Protect Your Lactation Coverage
UnitedHealthcare is proposing changes that could limit your lactation coverage.
Here’s what’s happening, why it matters, and what you can do.
⏰ Deadline to Object: September 1, 2026
What Is Changing?
UnitedHealthcare has proposed new restrictions to HCPCS code S9443, the billing code used for lactation counseling. Starting September 1, 2026, they plan to:
• Only cover lactation visits for members aged 9 through 64, which excludes newborns and infants from coverage entirely.
• Limit reimbursement to one lactation session per day, regardless of clinical need.
Their stated reason is to “align with CMS (Medicare) policy.” However, this code is not recognized or reimbursed by Medicare at all. There is no CMS policy to align with.
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Why This Matters for You
Your baby may lose coverage
Your IBCLC provides care for both you and your baby during every visit. She weighs your baby, watches your baby feed, and assesses your baby’s latch and intake. Removing infant coverage does not just reduce a billing line. It removes the clinical reason for the visit.
One session a day is not always enough
Newborn weight loss, latch difficulties, low milk supply, tongue tie, and other common issues sometimes require more intensive support. A blanket one-session-per-day restriction ignores clinical reality and can lead to premature weaning.
Breastfeeding support is a protected benefit
Under the Affordable Care Act and HRSA Preventive Care guidelines, comprehensive lactation support must be covered without cost-sharing for women and newborns. These proposed restrictions may conflict with that mandate.
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What You Can Do Right Now
1. Copy the letter below and personalize the sections in brackets with your name, member ID, and a brief note about your experience.
2. Mail or fax it to UnitedHealthcare at the address below. Mailed letters carry real weight.
3. Share this page with any UHC member who has used or is currently using lactation support. Every letter counts.
Mail your letter to:
UnitedHealthcare
Attention: Member Services / Appeals and Grievances
P.O. Box 31364
Salt Lake City, UT 84131
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Your Copy-and-Paste Letter
Personalize the areas in [ brackets ] before sending. The optional personal section in the middle is the most powerful part, so please add your story if you are able.
[Today’s Date]
UnitedHealthcare
Attention: Member Services / Appeals and Grievances
P.O. Box 31364
Salt Lake City, UT 84131
RE: Formal Member Objection to Proposed Lactation Coverage Changes, HCPCS Code S9443
To Whom It May Concern:
My name is [YOUR FULL NAME], and I am a UnitedHealthcare member (Member ID: [YOUR MEMBER ID]). I am writing to formally object to the proposed changes to how UnitedHealthcare reimburses for lactation counseling services under HCPCS code S9443, effective September 1, 2026.
I understand that UnitedHealthcare intends to restrict coverage to members aged 9 through 64 only, and to limit reimbursement to one lactation session per date of service.
These changes will directly harm my ability to access medically necessary lactation support. Here is why I am asking you to reconsider:
Lactation care involves both the parent and the baby. My International Board Certified Lactation Consultant (IBCLC) assesses, weighs, and observes my infant during every visit. The care cannot be separated into “parent only” without removing the clinical value of the encounter entirely.
One session per day is not always clinically sufficient. Breastfeeding complications, including latch difficulties, low milk supply, tongue tie, and newborn weight concerns, sometimes require more intensive support. Limiting visits to one per day without clinical exception creates a barrier to medically necessary care.
The stated justification is inaccurate. UnitedHealthcare states these changes align with CMS policy. However, HCPCS code S9443 is not recognized or reimbursed by Medicare, and has not been since 2007. There is no CMS policy to align with.
Breastfeeding support is a federally protected preventive benefit. Under the Affordable Care Act and HRSA Preventive Care guidelines, comprehensive lactation support must be covered without cost-sharing for women and newborns. These restrictions may be inconsistent with those requirements.
[OPTIONAL — PERSONALIZE THIS SECTION: I am currently receiving lactation support because (describe your situation, for example: my newborn had difficulty gaining weight, I had a painful latch, I needed help maintaining supply after returning to work). This care has been essential to my health and my baby’s health, and restricting it would cause real harm to my family.]
For these reasons, I am formally requesting that UnitedHealthcare:
• Withdraw the proposed restrictions to HCPCS code S9443 coverage.
• Continue to reimburse lactation services as provided to both the parent and the infant.
• Allow clinical necessity, not blanket session limits, to determine the appropriate frequency of care.
• Provide the specific regulatory citation supporting the stated alignment with CMS policy.
Please confirm in writing that this objection has been received and logged. I am prepared to escalate this concern to my state insurance commissioner and my employer’s benefits administrator if necessary.
Thank you for your attention to this matter.
Sincerely,
[Your Signature]
[Your Printed Name]
[Your Address]
[Your Phone Number / Email]
[Your UHC Member ID]
Questions?
If you have questions about how these changes might affect your care at Honeysuckle & Pearl, or if you need help understanding your UHC benefits, please reach out. We are here to support you.
Honeysuckle & Pearl, Holistic Lactation Consulting
340 Hwy 171, Lake Charles, LA 70611
