Breast Pumps and Insurance

chels0120

Hi ladies, I tried to search this and couldn't quite find answers. Wondering if any ladies on here have HealthNet insurance and have any information on whether they cover a breast pump, what type, how do you go about the process of running it through for reimbursement? I have called HealthNet twice and gotten zero help from the two women I have spoke to on the phone and they do not return emails. So frustrating.

sboston06

I would suggest talking to your OB about this...they might be a better resource than your insurance! I mentioned it to my OB and she said they will order the pump for me in the hospital when I deliver and a local store delivers them all to the hospital. They are usually lining the nurse's station every morning! I didn't expect my OB to be able to advise me on this but it makes sense as it's something she deals with every day.

stillcozy

I agree with talking to your OB I have no idea what your insurance offers and mine was as unhelpful as yours but my OB gave me
the prescription early and my insurance covered it 

Kellyj103

Have you tried https://www.breastpumps.aeroflowinc.com/qualify-through-insurance/
i found this link on TB and they worked with my insurance to figure out what I qualified for through my insurance. I have United Health. 

deuxbouledogues

Do you have a handbook available from your insurance co? Would HR be able to help you track one down? Mine was spelled out for me in my medical benefits handbook. I agree your OB is a good contact too or their office at least. 

pandamonium20

I second AeroFlow. My insurance customer service was worse than useless "Umm, I think we cover a manual one?" Was the response when I asked which pumps were covered. "Go to Walmart pharmacy for more information and to purchase your pump" was the advise given. That's BCBS! They're supposed to be on top of this crap.  

 I filed with AeroFlow and they had someone call me ~5 days later. My double electric pump of my choice was in my home 5 days after that. 

BettyRu

You can call almost any breast pump distributor and they will look up your insurance eligibility for you.  FYI, this is important.... If the breast pump company you call does NOT have the pump you want, call another.  Your insurance company may recommend a specific distributor, but you can more than likely use any one you want.  Call around and ask.

chels0120

Thank you guys so much!!! 

kellz14

@chels0120 They were of no help?  That's crap on their part - I would call back and ask to speak to a manager/supervisor and not let them off til I get an answer.  But that may be my ragey pregnancy hormones talking.

chels0120

@kellz14 sad thing is I did speak to a supervisor haha. After three transfers someone finally said why don't we have you talk to a distributor that we have a number for and see if they might know. The lady at the breast pump supply company walked me through it in 5 minutes and is even emailing my dr for the prescription and sending in verification paperwork to make sure the list of options will be covered. LOL AHHH! 

kellz14

@chels0120 Wow! Well that's great the supply company was helpful!

WVUPetunia

Ditto AeroFlow.  My unhelpful insurance company rep also said that just a manual one was covered.  AeroFlow spoke to them, and I ended up with a double electric pump (I already had one I paid for out of pocket from DS before Obamacare, but I figure hey, this one can live at work).

Schmooie730

Maybe this doesn't belong here, but my insurance will only cover a rented pump. I don't know how I feel about that. What are you ladies deciding? I'm debating if I just want to buy a pump of my own.

Soontobepartyofthree

Recently contacted my insurance regarding this and their answer was bland...shocking right? Anyway I called the medical supply companies in the area and they had really good information on how and when to get what you need. Sometimes can even get all of this situated months in advance! 

tayloca1987

I just went on the Medela website, found a supplier, they contacted my insurance told me what would be covered and upgrade options/prices. I got a prescription from my OB/GYN sent it to the supplier and got my pump in the mail like 3 days later. Never called the insurance company myself. 

BettyRu

Everyone with insurance questions... just call AeroFlow (or another, but these guys seem good).  Just call them, give them your insurance info and that's it.  They will all your insurance, tell you what's what and that you will need a prescription from your OB (everyone does).  It will save you A LOT of aggravation. 

stillcozy

@BettyRu just so you are aware Aeroflow doesn't work with all insurance. Mine was one they didn't work with which I thought was odd but had to go through the medical supplier at my hospital 

chels0120

We worked with Pumping Essentials and they were fantastic. They are doing all the paper work and hopefully we will have a pump in 5 weeks. 

deuxbouledogues

@Lindsayleigh1989 same here. Aeroflow is only helpful if they accept your insurance @BettyRu

trigur

Contact Byram Healthcare or visit their website.  You can enter your insurance info and see which pumps you qualify for. Provide your OB info and they will handle the prescription too. I had my free double electric pump in one week.

mimpy268

Your insurance company has to cover your breast pump, it falls under the Affordable Healthcare Act, just like birth control. 

mckcak23

Not all insurances cover it, they are supposed to unless you have a grandfathered plan. My insurance does not cover it, I have BCBS of IL. I have called BCBS and had Areoflow contact them, both came back saying it is not covered. 

LDSJM123

I got my prescription from the OB and had a good laugh at the diagnosis, "lactating mother" complete with filing code. 

Jodi1980

Byram did all the work for me with my insurance and approval script with my gyno. What I thought would be a hassle and last minute of finding a pump turned in to receiving my Medela a few months ago! I was very fortunate and ridiculously early planning to get one.

Jakes_girl

Schmooie730 said:

Maybe this doesn't belong here, but my insurance will only cover a rented pump. I don't know how I feel about that. What are you ladies deciding? I'm debating if I just want to buy a pump of my own.

I rented a hospital grade pump with my first to make sure I knew BF was for me. I loved it. The parts you pump with including the tubing and storage are all new. 

Sbento825

I also recommend Byram Healthcare. I went on their website filled out a form with all the details and they checked with insurance and my doctor. I had my pump in less than a week. My insurance said a pump was covered and gave me the name of local providers (none of which carried pumps) so finding this site was useful!! Turns out this provider was listed on my insurance website for mail order medical silly provider -
good luck

trigur

@mckcak23 I also have bcbs of il and it was covered. Try again. You might have gotten someone uninformed. Also, try byram.

jenkeale

Last time I used Aeroflow and had a good experience. I had UHC at the time.
This time, I tried edgepark because I got an email promoting them. I filled out the form, within a couple hours they had sent me a document to sign. The pump literally showed up the very next day. I was shocked how fast everything happened, especially since I have Tricare. 

stillcozy

For those who don't have one covered I see a lot of gently used medela pumps on garage sites mainly because people got them free and don't need them anymore. Could be a place to look if you want a nice one but not as expensive ? 

pandamonium20

.

LDSJM123

Agree with @Lindsayleigh1989 about buying one on garage sale sites or used to save money. If you do go that route, you'll want to buy this replacement tubing kit. Most stores carry them. Milk can make its way into the tubing, so you'll want new. https://www.amazon.com/Medela-Replacement-Parts-Advanced-PISKITA-ST/dp/B00217X8RW 

jwittwer

Aside from checking with your insurance, you can always talk to HR as well. My insurance doesn't cover a pump, but our office has a lactation program that does cover the cost of a pump, as well as all replacement parts (tubing, bottles, a tote bag, etc). 

I would think twice about buying a used pump though. Unless it's hospital grade, it is designed for a single user and the internal pump parts cannot be removed/replaced/sterilized. Check out the following link from Medela: 
https://www.medelabreastfeedingus.com/tips-and-solutions/14/can-i-buy-or-borrow-a-pre-owned-breastpump

If you can guarantee you're buying a hospital grade pump, then I'd go for it. Otherwise, I personally think it's worth it to spend the money on a new one. 

BettyRu

Just got my Spectra in the mail... I hope I made the right choice (I have a PISA from my first child).  AHHH, so not ready to hook up again... 

twinpeaksmama

I just received my Medela Pump in Style Advanced with On the Go Tote. I initially contacted my insurance company (Blue Cross) to find out what my plan covered. They gave me the phone numbers for Medela and Ameda. I called Medela first and was told that they didn't participate with my insurance. They were very helpful though and provided me with several other suppliers. I ended up going with Better Living Now and I am very happy with the service I received. They called my OB to obtain the script and let me know I had the option to upgrade my pump, which I did for a small fee. I've read a lot of good things about Medela, so I'm hoping this pump works well for me.

BettyRu

@Mbondi0 good call on the upgrade for Medela.  My first chid (over 2 years ago) I think the "free breast pump through insurance" was a newer phenomenon, so my insurance provided a Medela that had more bells & whistles than the really REALLY basic one that they send now.  The extra stuff that you got will be VERY helpful. I had a tote(ish) version and my friend had the backpack version.  Both were great (the backpack you can walk around and pump using battery power if needed).  I think you made a great choice!

LDSJM123

Just ordered my pump through "milk n mamas baby", for anyone looking for another option of somewhere to get their pump. The girl was fantastic on the phone. She was knowledgable, friendly, and the process was painless. They also have a really nice variety of pumps to pick from. My insurance does not cover a tote bag so it's considered a "starter" (went with the Madela Pump In style) but they do however send a replacement parts kit, and cover milk storage bags for the first year. So I think I can manage to find a bag to stick it all in. 

maggiemu42

My insurance only covers the ameda which I haven't heard great things about and will not compensate you for a different model (like I thought that they might pay up to the value of the ameda). So I figure I'll try it and then if I hate it, I'll just buy a different one. 

babycakesday

I called my insurance this morning and they sent me a list of local providers. I contacted EdgePark and ordered it this morning. I emailed them a copy of my prescription, but the lady offered to call my doctor and get one if I didn't have one. She also ran my insurance and listed the pumps covered. Less than 12 hours later, the pump is on the way. When I spoke with the insurance, they were very vague on the breast pump covered, but I was able to verify one was covered. If you wish to avoid the insurance, many medical supply companies list the insurances they work with and can verify what is covered for you. Otherwise, I say go straight to the source and call the insurance to get the info straight from them. I had a friend use Better Living Now and she was very happy. I also recommend EdgePark if your insurance works with them. I was able to get the Medela In style starter, but they had multiple to choose from. 

TxTeacher91

I have had a prescription from my doctor for like three months for my pump. I couldn't get anyone to give me a straight answer on how to get my pump. I called McKesson Medical Supply, sent them a picture of my prescription, and now my pump should be here next Tuesday. Super easy.   

BettyRu

@maggiemu42 try calling a different distributor if you haven't already...

ChrissyMarie128

Hi there! I just ordered my pump through Edgepark as well. I consulted a large lactation consulting group in my area and they HIGHLY recommended the Spectra S2. It is a retail pump that is hospital grade. I have read phenomenal reviews on it and feel very confident in my decision to get that one. I have previously used the Medla Pump inStyle and absolutely hated it. It was basically worthless in the pumping department and I ended up having to hand express another once the milk stopped coming out from a pump session. The lactation consultant also said the retail Medlas were 15 years behind in technology and the only Medla worth using is the hospital grade Medela Symphony. I totally believe that. I used the symphony in the hospital once and it was amazeballs. From my experience, I would avoid Medela at all costs. I know Edgepark Medical and Byram both offer the Spectra S2. The spectra is also available on Amazon for only $132!!!! Check it out and read the reviews. I can't wait to use my Spectra and pray it's as good as the reviews are claiming. I will never use a pump instyle again it was the biggest waste of $350 ever! 

The Spectra also is a closed system, so it's much more sanitary than other Medelas that are not hospital grade. I would also not recommend buying a used pump either. They are not closed systems and are not sterile and bacteria can be easily shared even with new tubing. To get a better understanding of that just research retail vs hospital grade breast pumps.