February 2013 Moms

Pump Not Covered-Blah!

Finally got through to someone at BCBS of North Carolina (I have the state plan) and breast pumps are not covered.  She stated that she had no idea when the state plan would allow for pumps to be part of the plan and as of right now they are excluded-even with a prescription.  I'm a little bummed and feeling blah about it.

I have had some people tell me if you plan on BFing you can go without it for awhile.  STM's who BF'd is that true and how long can I hold off on getting one?  I will be home with LO for 12 weeks and then return to work.  Eventually I will need to pump while I am at work.  Thanks in advance ladies. 

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Re: Pump Not Covered-Blah!

  • I didn't use one for my first until i went back to work. You should check with the state and see if the offer a rental one. If not you can look into the single electric pumps or the manual ones, Walmart are not that expensive for some, including double electric (range from $79-$180)
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  • I've heard of situations though where people have to pump almost immediately bc of latch issues or other unforeseen issues. I have bcbs in NY and only a rental is PARTIALLY covered, so I bought one today with thepromo codes on ddiapers.com.... there was a post about it earlier

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  • From my BF class, they say 5-6 weeks before you want to start pumping. You'll want it with plenty of time before you go back to work so that you can build up a supply for baby in day care.

    Other advice from the class, don't bother with a manual pump if you're going back to work and plan to pump - it won't be nearly efficient enough to be effective. (My insurance will only cover a manual, so I'm in the same boat, paying out of pocket.)

    I like to think of it this way - in the long run, the cost of investing in a good pump will still be significantly less than the cost of formula. 

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  • I have Highmark blueshield (I'm a state employee, so it's also a state plan), and they cover it, but only with a prescription stating medical necessity.

    I agree with PP's that investing in a good double pump will pay for itself. If you have any doubts, be sure to invest in a closed system pump (like the Ameda or Hygeia) so that if things don't work out, it can safely be re-sold.

    Although last time I had a pump ahead of the time the baby came, I hadn't planned to use it until the end of mat. leave to build a stash. Anyways, I had a very badly cracked left nipple, and had to pump one feeding a day in order to "rest" that nipple starting at two weeks. I never had much luck with a manual pump. 

    I'm sorry that your ins. won't cover a pump. That shouldn't even be allowed. =[

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  • I'm on Tricare (military insurance) which is exempt from the new health care laws, so we're stuck without coverage also =/ but we are on WIC, and I'm not sure if that's something you're eligible for, but they do provide hospital grade pumps for free after the first month if you're working or a student. Just thought I'd throw that out there! I'm not working yet, but I may be after a few months, but still going to have to shell out the money myself. I'm going with an Ameda pump because it has better reviews than the Lansinoh, and I just looked... unfortuately Ameda isn't included in the diapers.com deal :'( but it is only $139 on Amazon! I think I'm going to shell out the extra 40 bucks over the Lansinoh pump because the reviews just seem overall to be better... but it looks like you can get a Lansinoh pro pump with that deal for just over $100 which seems awesome!

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  • My pump is covered but I can't just go to a store to buy one. And all of the durable medical supply companies are out of stock due to an apparent nationwide shortage. I'm going to have to check if my hospital sells them!
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  • i have the same plan and only pay 20 of a pump after deductible. weird???
  • I would really recommend you go ahead and get a pump. Its helpful to have on hand in case you are incredibly engorged,sore, cracked, etc. I would not recommend a manual pump if you are going to be working full time...get a double electric. I started pumping at 6 weeks PP to build a stash for when I went back to work. I will do the same this time.

    I know its really taboo here on the bump, but if you can't afford a good new pump, look for a used one. I bought a medela PISA from craigslist when DS1 was born for $100 and let me tell you...that was probably the most well spent money ever. I bought all new attachments, accessories and tubing and never had a single issue. The woman I purchased from claimed to have used it just a handful of times and then stopped because she had supply issues. It was obvious the pump had not been used much. I used my pump 5/week 3/day from the time DS1 was 5 months old until he was 14 months old. Invest in a good pump. They are definitely worth it!
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  • I love my Hygeia pump.  I HIGHLY recommend looking into one.  It is a great, multi-user pump.  You might be able to find one online or locally.  I started pumping a bit at a time at 3 weeks because I had to go back to work two days a week at 5 weeks and wanted to have a little bit of a stash saved up.  I actually had really good luck with a manual pump as well.  If you are only pumping once a day or so it isn't bad. 
  • Also if you go on Hygeia FB they are really helping people with the "shortage issues and any issues with insurance so that is worth looking into. 
  • Hygeia actually made this post today:  It breaks our hearts to see so many moms unable to find pumps or get them covered by their insurance companies. While this might not be a solution that's workable for everyone, if you can prove that you have been denied coverage or are unable to get one of our pumps due to the DME situation, email us at socialmedia@hygeiababy.com and we'll give you a coupon code (upon verification of your information) that is good for $150 off the LBI on our site. It's our belief that the insurance companies pay about that amount for the pump, so if you have a chance in heck of getting reimbursed by them, that might work. We will also gladly work with anyone who emails us to try to find you a pump personally. socialmedia@hygeiababy.com
  • Wow. Thank you!!  I will definitely try this!!
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  • image ThenCaliSays:
    Hygeia actually made this post today:  It breaks our hearts to see so many moms unable to find pumps or get them covered by their insurance companies. While this might not be a solution that's workable for everyone, if you can prove that you have been denied coverage or are unable to get one of our pumps due to the DME situation, email us at socialmedia@hygeiababy.com and we'll give you a coupon code (upon verification of your information) that is good for $150 off the LBI on our site. It's our belief that the insurance companies pay about that amount for the pump, so if you have a chance in heck of getting reimbursed by them, that might work. We will also gladly work with anyone who emails us to try to find you a pump personally. socialmedia@hygeiababy.com

    I was using my iPhone so ignore the post below yours!  This is great information and I'm going to give it a try.  Thank you!!! 

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  • image Jaci85:
    i have the same plan and only pay 20 of a pump after deductible. weird???

    They said I'm 'grandfathered in' so I can't get a pump covered.   I started with the state in Sept 2011 so not too long ago. How about you? 

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  • image ljburrelli:

    image Jaci85:
    i have the same plan and only pay 20 of a pump after deductible. weird???

    They said I'm 'grandfathered in' so I can't get a pump covered.   I started with the state in Sept 2011 so not too long ago. How about you? 



    I started years ago too. I am wondering then if they told me the wrong info ... ugh how annoying!!
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