Pump Coverage through Kaiser?

skirby

While I usually find Kaiser easy-to-use...sometimes I find myself on a wild goose chase.

I figured I would check and see if I have coverage through Kaiser to buy a pump. I sat on the phone forever with member services and finally was told that yes, I have coverage, and that my OB or midwife should have told me already. 

When we went into our midwife appointment I asked about the pump and she told us that pumps are only covered if the baby has jaundice, or other medical need. 

That night we had our hospital tour, and so I figured I'd ask the woman running it if she knew. She told that the pump rental place, where they also sell pumps, could help me and clear up any confusion.  

I called the pump rental today, and they didn't know and gave me another number to call. The person there tried to help, but had no idea.

So, I sent an email to member services explaining that their information was conflicting. They wrote back and told me they don't know what exactly is covered and so I should call Durable Medical Equipment. So....I'll try that tomorrow. At this point, I'm really hoping it's covered so it's worth all this trouble.

I know we all have different plans, but have any of you had your pumps covered? 

Ang&Garrett

I had awesome coverage with my first and he had Jaundice and the rental of the pump was covered for a week or so.  I didn't check into buying one because I already had one.  However, they made me take home a hospital grade pump and said it would work better than the one I had.  I didn't notice a different.  Good luck, it will be a major score if its covered.

kittylove

Mine was not, nor was rental but I was able to claim it as a tax deduction since we spent so much in medical that year (fertility treatments + baby = EXSPENSIVE!).

legaleagles

I hadn't thought to see if my Kaiser would cover it (they've covered so much already - like my IF treatments...I wonder). I'm curious what DME says and I'd love an update.

If you have a FSA you can use that to buy breast feeding supplies. I have about $500 in my account that I plan to use for my pump and pump supplies. Though someone got me a pump for a gift, I just plan to return it and repurchase with my FSA card. 

skirby

If only I hadn't talked to the first rep., who told me that everything was covered and I would get a pump...she was wrong, and because of her I tried to pursue this. After talking to NINE people, here is the final answer:

Kaiser covers pump rentals if the doctor or midwife "deems it medically necessary." Something like going back to work doesn't count, but things like jaundice do count. There is the possibility of having a copay (my plan has $0 copay) if your doctor or midwife orders you a pump rental. If you are having difficulty breastfeeding, you might be able to ask your doctor/midwife if he or she could order you a pump rental.

If you doctor/midwife doesn't "deem it medically necessary" you can rent the pump from Kaiser on a two-week or month basis. It's $30 a month without the hygiene kit and around $49 with.

Thanks for your help, ladies!  

skirby

kittylove:

Mine was not, nor was rental but I was able to claim it as a tax deduction since we spent so much in medical that year (fertility treatments + baby = EXSPENSIVE!).

I am sure that was pricey! Since the pump purchase is not covered, I'm also planning on doing the tax deduction when I buy one. Since I'm going back to work, and have short breaks as a teacher, it's worth it to invest in a good one. 

legaleagles

skirby:

If only I hadn't talked to the first rep., who told me that everything was covered and I would get a pump...she was wrong, and because of her I tried to pursue this. After talking to NINE people, here is the final answer:

Kaiser covers pump rentals if the doctor or midwife "deems it medically necessary." Something like going back to work doesn't count, but things like jaundice do count. There is the possibility of having a copay (my plan has $0 copay) if your doctor or midwife orders you a pump rental. If you are having difficulty breastfeeding, you might be able to ask your doctor/midwife if he or she could order you a pump rental.

If you doctor/midwife doesn't "deem it medically necessary" you can rent the pump from Kaiser on a two-week or month basis. It's $30 a month without the hygiene kit and around $49 with.

Thanks for your help, ladies!  

Thanks for the info - and the hard work. Bummer that it's not covered. I got the Medela freestyle which a lot of friends recommended (I'll be going back to work at 6 months and will be pumping a lot at work so a double electric pump and fairly portable was necessary). 

futrkingsley

skirby:

If only I hadn't talked to the first rep., who told me that everything was covered and I would get a pump...she was wrong, and because of her I tried to pursue this. After talking to NINE people, here is the final answer:

Kaiser covers pump rentals if the doctor or midwife "deems it medically necessary." Something like going back to work doesn't count, but things like jaundice do count. There is the possibility of having a copay (my plan has $0 copay) if your doctor or midwife orders you a pump rental. If you are having difficulty breastfeeding, you might be able to ask your doctor/midwife if he or she could order you a pump rental.

If you doctor/midwife doesn't "deem it medically necessary" you can rent the pump from Kaiser on a two-week or month basis. It's $30 a month without the hygiene kit and around $49 with.

Thanks for your help, ladies!  

Some of this is medical plan stuff (co-pay) the other parts are pretty standard.  If you have a medical reason for inability to breastfeed (baby in NICU, jaundice) you can get a loaner pump.  I have yet to see a plan that pays for a pump outright that you get to keep.  When I gave birth you also couldn't expense it through a flex spending account, though it appears that has changed very recently.

saraj925

I was covered for a month because my LO had a toungue tie issue.....otherwise they dont cover it.  They do rent and sell pumps but there is a place online called best buy baby that is way cheaper and they dont charge shipping or tax...here are there prices and contact info.  Hope this helps

 Dear Customer,                
                                               
Thank you for your visiting our web site.          
                                               
The Medela FreeStyle hands free Breastpump( # 67060) is $ 280.00.
               
The Medela Pump In Style Advanced Shoulder Bag Breastpump(# 57027) is $ 210.00.
 
The Medela Pump In Style Advanced Backpack Breastpump(# 57062) is $ 210.00.
 
The Medela Pump in Style Advanced the Metro Bag Breastpump(# 57036) is $ 240.00.
 
We offer free shipping and no sales tax except on orders shipped to NJ.
 
We usually ship orders same day or the next business day by the UPS ground service
 
from New Jersey.
 
We are an authorized Medela dealer. We carry only brand new sealed breastpumps. 
 
Please give us a call and order at 800-339-1641 between 10:30 AM to 8:00 PM (Eastern time)  
 
Monday through Saturday. 
 
If you have any further questions, please feel free to contact us at anytime.
                                                                       
Thank you, 
                
Jimmy
Customer Service Representative
BestBuyBaby

skirby

saraj925:

I was covered for a month because my LO had a toungue tie issue.....otherwise they dont cover it.  They do rent and sell pumps but there is a place online called best buy baby that is way cheaper and they dont charge shipping or tax...here are there prices and contact info.  Hope this helps

 Dear Customer,                
                                               
Thank you for your visiting our web site.          
                                               
The Medela FreeStyle hands free Breastpump( # 67060) is $ 280.00.
               
The Medela Pump In Style Advanced Shoulder Bag Breastpump(# 57027) is $ 210.00.
 
The Medela Pump In Style Advanced Backpack Breastpump(# 57062) is $ 210.00.
 
The Medela Pump in Style Advanced the Metro Bag Breastpump(# 57036) is $ 240.00.
 
We offer free shipping and no sales tax except on orders shipped to NJ.
 
We usually ship orders same day or the next business day by the UPS ground service
 
from New Jersey.
 
We are an authorized Medela dealer. We carry only brand new sealed breastpumps. 
 
Please give us a call and order at 800-339-1641 between 10:30 AM to 8:00 PM (Eastern time)  
 
Monday through Saturday. 
 
If you have any further questions, please feel free to contact us at anytime.
                                                                       
Thank you, 
                
Jimmy
Customer Service Representative
BestBuyBaby

 

Thanks for the info! Way better deal then I was expecting!  

skirby

legaleagles:

skirby:

If only I hadn't talked to the first rep., who told me that everything was covered and I would get a pump...she was wrong, and because of her I tried to pursue this. After talking to NINE people, here is the final answer:

Kaiser covers pump rentals if the doctor or midwife "deems it medically necessary." Something like going back to work doesn't count, but things like jaundice do count. There is the possibility of having a copay (my plan has $0 copay) if your doctor or midwife orders you a pump rental. If you are having difficulty breastfeeding, you might be able to ask your doctor/midwife if he or she could order you a pump rental.

If you doctor/midwife doesn't "deem it medically necessary" you can rent the pump from Kaiser on a two-week or month basis. It's $30 a month without the hygiene kit and around $49 with.

Thanks for your help, ladies!  

Thanks for the info - and the hard work. Bummer that it's not covered. I got the Medela freestyle which a lot of friends recommended (I'll be going back to work at 6 months and will be pumping a lot at work so a double electric pump and fairly portable was necessary). 

I'm jealous of your 6 months off! I have to go back way too soon. This pump looks like a lifesaver!