If you’re a mom, and chances are you wouldn’t be reading this otherwise, then you’ve probably heard by now that the Affordable Care Act (aka Obamacare) has a provision to cover breast pumps for new mothers.  That is one gigantic high-five for breastfeeding women all over the country, considering how important it is for some women to pump regularly.  Not all mothers need to use a breast pump, but for some moms having a good pump can be the difference between breastfeeding and NOT breastfeeding.  As a full-time working mom, I definitely would not still be breastfeeding my 6-month-old if it wasn’t for my double electric pump.

My pump of choice: the Medela Pump-in-Style double-electric

A good pump does not come cheap.  Many popular double-electric pumps can cost as much as $300-$400, with hospital-grade pumps going much higher.  Being able to use health insurance to cover that cost is a huge relief for many families on a budget.  But let’s be honest, life is complicated enough as a new mom without having to navigate the rules and regulations of health insurance coverage.  To help you take advantage of the new law, I’ve done a little research for you.

Your first step is to contact your insurance plan’s member services department to find out what you are entitled to under your plan.  Most providers have a toll-free number (usually on the back of your insurance card) that you can call to find out more about your coverage and benefits.  Here are some questions you should ask:

–       What type of pump can you get (hospital-grade, manual, electric, etc.)?

–       What brands can you choose from (Medela, Ameda, etc.)?

–       Can you purchase a pump and submit a receipt for reimbursement?  If so, how much will you be reimbursed for?

–       Can you submit a claim for a pump you have already purchased?

–       Where can you buy the breast pump?

 

You may need to be fairly persistent in order to find out what your options really are.  After all, your insurance company would probably prefer not to have to pay for anything.  But as a customer, you are entitled to know what coverage is available to you and to use that coverage when needed.

Understanding health insurance can become quite the mind-game.  To help you prepare for the challenge, Medela has put together a ton of useful information on their Website, including how to talk to your insurance company and how to file a claim.

Once you know the what, where and when, it is up to you to find the option that is the best fit for your needs and still meets the requirements of your insurance plan.  Choosing a breast pump can be a challenge as well, and your choice depends on several factors including how often you’ll pump, where you’ll pump and how much time you’ll have available.  If you are not sure what to look for, Babycenter.com has a great guide on how to buy a breast pump.

What have your experiences been like when dealing with your insurance company?  Have you been able to get coverage for a new breast pump?

 

5 COMMENTS

    • Ruthie, that sucks! Do you have an HSA card? Because you could use those funds towards a pump purchase. Maybe renting one is a good option, although the rental ones aren’t very portable. I kept googling for a cheaper Medela Freestyle and i eventually found one at Away Baby Essentials.

  1. i heard from a friend of mine of a company called Aeroflow Healthcare that helped her get a medela advanced electric breast pump for free through her insurance. i gave them a call and it was awesome, the only thing i had to worry about was getting my dr to fax over a prescription to them for insurance purposes. they did everything else, dealt with the insurance company ( we all know how frustrating that can be ) and shipped it to my house. this process took less than 5 days and saved me a lot of time and hassel. i would recomend them to anyone..

  2. There is a local place now that has several insurance contracts and is able to provide breast pumps in Austin. A lot of my friends had to order theirs through a mail order supplier and they couldn’t get them until after the baby was born, so it took like 2 weeks to get the breast pump delivered! Anyhow, this place is called Medical Express and it is really easy. They need a prescription and check your insurance to make sure it is covered. My insurance wouldn’t let me pick up the pump until the baby was born, but I was able to send hubby to pick it up after my little one arrived. Much better than waiting 2 weeks for it to be delivered to my house from a mail order supplier! I got a Rumble Tuff (love it!), but they also have Ameda and Lansinoh. I think they were working on getting Medela, but don’t know if they have it now or not. Anyhow, just wanted to pass it along so local Austin moms can try this place instead of having to have it shipped.

  3. I second the recommendation for Medical Express. They were listed in my insurance as PSI Premier Specialties Inc (legal name), but they go by Medical Express, PSI. # is 512-445-0600. Easy process, really nice woman who walked me through all of my options. So nice that we are able to get insurance to pay for a breast pump….it is SO SO important for women to have access to breastpumps so they can continue to pump when they return to work OR just have a break for a minute and let someone else feed the baby!

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