March 2013 Moms

insurance/pump rant

So I just found out DH's insurance covers the full cost of a double electric (I just switched to his insurance Feb 1). At first, I was like: YAY!  Then I started looking at the 3 companies they gave as places where I would have to obtain the pump from.  One place does not sell pumps - great? Another place only sells their proprietary pump, so I would be at their mercy if I needed parts, not to mention I've never heard of this company, and they don't have bags or bottles to go with. Luckily, the 3rd place has a Medela Pump.  They're calling it the advanced, which I am forced to assume is the PISA, as Medela doesn't have anything on their website that goes by just Advanced.

Here's the thing - I cannot even order the pump until after I have given birth. Then it takes a week for them to call insurance, call my DR, process the request, tell me if I owe anything, and then they can ship it. Yeah, sounds like the first thing I'm going to want to do as we leave the hospital. Lactation consultant is covered too, but if I already have access in the hospital after birth, isn't that the ideal time to get my coaching session and be shown how to use the pump?  Which now I can't do because I will not be able to have the pump with me. so now if I need a coaching session, I'm going to have to make a separate appointment.  What if I can't figure this stuff out on my own? I'm really going to have to beg to get appointments with people that are covered by insurance right away, and then drive all over the place trying to get to them?

This really has me freaked out - I really want to be able to BF, and I don't want to miss out on anything because my insurance is betting against me actually giving birth (at least that's what it feels like, or why else would they put off sending a pump? because people order them for fun?). Please tell me I'm overreacting...

Pregnancy Ticker

Re: insurance/pump rant

  • That does suck that you're going to have to do all that running around to take care of it with a newborn.  I'm convinced they do crap like that just to get people to say screw it and buy it themselves.  But it could be worse, mine only covers a manual.  Gee, thanks for sparing me that $20.  

    If I were you, I'd check into renting one through the hospital to get by until your good one comes in.  

    TTC #1 since April 2010
    BFP 4/18/12, M/C 4/27/12 at 6w6d
    BFP 7/1/12 - Counting down to our little girl, EDD 3/8/13
    BabyFruit Ticker
    Image and video hosting by TinyPic Image and video hosting by TinyPic
  • Its standard to not get the pump before the baby comes for some insurance since its only covered for "medically necessary" situations..whatever that means, but they say how do you know if you need it to BF if you don't have the baby.

    I wouldn't worry about needing to be coached on how to use a pump. Its pretty self explanatory IMO.   FWIW, I'm in the same boat as you, my ins. won't cover it until after baby comes w/a Px. 

    "Grow old and be bold and know that you are the magic of my song" -Stephen Leonard

    Baby Birthday Ticker Ticker
    Baby Birthday Ticker Ticker
    BFP 1: missed mc @ 5w2d/discovered @ 11w+, 11/07, BFP 2: natural mc@ 6w+/-, 6/08, BFP 3: bradycardia & abnormal growth @ 6w to 9w, no hb 9w5d, 8/10

    BFP#4: Baby W is born at 41w1d on 7/18/11

    BFP# 5: EDD 3/8/13, Baby C arrived 3-4-13.  "March forth, little girl" :)

    BFP# 6: EDD 8/25/14, Please complete our family, bebe <3 </font>

    *In my bag:  Nikon D600, Nikon D80, Nikon F65, Nikkor 35mm 1:1.8DX, Nikkor 50mm 1:1.4D, Nikkor 105mm Micro 1:2.8D, Sigma 70-200mm D 1:2.8 APO DG HSM, (2) SB-700, (2) SB-24* 

  • My doctor won't write me the script until I give birth either. He actually says he is REALLY annoyed insurance pays for it at all! When I asked about mine he complained that everyone is getting them now and some women get a new one with every pregnancy and don't even use them. His rant was it makes insurance more expensive in the long run and it causes all the medical supplies stores to be sold out of them! So he said no way will he write an order for one until he sees that the patient really is going to breast feed and needs one!
  • My insurance doesnt pay anything towards the cost of a pump.  I am going to wait to see how it goes with breastfeeding and then maybe rent from the hospital. 

    Also, both the instructor from my breastfeeding class and my doctor told me that I really shouldnt pump for at least a month after birth anyway because it confuses your body.  So you have a at least 3 weeks to get the pump.  That should be plenty of time. 

    Pumps are expensive so I can totally see why they wait until you've given birth.  There is that part of me who thinks people order them with no intention on breastfeeding and then sell them on Craigslist or ebay or something.

     

     

     

  • Sorry - I think your doc is a tool pp.  

     

    OP - sorry you're having a tough go of it.  For as confusing as the process was for me to navigate, I'm happy with the outcome from my providers, thankfully!  One less thing for me to worry about.  Fingers crossed yours goes smoothly when you are able to get it. 

  • image luvsdogs2:

    That does suck that you're going to have to do all that running around to take care of it with a newborn.  I'm convinced they do crap like that just to get people to say screw it and buy it themselves.  But it could be worse, mine only covers a manual.  Gee, thanks for sparing me that $20.  


    Mine only covers manual as well. Sucks when we pay so much for health insurance.  

    BabyFetus Ticker
  • Most people are in the same boat on this one.  It sucks. 

    My plan is to buy a $30 manual pump to hold me over, as I would want one for an emergency anyway.

    Then if the pump is back-ordered or it takes a while to come once the order has been placed with the medical supply company, I will get weekly rental quotes from our hospital.

    Frustrating, but I don't know of any medical supply items that are approved prior to need.  Even wtih cancer, and other extreme illnesses, anything that's rented or purchased that is considered durable medical equipment can't be used until the patient is in need.  Insurance companies don't want to be on the hook, if, say, you miscarry.  :(  Understandable, but annoying.

    Due March 25, 2013

    image
  • My husband's insurance decided that they were not going to comply with healthcare law so even though I have Harvard Pilgrim, his company was "grandfathered in" so they ar NOT covering the pump or breastfeeding classes or anything else. UGH
  • image CloudBee:

    Most people are in the same boat on this one.  It sucks. 

    My plan is to buy a $30 manual pump to hold me over, as I would want one for an emergency anyway.

    In my experience, the cheap-o manual pumps are total crap. Now, I'm a D-cup which might be the issue. In the end, my $30 manual pump just became the funnel I used when I hand-expressed in the beginning to relieve engorgement and/or get a small bottle for my newborn when I had to leave her with my mom for an afternoon.

    I suggest spending the little bit extra (think it's only $40, I got it on clearance for $15) for Medela's basic manual pump. I haven't used it for actual pumping yet, but I did get curious and try it out and definitely felt a quality difference.

    DD- 11/17/08, DD- 11/16/09, DS- 3/20/13 
    Lilypie Second Birthday tickers
     Lilypie Fifth Birthday tickersLilypie Kids Birthday tickers
    Daisypath Anniversary tickers
  • I have UHC and it sounds exactly like your problem. They have me 3 places but only one allows you to get a Medela. When I called to order one they told me I could call a week before my expected delivery and they would contact the doctor and do all the confirmation stuff and then when I have the baby I have to call and they will ship it.

    I'm not planning on pumping for a couple of weeks after birth anyways unless I need to because we are having difficulty or she has to stay at the hospital longer. In that case I will just rent one from the hospital until I get mine in. Try not to stress too much. It will all work out in the end.

    Lilypie Second Birthday tickers
    Lilypie Pregnancy tickers

    **BFP #1 12/09 Diagnosed with Anencephaly D&C 3/17/09**
    **BFP #2 5/28/12 Blighted Ovum m/c 6/15/12**
    **BFP #3 7/12/12 EDD 3/21/13 - Madelyn born 3/5/13**
    BFP #4 4/2/14 - EDD 12/15/14 **RCS scheduled for Dec. 2nd!**

  • image mkc5869:
    I have UHC and it sounds exactly like your problem. They have me 3 places but only one allows you to get a Medela. When I called to order one they told me I could call a week before my expected delivery and they would contact the doctor and do all the confirmation stuff and then when I have the baby I have to call and they will ship it. I'm not planning on pumping for a couple of weeks after birth anyways unless I need to because we are having difficulty or she has to stay at the hospital longer. In that case I will just rent one from the hospital until I get mine in. Try not to stress too much. It will all work out in the end.

    I have UHC and mine has already been approved by my doctor.  There is a shortage so they had a cheaper one than the one that I ordered.  They said that if I wanted to wait for the nicer pump, I could do that but it would not come in until the beginning of March.  They will ship it to me as soon as it comes.  If I decide that I need one before it comes in then I will just go buy one and will then have one for work and one for home.  I went shopping with DH so that he knows exactly what to buy in case he has to go buy one for me.

    BFP on IVF #2 6/29/2012. Beta #1 7/3 = 522; Beta #2 = 1180; Beta #3 = 6491 image BabyFruit Ticker
  • When I contacted the company, I am only allowed to start the process 1 month prior to my due date and they need the prescription and verification from my OB of said date.  I am hoping to have the pump prior to delivering, but I am not sure.  I have pumped previously though, so I am fairly confident with the actual usage of the pump.  Is it possible to go back to the LC afterwards?  Ours involved a co-pay, but it was well worth it.  I had some breast feeding issues a couple of months after DD #1 was born and went back to the LC Dept. at my hospital.  They were very helpful.
    DD #1 - 01.08
    DD #2 - 03.13
  • Don't freak out.  The pump has nothing to do with your ability to BF.  Everything I've read and my friends who EBF say that you shouldn't even use the pump (unless it's medically necessary) until after your supply is established, around 4-6 weeks.  I can't imagine using the pump is rocket science, I don't think you'll need a coaching session to figure it out.
    Baby Birthday Ticker Ticker Baby Birthday Ticker Ticker
    image



  • My insurance said the cover only manual but then they said my doctor could prescribe an electric pump. They didn't tell me I can only buy it from certain stores though they told me to buy it and file a claim with the receipt and prescription. Maybe i should call and check again
  • image pamelaam2468:
    My doctor won't write me the script until I give birth either. He actually says he is REALLY annoyed insurance pays for it at all! When I asked about mine he complained that everyone is getting them now and some women get a new one with every pregnancy and don't even use them. His rant was it makes insurance more expensive in the long run and it causes all the medical supplies stores to be sold out of them! So he said no way will he write an order for one until he sees that the patient really is going to breast feed and needs one!


    Your doctor is a douchebag. Sorry.

    OP you can always rent a high quality pump for a month while waiting for the insurance. But as a PP said, you may not need it the first couple weeks.

    Daisypath Anniversary tickers Lilypie Second Birthday tickers
    Lilypie Pregnancy tickers

    March 15 Oct. Siggy Challenge: Halloween Costume Fails
    image

    Image and video hosting by TinyPicAnd just because it's Halloween!
    image
Sign In or Register to comment.
Choose Another Board
Search Boards