Anyone not able to get breast pump covered?

mel72

I'm on my 2nd level of appeals and I refuse to give up, primarily b/c I do not care for Cigna!  Apparently the prescription by my dr. stating that DS was in the NICU and the breast pump was medically necessary isn't good enough, I have to ask him for a letter  Anyone unsuccessful in getting reimbursed?

Mrs. Destructo

Yup. Our plan flat-out didn't cover breast pumps, even though I had 2 kids in the NICU that were born before they were able to suck.

jkparish

I am on bedrest for PTL and called BCBS to ask about covering the breastpump (ANY percentage) and I was told they absolutely do not cover it, even if Jaden is born too early and has to spend time in the NICU.  I asked about every possible situation: the doctor prescribing it as medically necessary, etc, and they flat-out denied coverage and said under no circumstances would it be covered.

It is SO frustrating, because most BCBS policies cover it 80%-100%.  Apparently, mine does not.

Good luck to you! 

umbcpt

FYI, I didn't know insurance covered it at all, but my hospital's lactation consultants sell the Medela Pumps at cost, which saves about $100.  I got the Advanced for $200, when all of the stores were selling it for $320.  So although it was not covered, a $100+ savings is huge.  I learned about it at my BF class when PG with DS.  Perhaps your hospital has a similar program?

nicnjed

katybuggy:

I am on bedrest for PTL and called BCBS to ask about covering the breastpump (ANY percentage) and I was told they absolutely do not cover it, even if Jaden is born too early and has to spend time in the NICU.  I asked about every possible situation: the doctor prescribing it as medically necessary, etc, and they flat-out denied coverage and said under no circumstances would it be covered.

It is SO frustrating, because most BCBS policies cover it 80%-100%.  Apparently, mine does not.

Good luck to you! 

 This!  Although we were disappointed, I can't complain too much since we didn't have to pay for anything the entire pregnancy/delivery/NICU stay!

lemen99

I haven't yet, but I need to follow-up. 

OneLady

Mrs. Destructo:

Yup. Our plan flat-out didn't cover breast pumps, even though I had 2 kids in the NICU that were born before they were able to suck.

Ditto this:(

jkipp82

I have bcbs and it was not covered.   i could loan one for free from the hospital while ds was in the nicu.  then i got a used one from my aunt so i didn't pursue it any further.

Ali05

My claim was denied....I just haven't had the time to apeal it.

TriciaJoy

I wasn't able to get mine covered. We even had a complex case manager who was able to get a lot of stuff covered, and expedite a lot of things for us, but they do not cover breast pumps at all.

Our hospital had a program that would cover them only while the kids were still in the hospital, but it was income based and we didn't qualify for that, either.

Mrs Manners

katybuggy:

I am on bedrest for PTL and called BCBS to ask about covering the breastpump (ANY percentage) and I was told they absolutely do not cover it, even if Jaden is born too early and has to spend time in the NICU.  I asked about every possible situation: the doctor prescribing it as medically necessary, etc, and they flat-out denied coverage and said under no circumstances would it be covered.

It is SO frustrating, because most BCBS policies cover it 80%-100%.  Apparently, mine does not.

Good luck to you! 

My insurance (Humana) told me the EXACT same thing when I called them before ds was born. However, when the breast pump was billed as part of his NICU bill, they covered it. Maybe the $65 rental was a drop in the bucket of his whole bill?