject: ACA - BCBS

This was posted to one of my local groups:For anybody with BCBS that was curious about the coverage, this is the fact sheet about what they'll cover under the Affordable Care Act and how electric & hospital grade pumps are excluded - http://www.bcbsnm.com/affordable_care_act/pdf/preventive_services_nm.pdf - this is for New Mexico, but they have the same fliers for Texas and Illinois.

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Dee, RNs are not mentioned -- only nurse practitioners which is an advanced practice nurse.

And you have to be an "in-network" provider.

Only manual pumps? Talk about CHEEP CHEEP CHEEP! (Maybe they are chicken to spend any more money....)

Jan

I noticed they specified a helper with a state-recognized certification. That would seem to allow them to *not* cover any private practice consultations at this time, since there is no licensing yet, so no state-recognized certification, unless they are defining that some other way. Would seem to only cover RN and MD consultations, such as in hospital or at the ped's office. And what about non-RN IBCLCs working in hospital? Would that also be disallowed? Hmmmm.

Dee Kassing

To: Sent: Tue, August 7, 2012 10:00:21 AMSubject: ACA - BCBS

This was posted to one of my local groups:For anybody with BCBS that was curious about the coverage, this is the fact sheet about what they'll cover under the Affordable Care Act and how electric & hospital grade pumps are excluded - http://www.bcbsnm.com/affordable_care_act/pdf/preventive_services_nm.pdf - this is for New Mexico, but they have the same fliers for Texas and Illinois.

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My understanding of what I read is that there will be " no cost sharing " for

those in network... There will be cost sharing for those who are not in network.

Meaning mother can choose to see someone out of network and pay some out of

pocket. As far as the " state " issue... Wouldn't that be our RLC? Which is

registered ...

Will be interested to see how this unfolds

D.

>

> This was posted to one of my local groups:

>

> For anybody with BCBS that was curious about the coverage, this is the fact

sheet about what they'll cover under the Affordable Care Act and how electric &

hospital grade pumps are excluded -

>

> http://www.bcbsnm.com/affordable_care_act/pdf/preventive_services_nm.pdf

>

> - this is for New Mexico, but they have the same fliers for Texas and

Illinois.

>

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