Lactation coverage for Sana Benefits in Houston and San Antonio
We are direct in-network providers with Sana Benefits. Sana operates as a “No Network” plan, so no referrals or preauthorizations are required for our visits. Sana applies annual visit limits and a non-covered infant fee, so most patients have some out-of-pocket cost. Verification puts your estimated out-of-pocket cost in writing before you book.
How we work with your insurance
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You submit the intake form
Tell us about your plan and what is going on with feeding. The form is HIPAA compliant and routes directly to our billing team.
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We verify your benefits
Our billing team confirms your Sana coverage is active and in good standing. No referrals or preauth steps required.
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You get a written estimate
Before your first visit you receive an email confirming coverage and your estimated out-of-pocket cost.
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We file the claim
After your visit we submit the claim to Sana. If anything is owed (a home-visit travel fee, for example), it is billed to the card on file.
Plan-specific details for Sana patients
No referrals or preauthorization
Sana operates as a “No Network” plan, which means no referrals or preauth steps are required for lactation visits. You can book directly after your verification email confirms active coverage.
Visit limits apply, like Aetna
Sana covers a set number of lactation visits per year. Once you reach that limit, additional visits have out-of-pocket costs. Verification confirms how many visits your plan allows and your estimated cost before you book.
Mom and baby billing
Sana pays a single claim per visit, mom or baby, not both. We bill the lactating parent under the lactation benefit and apply a non-covered infant fee for the baby’s portion. Verification confirms the estimated amount before you book.
Home-visit travel fee is patient-billed
The lactation consultation portion of a home visit is billed to Sana. The $70 home-visit travel fee is billed directly to your card on file and not submitted to insurance.
Direct in-network, not via Aetna
We are in-network with Sana Benefits directly through our own contract. Sana members sometimes see Aetna logos in plan documents because Sana works with various networks for different services, but lactation visits with us bill direct to Sana.
What Sana coverage looks like with us
Typically covered
- Initial postpartum lactation consultation (in office)
- Follow-up lactation visits
- Tongue-tie and oral function assessment
- Pumping and back-to-work consultation
- Home visits
Patient-billed regardless of plan
- Home visit travel fee ($70)
- Late-cancellation and no-show fees
- A non-covered infant fee (the baby’s portion)
- Out-of-pocket costs after you reach your plan’s visit limit
- Visits during periods of inactive coverage
- Chiropractic care, bodywork, and laser therapy are cash-pay services, not billed under your medical plan
Confirming what your specific plan covers is the point of the verification step. Sana is generally one of the most predictable carriers we work with, but verification still confirms active coverage before your first visit.
Sana-specific questions
Do I need a referral for a Sana lactation visit?
No. Sana is a “No Network” plan, which means no referrals or preauthorizations are required for our visits. Submit your intake form, complete verification, and book.
Will I have any out-of-pocket costs?
Most likely, yes. Sana pays a single claim per visit, so the baby’s portion is billed as a non-covered infant fee, and after you reach your plan’s annual visit limit, additional visits have out-of-pocket costs. The home-visit travel fee ($70 if you choose a home visit) and any cancellation or no-show fees also apply. Verification puts your estimated out-of-pocket cost in writing before you book.
My Sana card mentions Aetna. Are you billing through Aetna?
No. We bill Sana directly through our own in-network contract with them. Sana works with various network partners for different services, which is why Aetna or other names may appear on plan documents. Lactation visits with us go directly to Sana.
Do I need to wait for my insurance to be verified before booking my appointment?
No. You can book your appointment before your insurance is verified. As long as you submit your insurance information at least 1–2 business days (Monday through Friday) before your appointment, our team will have enough time to verify your coverage prior to your visit. If you are submitting the day before your scheduled visit, please submit by 3 PM so we have time to verify.
If we discover that your plan is not covered or has unusual restrictions, we will notify you by email and text message. If you decide to cancel your appointment due to lack of coverage, we will waive the cancellation fee as long as you request cancellation on the same day we notify you.
Have a different carrier?
We are in-network with these as well.
Ready to Get Started?
Request your appointment, and we’ll verify your insurance benefits before your visit.
Request Appointment Opens our secure intake form in a new tab.