Obamacare - Insurance-covered Breast Pump

mrs-smith2b · June 2013

I read that due to Obamacare all insurance should cover a breast pump or pump rental starting January 1, 2013. I called my insurance, Signature Care, and they said that our plan is "grandfathered in" and therefore doesn't have to cover a breast pump. Does anyone know about the validity of this? Is there anyway I can fight this? Thanks for your help.

Dstevens429 · June 2013

I have heard of this but don't know to much about it. Sorry, maybe they will cover a rental.

mrs-smith2b · June 2013

Dstevens429:
I have heard of this but don't know to much about it. Sorry, maybe they will cover a rental.

Thanks! They said they wouldn't cover a rental either.

opheliainwaders · June 2013

I think that there were some plans that didn't have to cover certain services until 2014. Maybe see if you can use an FSA to purchase it?

Jessicadbaker · June 2013

Try calling back and speaking to someone else. I have United. First time I called I was told they don't cover a pump. Called a few days later and YES they did cover a pump I even had several choices.

shani0112 · June 2013

I have bcbs Tennessee and was told they would cover the cost of a pump up to a whopping 25. I believe this will change in January as the policy will start a new year.

MrsG071809 · June 2013

I was originally told the same thing (but I have Cigna), and then when I called later was told that it actually was covered and was able to get mine. So it doesn't hurt to call again and see if you get a different answer!

dandywarhol · June 2013

Sounds like hooey to me. I live in NYS and according to the nurses and lactation consultants I spoke with all (at least in NYS) are eligible for a pump. There is some discrepancy of what type of pump but either medicaid or ins. is required to cover one.

TexasAggie06 · June 2013

I have BCBS in TX and was told that they only cover a manual pump.

jess9802 · June 2013

It is true that certain provisions of the ACA do not apply to grandfathered plans until 2014. Can't say whether your plan is grandfathered or not. It couldn't hurt to call your insurance back and verify that, or talk to HR at your company to see if they can confirm whether your plan is grandfathered.

Shel79 · June 2013

I was told basically the same thing by BCBS, and that they'd only cover a manual pump.

TJ1979 · June 2013

TexasAggie06:
I have BCBS in TX and was told that they only cover a manual pump.

I'd call back! I have Bcbs in tx too. With a rx from your dr you should be able to get a double electric.

mrs-smith2b · June 2013

Thanks for all the advice! I'm going to have my husband talk to HR about this. It sounds like they are grandfathered in until January 2014 according to the woman I spoke with today. I'll just call back again! :

snok83 · June 2013

Yeah unfortunately, I also have BCBS and it is true. When I called in to inquire about the breast pump, first thing they told me was that some companies were grandfathered in and not eligible for the free pump. So they checked for my specific employer. Luckily for me, my employer did cover it. Both medical stores that offered the free pumps told me the same thing that some of the people with BCBS insurance were not eligible for the free pump and they doubled checked my plan to be sure before I could get it.

silvercamaro77 · June 2013

It's not the insurance carrier that makes the difference it's the plan you have with the carrier which is why some people with BCBS of TN have it covered and some don't.

It is true that not all plans are giving free pumps but it can't hurt to call a few times to get different people to make sure you're getting correct information.

Obamacare - Insurance-covered Breast Pump

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