Breast Pumps covered by Health Insurance (U.S.)

[Rona]

Hi ladies, how's everyone. I used Aetna and get 100% coverage also. Just received mine yesterday. She said it will take up to 6 weeks but got mine less than 10 days. You can upgrade with additional payment which I did. They have few choices including Medela, I want the In Style so I topped up $58. Aetna have few online places you can order. I called them rather than email. I used Sunmed.

Here the link, scroll down to see where you can place the order:

https://www.aetna.com/individuals-f...thier-living/womens-health/breastfeeding.html

 

[BubblesBump]

Does anyone live in Michigan and got a free breast pump? I have Blue Cross Complete of Michigan (medicaid), does anyone else have this insurance and had it covered?

 

[Cala]

My insurance (Blue Shield PPO) as of right now, it has to be deemed medically necessary in order for them to cover a breast pump. Also, once the baby is discharged from the hospital, the breast pump is no longer covered. So in order to qualify baby would have to be in the hospital with medical issues that required feeding from a bottle through breast pump and that pump would have to be acquired before the baby is discharged.

My insurance is usually fantastic, but they are behind on this one.

 

[DLA]

OMG! THank you so much for this thread! I just called my insurance company and sure enough BFing supplies are covered in full (except for the pump, it caps out at $75). This is so amazing! I wish they had this when I had my son. They even reimburse you for child prep or BFing classes or if you use a lactation consultant! Amazing!

 

[HappyBunnyAB]

Thank you for posting this! I have Blue Shields and I get one too but when I called they said I needed a prescription. I'm assuming my OB would be the one to give me one. I'm going to ask him on my next appointment.

 

[Bethi22]

Every US insurance will cover some form of breast pump you just need to contact them.

 

[surprisedmama]

Our plan is grandfathered in so they are not required to provide that benefit to us.

But, they will give us a pump if we complete all of our prenatal appointments and our postpartum appointment. It's the Medela Pump in Style Advanced.

 

[Calibeachbum]

What!!! I'll have to check if Kaiser Permanete offers this!

I have Kaiser, I will be stalking this thread.

 

[Calibeachbum]

Just called Kaiser and they cover breast pumps. The lady on the phone even said they had some recent changes which are good. My just needs to write a rx. Thanks for posting because the last time I checked they did not cover breast pumps!

 

[calliebaby]

I have ODS and a pump is covered at 100% as long as I buy it from a medical supply company or a hospital.

 

[Cala]

Every US insurance will cover some form of breast pump you just need to contact them.

I contacted mine today, posted earlier, and they only cover it if medically necessary if the mother is discharged before the baby and the baby is in need of her breast milk through a pump. Other wise, if mom and baby go home, it isn't medically necessary to have a breast pump and it isn't covered.

 

[Gabi1787]

I have BCBS PPO and called about a week ago, they cover one 100% and there are 4 options you can choose from. I just got mine today, Medela Pump In Style Advanced Backpack!

 

[Guppy051708]

I have a congenital condition that doesn't allow me to produce enough milk.(Insufficient Glandular Tissue). My health insurance (Anthem Blue Cross Blue Shield of Massachusetts, PPO), said they would only cover a breast pump if there was a medical condition that warrented it. Obviously i was covered, but other coworkers that my husband works with (our insurance is privately funded through his employer), they could not get insurance to cover it bc they didn't have a medical reason. I did have to pay my deductible/coinsurance, but in the end it only costed me $19.99. I also had to get a diagnoses (which i had since BFing DS1) as well as prescription. I was limited to medical supply stores. Also, i was not allowed a hospital grade pump. I did get a pump that was about $220, but it wasnt hospital grade (those are thousands of dollars, so i can't say im surprised but with my condition it would have been nice lol)

For those of you who can't get insurance to cover one (it's always worth finding out!), if you have a FSA or an HSA account, by law it is a covered expense. So that would be another way to fund it.

The last option, you can pay out of pocket for it (which stinks bc you have to come up with the funds), BUT breast pumps are now a legal tax deduction! So that would help. It wouldn't help much until tax season but at least it could help in some way.

 

[wristwatch24]

Thanks for this post! I called my insurance company today and they told me I needed a prescription from my doctor for a pump, and I have to order the pump from some sort of specialty medical supply place (he provided me with a phone number) and that they cover up to $178.50. I have a strong feeling that when I call this medical supply company all of the pumps will be well over this amount, but we will see! My mom already bought me a pump, but I could always return it if I am able to get a good pump that is less than or only slightly more expensive than the covered amount through this medical supply company.

 

[CastawayBride]

Every US insurance will cover some form of breast pump you just need to contact them.

I contacted mine today, posted earlier, and they only cover it if medically necessary if the mother is discharged before the baby and the baby is in need of her breast milk through a pump. Other wise, if mom and baby go home, it isn't medically necessary to have a breast pump and it isn't covered.

This is true, BCBS told me about it when I called to tell them I was pregnant and to make sure I was going about everything right in terms of notifications.

The companies that are NOT covering them are under a grandfather clause. They basically got an extension before they have to comply, this was instituted along with the new Obama care rules.

 

[Bethi22]

Aww that stinks... I had Aetna until last month (they were covering a double electric Medela) and my husbands company switched insurance so I now have Premera and got all worried... just what I need at 8 months pregnant is new insurance, lol. Turns out, I can get get any pump I want and they'll reimburse me 90%. Good deal!

 

[bella21]

FYI ladies if anybody has or plans on getting WIC they will also provide you with a free pump so if your insurance doesn't cover it then always an idea to try through them