Are You Eligible for Insurance Breast Pump Coverage?

As a new mother, one of the most important questions on your mind is finding the right breast pump to assist with your breastfeeding journey. What’s more, you’re likely considering insurance breast pump coverage to help cover the cost of this essential piece of equipment.

In this article, we’ll discuss what you need to know about insurance breast pump coverage, including what it is, who’s eligible, and what types of breast pumps are covered.

What is Insurance Breast Pump Coverage?

A breast pump is a medical device used to extract milk from a lactating woman’s mammary glands. Breast pumps can be manual or electric and can vary greatly in terms of features, effectiveness, and price.

Insurance breast pump coverage is a provision of the Affordable Care Act (ACA) that requires most health insurance plans to provide breastfeeding support, counseling, and equipment at no cost to the patient. This includes coverage for breast pumps and their associated supplies, such as tubing, flanges, and storage bags.

Who is Eligible for Insurance Breast Pump Coverage?

All women with qualifying health insurance plans are eligible for insurance breast pump coverage. This includes those with private health coverage, Medicaid, and Medicare.

Under the ACA, insurance providers are required to cover the full cost of a breast pump and associated supplies if the plan is considered “grandfathered” or “non-grandfathered” and was created after March 23, 2010.

It’s worth noting that while insurance breast pump coverage is guaranteed under the ACA, insurance providers can choose to limit the types of breast pumps they cover. This means that not all breast pump models may be covered by insurance.

What Types of Breast Pumps are Covered?

Insurance providers are required to cover the cost of either a rental or a purchase of a breast pump – although the specifics on the type of breast pump covered may vary depending on your provider. Generally speaking, most insurance plans will cover either a manual or electric breast pump.

Manual breast pumps are generally less expensive than electric breast pumps, and they work by manually pumping a handle to extract milk. While these pumps can be effective, they can also be time-consuming and tiring to use.

Electric breast pumps, on the other hand, use an electric motor to extract milk from the breasts. These pumps come with a variety of features, such as adjustable suction and speed settings, and they are generally quicker and easier to use than manual pumps.

How to Get Insurance Breast Pump Coverage?

If you’re interested in obtaining insurance breast pump coverage, there are a few steps you’ll need to take. The first step is to check with your insurance provider to see what types of breast pumps are covered under your specific plan.

You’ll also need to obtain a prescription for the breast pump from your healthcare provider. This prescription will be necessary when filing a claim with your insurance provider to obtain coverage for the cost of the pump.

Finally, you’ll need to find a supplier that accepts insurance. Many suppliers of breast pumps offer an online form that can be used to verify insurance coverage and check on the models that are available to you.

FAQ

What if my insurance provider won’t cover the breast pump I want?

If your insurance provider won’t cover the breast pump you want, you may have a few options. First, you can try to appeal the decision with your insurance provider or look into other breast pump models that are covered.

Second, you can purchase the breast pump out of pocket and file a claim with your insurance provider for reimbursement. Keep in mind that reimbursement may not cover the full cost of the pump.

Do I need a prescription for an insurance breast pump?

Yes, you’ll need a prescription for an insurance breast pump. This prescription can be obtained from your healthcare provider.

Can I get an insurance breast pump before my baby is born?

Yes, you can typically obtain an insurance breast pump before your baby is born. In fact, many insurance providers recommend that you start the process of obtaining a breast pump before your due date.

How often should I replace my breast pump?

The frequency at which you should replace your breast pump will vary depending on the model and how often you use it. Some insurance providers may cover the cost of a new breast pump after a certain period of time, such as every six months. However, if your breast pump is no longer working effectively or if it shows signs of wear and tear, you should replace it as soon as possible.

Conclusion

Insurance breast pump coverage is an essential benefit for new mothers. By understanding what types of breast pumps are covered, who’s eligible for coverage, and how to obtain coverage, you can make the most of this important benefit and ensure that you have the right tools for a successful breastfeeding journey.