When you’re exhausted, sore, and worried about feeding, the last thing you need is a prior authorization, a surprise denial, or a visit cut short because a plan only “approved” 30 minutes.

I’m Donna Kimick, IBCLC, and Lakeshore Lactation is a private-pay, home-visit practice serving Nassau and Suffolk County. I don’t bill insurance directly. Here’s why — and what that means for you.

Care that fits your baby, not a billing code

A thorough home visit often runs well over an hour. We look at latch, transfer, milk supply, pumping, pain, sleep, and everything else going on in your household that day.

Insurance plans often:

Cap visit length
Limit how many visits they’ll cover
Decide which diagnoses “count”
Dictate documentation that has little to do with what you actually need

When I’m not chasing codes, I can stay until we have a real plan — not until the clock the insurer set runs out.

Home visits don’t fit the insurance mold

I come to your home in Nassau or Suffolk — your couch, your pump setup, your other kids underfoot. That’s different from a quick clinic stop, and plans rarely price or credential that kind of care fairly.

Private pay means:

No waiting on prior auth when feeding is falling apart tonight
No “we’ll see if it’s covered” after you’ve already had the visit
Transparent fees you know before I walk in the door

New York’s licensing gap is real

In New York, IBCLCs are highly credentialed — but we’re still not a standard licensed provider type for most insurance networks. Many plans won’t contract with private-practice IBCLCs at all, or they reimburse so little that sustainable home visits become impossible.

That’s a system problem, not a reflection of whether lactation care is medically necessary. It’s also why I’ve been involved in advocacy for lactation consultant licensure in New York: families deserve coverage that matches real clinical care. Until that system works, opting out of direct billing is how I keep showing up for Long Island families now. In the future, I’m hopeful that insurance will become fairer for private-practice IBCLCs, so families can use their benefits with providers like me.

You stay in the driver’s seat

Payment is due at the time of service. After your visit, I can provide a detailed superbill (itemized receipt with the codes insurers usually ask for) so you can submit it yourself for possible out-of-network reimbursement.

A few honest notes:

Some plans reimburse well; some reimburse partially; some reimburse nothing
Reimbursement is always the insurer’s decision — I can’t guarantee it
I’m happy to help with documentation; the claim itself is yours to submit

If cost is a barrier, ask me about sliding-scale or a payment plan. Access matters more than paperwork.

What you’re paying for

You’re not paying for a 15-minute pep talk. You’re paying for:

Over two decades as an IBCLC
Unhurried clinical assessment in your home
A clear feeding plan you can actually follow
Follow-up support and coordination with your pediatrician, midwife, or OB when it helps
Care aimed at protecting breastfeeding — not steering you to formula because “another visit isn’t covered”

Bottom line

I don’t take insurance so I can practice lactation care the way it should be practiced: in your home, on your timeline, guided by what you and your baby need — not by what a plan will approve.

If you’re in Nassau or Suffolk and want that kind of support, I’d love to hear from you.

— Donna Kimick, IBCLC
Lakeshore Lactation