3rd Trimester

Anthem & Breast Pumps

I spoke to my insurance company last week and they said that breast pumps were covered 100% under a Durable Medical Equipment supplier. Problem is the list they provide does not include any companies that carry them. Does anyone have Anthem? If so, have you ordered a breast pump and put it through insurance? If you have gotten the pump through an online supplier can you tell me where you may have gotten your pump so I can try to order one before my EDD?

Thanks so much!!!

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Re: Anthem & Breast Pumps

  • Are you in Caifornia? I have Anthem too PPO plan and they said a pump was only covered 50. They couldn't give me any info on any DMEs other than asking me if I had an Apria near me. I had no idea, so I did a google search and it looked like they have the Medela brand. All of the other websites for DMEs near me didn't offer breast pumps.
  • I have Anthem and I'm able to get one through Byram Healthcare, but I can't order it until 30 days before my due date.
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  • I have Anthem and couldn't find a DME within 100 miles of me that carried one, and I called probably 75 places. After speaking with 6 different people, I finally got a nice representative who told me I could buy one locally at BRU or someplace similar, submit a claim, and she would put it through for me. I got a PISA plus all my extra supplies extra shields, connectors, storage bags, etc. paid for 100 percent. I got the reimbursement check a week later.

    While it worked out in the end, it was such a PITA.
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  • I was told edgepark.com & another one which is completely out of breast pumps & has no idea when they'll get them back in stock.

    You should be able to search on their website for a provider for DME, then go from there. I found a few non-national places that have pumps for California.

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  • image RootBeer29:
    I have Anthem and I'm able to get one through Byram Healthcare, but I can't order it until 30 days before my due date.

    http://www.byramhealthcare.com/breastpumps/index.php

    Due to a national manufacturer shortage, we are out of stock, with no release date at this time for any of the breast pumps.

    Please contact your insurance company for alternative vendors.

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  • I am having the same trouble here in PA with Blue Cross. No one has them.
  • Check around to your local hospitals.  Most of them have women's stores that count as DME's and can sell the pump and file the claim.  That's where I found mine.
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    Married 9/26/09 BFP #1 12/09 Blighted Ovum 12/23/09 D&C 1/10 BFP#2 5/1/10 DS born 12/18/10 38wks 10 lbs 1 oz BFP #3 6/25/12 EDD 3/5/13 RCS DS2 born 2-22-13 38wks 8 lbs 4 oz

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  • Wow thanks so much for the advice! I will be checking this out tomorrow. Please keep posting if you have any further information to try and help others out too. Good luck all who are having challenges too!
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  • Anthem told me they will cover a manual breast pump at 100% and will cover nothing towards an electric one. It really makes me mad as we pay so friggin much and hardl ever use it. 
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  • I am going through our local hospital womens store. They recently made a huge order due to the need. It is a Medela pump in style, stocked with carry bag. Anthem pays 100percent. Mine should be in a few weeks before I am due.
    2nd EDD 02/01/13 - MC 5 1/2 weeks 6/5/12. Baby Birthday Ticker Ticker Pregnancy Ticker
  • image 5dogs:

    image RootBeer29:
    I have Anthem and I'm able to get one through Byram Healthcare, but I can't order it until 30 days before my due date.

    http://www.byramhealthcare.com/breastpumps/index.php

    Due to a national manufacturer shortage, we are out of stock, with no release date at this time for any of the breast pumps.

    Please contact your insurance company for alternative vendors.

    Yes but if you actually call in, they tell you the wait is really only like 2-4 weeks.

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  • I have Anthem PPO. It's covered if I go through a DME but subject to my deductible ($500) and co-insurance (10%). I asked for a list of DME in my local area. I haven't called any yet. I'm pretty sure only two of the 10 or so might carry one - the others are for ears and prostetic limbs so I doubt they'd carry a breast pump!

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  • I have Aetna and was given a list of three DMEs.  One doesn't have any in stock and doesn't know when it will get them.  One doesn't carry breast pumps.  One has two types in stock, but my insurance won't cover either of them.  I still have some time though, because my insurance won't cover a breast pump until 60 days after the baby's birth.

     My sister's insurance only covers manual pumps.

    It seems like the whole idea of fully covered breast pumps was just a nice thing to put into the bill to sell the idea.  But, without any standards it's utterly useless.


  • I Have Anthem BC and just got off the phone with edgepark ..  she said the Medela electric is whats available for BC customers, ordered it b/c Im within 30 days of my due date and said I should have it within 2 weeks ..  I did have to wait on hold for almost an hour to speak with someone .. it was pretty easy .. Im surprised b/c last time I called I also got the national shortage message and wasn't counting on getting one at all !!  the number I called is 800 321 0591 .. mine pays 100% .. Good luck to all of you !!!  
               5 years IF & 2 losses

            ~~ DS Born 2/28/2013 ~~
                8lb 13 oz 22 inches 
    Happily expecting another miracle !
     EDD 11/20



  • Anthem told me they'll pay 100% for a device from Edgepark Medical or Liberty Medical, and they also told me Apria Healthcare but the guy I talked to there said they were no longer contracted with Anthem after Jan 1.  I haven't been able to get through to edgepark or LIberty.  The lady at Anthem also told me that if I can't get one through from one of those suppliers that I could buy elsewhere and just submit the receipts and they were covering breast pumps from non-medical supply companies, but I haven't purchased one yet.
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