Before you purchase an expensive breast pump...

jayandjuliecruz · February 2010

Call your insurance company and find out if a breast pump is covered under your insurance. Most of the time it would be under Durable Medical Equipment. If you have Cigna, give them the code E0603. Most of the time the pump will be covered. You may need to get a prescription from your doctor. If your baby has to spend any time in the NICU this would be considered medical necessity for you to get a pump. I would also check with your hospital and find out if they would give you a pump and charge it to your hospital bill. This is the most ideal way to go. If not, you can still get reimbursed from your insurance company.

I have Cigna and they are covering all but 20% of the pump. Yay!

And Ketch · February 2010

jayandjuliecruz:
Call your insurance company and find out if a breast pump is covered under your insurance. Most of the time it would be under Durable Medical Equipment. If you have Cigna, give them the code E0603. Most of the time the pump will be covered. You may need to get a prescription from your doctor. If your baby has to spend any time in the NICU this would be considered medical necessity for you to get a pump. I would also check with your hospital and find out if they would give you a pump and charge it to your hospital bill. This is the most ideal way to go. If not, you can still get reimbursed from your insurance company.
I have Cigna and they are covering all but 20% of the pump. Yay!

Thanks for this. I've been meaning to call and find out if my insurance will cover this. What kind did you get? Does it matter for insurance?

Mrs.B6302007 · February 2010

Good to know. I have Cigna as well.

MWoodside · February 2010

Mine doesn't unless there's a medical necessity like cleft palate or unless mother has to leave hospital while baby has to stay. Too bad for me.

earthycrunchymama · February 2010

Interestingly, Mass Medicaid does NOT cover. you'd think they would because other wise a lot of patient might turn to formula (esp. working moms) without a pump and would be WIC eligible. wouldn't paying for a breastpump cost the state less in healthcare then it would to pay for months on end of baby formula?

different state budget for MassHealth/Medicaid and WIC but I don't follow the logic since it could help keep costs down. and a person income-eligible for Medicaid might not be able to afford a pump on their own... Tongue Tied

msrestles · February 2010

The hospital we delivered at for our first, and hopefully for our second one had rentable hospital grade pumps, for a reasonable amount! You can always look into that idea as well!

earthycrunchymama · February 2010

earthycrunchymama:
Interestingly, Mass Medicaid does NOT cover. you'd think they would because other wise a lot of patient might turn to formula (esp. working moms) without a pump and would be WIC eligible. wouldn't paying for a breastpump cost the state less in healthcare then it would to pay for months on end of baby formula?
different state budget for MassHealth/Medicaid and WIC but I don't follow the logic since it could help keep costs down. and a person income-eligible for Medicaid might not be able to afford a pump on their own...

I should also note that Medicaid doesn't cover birthing or parenting classes either... some insurances pick up a portion. again, you'd think that people medicaid-eligible wouldn't have the resources to afford some of these types of classes but might really need it.

bride47 · February 2010

jayandjuliecruz:

Call your insurance company and find out if a breast pump is covered under your insurance. Most of the time it would be under Durable Medical Equipment. If you have Cigna, give them the code E0603. Most of the time the pump will be covered. You may need to get a prescription from your doctor. If your baby has to spend any time in the NICU this would be considered medical necessity for you to get a pump. I would also check with your hospital and find out if they would give you a pump and charge it to your hospital bill. This is the most ideal way to go. If not, you can still get reimbursed from your insurance company.

I have Cigna and they are covering all but 20% of the pump. Yay!

Are you getting this through your prescription drug plan?

earthycrunchymama · February 2010

bride47:
jayandjuliecruz:

Call your insurance company and find out if a breast pump is covered under your insurance. Most of the time it would be under Durable Medical Equipment. If you have Cigna, give them the code E0603. Most of the time the pump will be covered. You may need to get a prescription from your doctor. If your baby has to spend any time in the NICU this would be considered medical necessity for you to get a pump. I would also check with your hospital and find out if they would give you a pump and charge it to your hospital bill. This is the most ideal way to go. If not, you can still get reimbursed from your insurance company.

I have Cigna and they are covering all but 20% of the pump. Yay!

Are you getting this through your prescription drug plan?

I was looking at multiple insurances and how they work it - most have it as durable medical equipment. you get it through a medical supply company in that case rather then a pharmacy. your insurance should be able to tell how to bill and where to bring an Rx from. Wink

bride47 · February 2010

earthycrunchymama:
bride47:
jayandjuliecruz:

Call your insurance company and find out if a breast pump is covered under your insurance. Most of the time it would be under Durable Medical Equipment. If you have Cigna, give them the code E0603. Most of the time the pump will be covered. You may need to get a prescription from your doctor. If your baby has to spend any time in the NICU this would be considered medical necessity for you to get a pump. I would also check with your hospital and find out if they would give you a pump and charge it to your hospital bill. This is the most ideal way to go. If not, you can still get reimbursed from your insurance company.

I have Cigna and they are covering all but 20% of the pump. Yay!

Are you getting this through your prescription drug plan?

I was looking at multiple insurances and how they work it - most have it as durable medical equipment. you get it through a medical supply company in that case rather then a pharmacy. your insurance should be able to tell how to bill and where to bring an Rx from.

Thanks, we will check it out!

Abc15379 · February 2010

That's odd. I have Cigna and they told me they only cover it if mom and baby are separated. Did their policy change?

PMBridetobe · February 2010

Each insurance is different depending on the options your employer selected. For me, one is not covered so I set aside FSA $$ to rent it.

willowcormar · February 2010

Ohh I have Cigna! I should call them! Thanks!!

anvloveskme · February 2010

I have Kaiser Permanente and if I buy the Madela one at my clinic it is 20% off.

squishles10 · February 2010

We have BCBS and they don't cover it. They said it's a convenience item. Flex spending won't cover it either. Same reason. Flex will cover classes, insurance won't. I am surprised other insurances cover it, since we have pretty awesome insurance. I had 3 friends check and none of their insurances cover it either (maybe we have all BCBS, who knows). Congrats if they do though!

jayandjuliecruz · February 2010

I am having twins, so we will most likely be "separated" for some amount of time. To be technical, you are separated from your baby when they go to the nursery. They shouldn't really give you a hard time as long as your doctor says it is ok.

jayandjuliecruz · February 2010

Honestly, with my last pregnancy i had BCBS and they covered it. I bought it from the lactation office at the hospital and was reimbursed. This time around our insurance isn't as good, but i just called. They said it would be covered after my deductible and all i would pay is 20%, which is normal for my insurance. Just something for all of you to check in to.

Oh, and for whoever asked, i got a Medela Pump In Style Advanced with the last one and plan to do the same this time around.

HisDollface · February 2010

you may also want to look into renting one through your insurance. Mine was $17.50 for a small hospital grade pump for 3 months, and then $5 per month after that(I think). I only used it for a few months though. I was glad I didn't purchase one. We rented through Apria.

Before you purchase an expensive breast pump...

Re: Before you purchase an expensive breast pump...

Choose Another Board

Search Boards