Mandatory that insurance pays for breast pumps!

[~Brandy~]

I shared this on another thread but thought I would post this for those that dont already know. The obama care act requires insurance companies to cover your breast pumps.

I ordered mine from Lucinacare but there are other sites as well that will do the submitting to insurance for you and you dont have to do the leg work.




New Healthcare Coverage for Breast Pump Insurance!



Affordable Care Act Begins (ACA)

Lucina Care is pleased to announce that the Affordable Care Act that was signed into law last year by President Obama and is already taking effect! This is great news because this new law makes it mandatory for insurance companies to provide breast pump insurance for new mothers!

The benefits of breastfeeding to both the mother and her newborn infant have been well documented for many years by expert healthcare professionals. Breast milk enhances the child’s immunity system, provides better nutritional value than baby formula, and even reduces the occurrences of diseases, such as childhood diabetes, asthma, respiratory infections, and even obesity. Breastfeeding also helps the new mother to drop some of the excess pregnancy weight in a much faster period of time.

Lucina Care has always known the many benefits and advantages of breast milk, and now the insurance companies are required to provide assistance to new mothers by increasing your coverage to include breast pump insurance as an additional benefit! In most cases, there will be no additional costs, co-payments, or deductibles to the family as well.

In accordance with the ACA and your healthcare insurance provider, new mothers can now acquire a double electric breast pump and the necessary supplies through Lucina Care. The below list of approved insurance companies have already agreed to partner with us to provide these valuable new services.

If your healthcare insurance provider is not already identified on the list below, contact us immediately to ask if you can use our services as an out-of-network provider for these new and necessary medical benefits! It is also possible that you can get a financial reimbursement from your healthcare insurance provider by simply submitting a receipt from Lucina Care. Breast pump insurance programs are currently covered be these following providers:

Aetna
United Health Care
Tricare West
Humana
Pomco
If your insurance company is not listed above, please call us. We will contact your provider.

888-809-9750



The site to order https://lucinacare.com

 

[MoBaby]

Also with BCBS. There are only certain makes and models. How did you order it before the baby came and have it paid for?

 

[~Brandy~]

I just placed the order through Lucinas site and entered insurance information. I didnt have to supply them with anything else. They took care of all of it.

 

[Night Flower]

THANKYOU!

I'll look into this. I definitely want to breast feed. And when I go back to work, offer breastmilk via bottles.

 

[hmusgrove]

wow that's great!!!! thank you for sharing this information does every single insurance have to pay for it?

 

[~Brandy~]

wow that's great!!!! thank you for sharing this information does every single insurance have to pay for it?

Yes, it is part of the Obamacare. There isn't a restriction on what type of breast pump it has to be but they MUST pay for one for you.

Aetna is the insurance I have and they have purchased my pump and it was 300.00

 

[Jessica_MTY]

edit - previous post wrong

great news for US mamas!

 

[BrandysBabies]

Does medicaid have to pay for them as well?

 

[birdlee337]

Interesting! I'm going to have to look into this!

 

[~Brandy~]

Does medicaid have to pay for them as well?

Yes, I saw people talking about it at another place online. They ordered from Edgepark. Below is a link and a copy/paste that might help you.

https://www.edgepark.com/faq/breast...nt_annoucements&utm_campaign=breast_pump_faqs

New Legislation

What's the new legislation about breast pumps?
The U.S. Department of Health and Human Services (HHS) has adopted guidelines for several woman-specific health services to be covered by health plans. These services include "breastfeeding support, supplies, and counseling." According to the HHS Web site Healthcare.gov, "Pregnant and postpartum women will have access to comprehensive lactation support and counseling from trained providers, as well as breastfeeding equipment." The Web site adds: "Breastfeeding is one of the most effective preventive measures mothers can take to protect their health and that of their children. One of the barriers for breastfeeding is the cost of purchasing or renting breast pumps and nursing-related supplies."

What does this legislation mean to me?
This means that commercial health providers are now required by law to allow breast pumps as a covered expense for lactating women. There is some variation around co-pays, depending on your insurance carrier and plan.
Ordering Details

How do I get a breast pump through Edgepark?
When it comes to helping customers get their supplies, Edgepark tries to make the experience as easy and hassle-free as possible. Here's how the ordering process works:
Please call us at 1-800-321-0591 (Mon-Fri 8am-5pm, EST)
An Edgepark customer care specialist will ask for your health insurance plan information (policy number and insurance phone number) and your doctor's information, including his or her name and phone number.
Edgepark will then contact your health insurance and doctor on your behalf to confirm coverage and complete your order. If there is an amount due, Edgepark will contact you to confirm your coverage. Be aware, many insurance companies won't cover breast pumps until the baby is born.
Your equipment is sent right to your door free of charge after order processing (order processing can take up to 5 days for first-time orders, then 1-3 days shipping).
What's the best way to contact Edgepark about the status of my breast pump order?
Please note that it can take up to two weeks for Edgepark to verify your insurance, obtain a valid prescription and process your order for shipment. Edgepark will contact you if additional information is required. In the event you still need to contact a customer care specialist, call 1-800-321-0591 from 8 a.m. – 5 p.m., Monday through Friday.

What are the advantages of ordering my breast pump through Edgepark?
Edgepark handles contacting both your insurance provider and your physician on your behalf. This usually means your breast pump is shipped to you with minimal or no out-of-pocket expense and arrives at your door in approximately one week's time.

How soon before the delivery of my baby and how late after their birth can I order a breast pump?
Depending on your insurance plans guidelines, we can provide a breast pump to you up to 30 days prior to your baby's date of birth and up to 12 months after delivery. United Healthcare Plan members, please be aware that United Healthcare requires your baby to be born prior to receiving a breast pump.

Which breast pumps are available from Edgepark?

View Breast Pumps

Do I need to get a prescription from my doctor before calling Edgepark to place my order?
If you have a paper copy of a prescription, it will help us process your order more quickly if you can scan and e-mail a copy to [email protected] or fax to 330-963-6839 after you have placed your order.

If not, an Edgepark Customer Care Specialist will reach out to your doctor during the order verification process on your behalf. In the event your Physician does not respond in a timely manner, we may contact you for assistance in securing a prescription.

How soon will I receive my breast pump after placing my order with Edgepark?
This will vary. Commercial insurance providers require a "verification process" where an Edgepark Customer Care Specialist verifies your doctor's information and diagnosis by calling his or her office and your health insurance provider to verify coverage. This process takes between 3-5 business days.

If the breast pump you requested is approved through your health insurance without additional co-pays and currently in stock, then you will receive your order (usually within a week of calling).

If the breast pump you requested is not approved through your health insurance and/or there are additional co-pays, we will call you to determine next steps. At this point, you may elect to cancel your order or submit payment information.

Can I return my breast pump if it did not meet my needs?
Breast pumps are non-returnable.

 

[MoBaby]

You'll have to call about Medicaid coverage. It can vary by state. I'd call your Medicaid provider or wherever claims are submitted to and inquire there. Wic may cover the pump if you have that also.

 

[wannabemom84]

Yea it is true..I have Carefirst BCBS and I inquired and they gave me the suppliers that they deal with. It was three different sites/numbers. I got the Hygeia double electric with only really needing to send them a prescription from my doctor and my insurance info. It was mailed the next day. I am 18 weeks. I didn't know how long it would take so I called early..but I got it way faster than I expected lol.

 

[overcomer79]

beware I think it is only after you meet your deductible. I think mine has to wait until after baby is born before they will cover it.

 

[MoBaby]

As far as what I read it had to be covered 100% with no cost sharing per the aca so it shouldn't matter if your deductible is meet or not.

 

[jenmcn1]

Wow that's impressive that something good is actually coming out of Obamacare. I've only heard negative things so far. So that's great!

 

[Melly Belly]

This thread actually prompted me to get the information to call my ins co, because my insurance plan changes in jan, so if i can get my pump earlier, yay...if not i think they still do cover it also

 

[overcomer79]

It makes me wonder...I'm doubly insured if I can pick which oe to go through like I do my meds.

 

[ltrip84]

I called and asked my insurance about this about a month ago. They told me they cover it 100% and it doesn't matter whether or not I meet my deductible it will be covered 100% no matter what. They also told me that I can not obtain a breastpump until after I give birth. I was afraid since they are "free" they might be cheap ones, but from the ones I have to choose from, they seem to have the really good hospital grade double electric pumps. I have United Healthcare.

 

[~Brandy~]

It makes me wonder...I'm doubly insured if I can pick which oe to go through like I do my meds.

I have double coverage as well. However, since the first insurance covers at 100% I didnt have to submit to secondary.

 

[~Brandy~]

I called and asked my insurance about this about a month ago. They told me they cover it 100% and it doesn't matter whether or not I meet my deductible it will be covered 100% no matter what. They also told me that I can not obtain a breastpump until after I give birth. I was afraid since they are "free" they might be cheap ones, but from the ones I have to choose from, they seem to have the really good hospital grade double electric pumps. I have United Healthcare.

You can order from lucinacare.com ahead of time if you have united healthcare. That site will take care of all the contacting of the insurance and such as well. They told me via email they can ship it the same month as your due date that it didnt have to be after delivery.