Our Journey with anthem/BCBS
How Advocacy, Community, and a Lot of Grit Changed Access to Lactation Care in Virginia
In July of 2025, we received news that completely knocked the wind out of us.
We learned that The Lactation Network would no longer be accepting Anthem and BCBS plans. Just like that, we were left with more questions than answers. Prior to this, IBCLCs were rarely given the option to be directly in-network with Anthem and BCBS plans, which is why TLN’s ability to bill these plans out of network had been so significant. It allowed us the opportunity to work with them and provide care to so many families who otherwise would not have had access.
Here in Richmond, about half of our clients rely on Anthem and BCBS coverage. Immediately, everything started spinning.
How are we going to support these families? How are we going to keep our business running? What about our employees, these incredible women who have trusted us and who show up every single day providing beyond exceptional care to our community? Are we going to stay afloat?
Honestly, there were moments where we truly did not know what the future of Coming Home would look like in the coming months.
The Email I Will Never Forget
I vividly remember the night I read the email from TLN stating that this change would go into effect with two weeks’ notice.
I texted Katie asking if she had seen it. This is exactly why I try not to check work emails before bed. Nothing good ever comes from it. We immediately got on the phone and talked for over an hour. There was shock, disappointment, confusion, grief, and a whole lot of “what if.”
We both admitted that we were scared. Not just for the business- but for our employees, our community, and for ourselves! We had grown to love the work we do. Supporting moms and families in a way the traditional healthcare system often misses. Being able to show up in their homes during the earliest postpartum weeks, when they are healing, exhausted, and overwhelmed, and when the last thing they need is another appointment to leave the house for. This work is about real people showing up in the hardest moments, and making sure moms feel seen and supported, not overlooked once the baby arrives. The idea that everything we had worked for over the past four years could simply disappear was devastating.
Hard Conversations Everywhere
Within days, we had to start having really hard conversations.
With our employees, being transparent while also admitting that we did not yet have answers. It is hard to run a small business like ours, where the only way we make money is by providing hands-on services, and insurance coverage plays such a massive role in access.
With our clients, current, former, and future, many of whom were disappointed and confused themselves.
And with ourselves. Real, honest conversations with each other and with our spouses about what we would actually do if Coming Home could not come back from this. We had seen small, private practices close under circumstances far less than this, and we were honestly worried about what this could mean for our futures and for our own families.
I remember Hannah and I had lunch scheduled just to catch up as friends. It was only a day after we had received the email from TLN. Instead of an easy, lighthearted lunch, it turned into us sitting there crying together about what was happening with Anthem and what it could mean for all of us.
We held an emergency meeting with the rest of our team, asking for patience and grace while we tried to figure out what this all meant. Every single person on our team was incredibly thoughtful and supportive. They offered advice, shared ideas, and were ready to spring into action wherever we felt was needed. It was yet another reminder of why we admire and value each of the hand-picked women who make up the Coming Home team.
Scrambling, Pivoting, and a Community That Showed Up
Over the next couple of months, we scrambled because we had to. If there is one thing I have learned from owning a small business, it is that sometimes you have to get really creative and put yourself out there. The worst anyone can ever say is no, but the best thing they can do is come alongside you, and that is exactly what happened.
We reached out to RVA Chiro and Wellness, and Dr. Lisa was immediately willing to help, allowing us to use office space so Anthem families could be seen with a lower out-of-pocket cost.
We established a partnership with Complete Care for Kids so we could continue seeing Anthem clients in their office.
We got creative and began offering package options and payment plans because, as many of you know, breastfeeding, pumping, and feeding challenges take time. We so desperately wanted families to be able to afford the care we knew they needed. And truly, God bless our assistant Kasey. She was bombarded with texts and emails as we rolled out new ideas and new offerings for clients, often in real time. She kept up with all of it with grace and patience, and we could not have gotten to where we are today without her.
All of this helped, but it was not the same. Not like it had been before July. Prior to that, we were booming and in the middle of building our team with the addition of Savannah. We were beyond excited to continue growing our team with the most thoughtful and smart providers we knew, and the sudden shift made the contrast feel even heavier.
The Panera Moment
In September, Katie and I were sitting in Panera during one of our weekly business meetings. I remember feeling especially drained that day. The world felt heavy, like every day brought another tragedy we were somehow expected to tolerate and move on from.
That frustration spilled into our ongoing conversations about Anthem and the fact that IBCLCs still were not allowed to be in-network providers in Virginia.
Katie said, almost casually but with so much passion, “Why don’t we start a petition?” It felt like the confidence boost I didn’t even realize I needed, a reminder that maybe we could still do some good in the world in that moment.
I was immediately on board. At the same time, both of us said out loud what we were probably thinking in the back of our minds. We are a small business in Richmond, Virginia. Would this really make a difference? But we figured it was worth trying. It felt like a hopeful step forward, the one thing we had not yet tried after months of looking for answers and doing everything we could.
Katie got to work and created a petition using the Change.org signature platform, attaching a clear explanation of the loss of Anthem and BCBS coverage and what that meant for access to lactation care across our community. We shared it with family, friends, clients, and our broader community. You can read and view the petition here. Before we knew it, we had over 1,000 signatures.
That is when things started moving fast.
When Everything Accelerated
A local CBS reporter, Melissa Hipolit, reached out after seeing the petition. What followed honestly felt like a blur.
We spoke on a Tuesday. By that Friday, we had a possible interview scheduled with a former client who had previously been covered by Anthem.
Wednesday & Thursday, Anthem began calling me directly after Melissa reached out to them for a statement.
One question the Anthem representative asked me still sticks with me.
“So why won’t we go in-network with you?”
I remember responding without hesitation, “I am not sure. You tell me.”
She said she was going to investigate and call me back.
Friday Morning, The Call
Friday morning came, and everything felt like it was on pause. We did not yet know if the interview was actually going to happen.
I had a physical therapy appointment scheduled that morning. I remember telling my PT, “I am probably going to need to be on my phone while you dry needle and work on my hamstring.”
Sure enough, while I was laying there face down with needles in my leg, my phone rang.
The Anthem representative said, “Kelsey, I am currently in a big meeting with a lot of people, and we are all talking about you.”
She explained that Anthem was going to make a change. They were going to allow IBCLCs in Virginia to become in-network providers.
I remember saying, “Just like that? You are just going to change it?”
She simply responded, “Yes.” And in that moment, my mind started racing. Why did this suddenly seem so easy, when so many lactation consultants had been fighting for this for years? Why now? What made this particular Anthem representative care enough to push it forward? And what would this actually mean for us? The questions kept coming, spilling over one another as I tried to process what was happening.
I was completely stunned.
Watching It Happen in Real Time
I immediately called Melissa, and we decided to move forward with the interview that afternoon.
I ran home, got ready, and logged into Availity, the site where providers apply to become in-network.
And there it was.
An option that had never existed before. IBCLC, Anthem in-network.
I could not believe it. Years of this being impossible, and now it was happening in real time.
That afternoon, we met at the home of a former client, Rebecca Saur, and her sweet son Theo. Melissa interviewed us about everything that had led to that moment, including the phone call that had happened just hours earlier.
The interview aired later that week and included both a written article and a televised segment through CBS. The coverage highlighted what the loss of Anthem and BCBS coverage meant for families trying to access lactation care in our community. You can read and watch the CBS coverage here.
Later that day, someone from Anthem did exactly what they said they would. They called and walked me through the application process. I submitted applications for all four of our IBCLCs.
And then we waited.
The Not So Pretty Part, Insurance Reality
As anyone who has dealt with insurance knows, nothing moves quickly.
The next few months were filled with phone calls, emails, and the realization that we needed help. We hired a biller who specialized in lactation coding and billing. Despite how much I try to figure things out on my own, this was way over my head.
Even our biller was honest. Reimbursement rates with Anthem were largely unknown. We were some of the first IBCLCs in the country working directly in-network with them.
The reality was sobering. We waited well over a month to get our contract with Anthem explaining rates and codes. Some reimbursement rates were as low as $15 for certain codes. Yes, $15 for a one to two hour in-home visit with a highly trained provider.
With only two to four usable codes available to IBCLCs, Katie and I had to be extremely thoughtful. We had employees to pay and a business to protect.
Where We Landed, For Now
After a lot of discussion, we decided on a temporary plan.
Clients pay upfront for in-home visits, and we reimburse once Anthem reimburses us.
In-office visits are offered at no upfront cost, thanks to the incredible generosity of Dr. North at Bitty Bites Pediatric Dentistry, a partnership we are endlessly grateful for.
Our goal is to eventually move away from upfront costs altogether. Until we have more data, this is the only way we can continue offering the level of care we believe families deserve without putting the business in a risky financial position.
Balancing all of this while being a present mom, wife, and provider is exhausting. We are endlessly grateful for our supportive husbands. We love you, Nate and Phil. A soapbox for another day, but the importance of a supportive spouse in the midst of running a business cannot be overstated.
Where We Are Now
We officially began seeing Anthem and BCBS clients at the start of the new year. While we are still gathering data, we are hopeful.
We are incredibly proud to be the first IBCLCs in Richmond, Virginia to be in-network with Anthem and BCBS. Even more meaningful is knowing that this advocacy opened doors for IBCLCs across the state.
We have heard from providers in Charlottesville, Virginia Beach, Roanoke, and beyond, all expressing gratitude for the work that expanded access to care.
This journey has been overwhelming, exhausting, emotional, and humbling.
And I would not change any of it.
Because every mom and baby deserves access to thoughtful, compassionate, skilled care, and we will keep fighting to make that happen.
-Kelsey
