Breast pump!

Cailin+Deas+Rua

Woohoo, my breast pump came today.  (I never thought I'd be so excited about that...)

I fought with my insurance company for ages about it and they kept telling me they didn't cover a breast pump unless it was medically necessary.  Well, I dropped an email to a local lactation consultant and within 10 minutes she called me- from her cell phone, in line at the grocery store, to give me some advice on what to do next.

If anyone is fighting with their insurance about a pump, contact a consultant!  She knew exactly what to do to get me what I needed :-)   

CoachAP

With the new Obamacare changes, shouldn't be any restrictions based on your insurer.  They probably aren't up to speed on the new coverage yet.

Cailin+Deas+Rua

Yeah, that was my problem.  The insurance company was refusing to cover it even though the law says they have to.  Even after I told them what the law said, they argued that it wasn't their policy.  The LC whipped them into shape and now I'm getting the things covered that they are supposed to be covering.

jln14

Awesome work and great advice! I called my insurance company twice last week (in the same day) to verify what I needed to do to get one and got completely different answers both times!! The second time was exactly what I wanted to hear, they cover them 100% no matter where you buy them, just send bill and doctor's not, so I made them take note of the conversation for future reference.  Now I just need to pick which one to buy!

Trish&Pete07

I just got off the phone with my insurance company and they do not cover a breast pump at all, even if it is deemed medically necessary or if I get a prescription for one through my dr. But I'm in Canada so that is another can of worms. My company insurance sucks won't even cover partial cost of a semi-private hospital room. My provincial coverage only covers a ward room, which I am fine with but still it sucks. 

StarBe

YAY for free breast pumps!!

Just fyi "obama-care" does not necessarily guarantee coverage of breast pumps - there are companies who have grandfathered plans in the US and are not being forced to cover breast pumps. 

tondraluv

StarBe:

YAY for free breast pumps!!

Just fyi "obama-care" does not necessarily guarantee coverage of breast pumps - there are companies who have grandfathered plans in the US and are not being forced to cover breast pumps. 

So true, there are also A LOT of loop holes in the portion of the ACA.

tondraluv

StarBe:

YAY for free breast pumps!!

Just fyi "obama-care" does not necessarily guarantee coverage of breast pumps - there are companies who have grandfathered plans in the US and are not being forced to cover breast pumps. 

Cailin+Deas+Rua

https://bucks.blogs.nytimes.com/2013/01/28/breast-pump-coverage-under-new-law-varies-in-practice/

LanaLewis

What would you recommend doing first if I want to try to do this? We have United Health Care. Should I call my insurance, if so, who do I ask to talk to? Or should I ask my OB next week at my 32 week appt? I was gonna wait until the baby's first pediatric appointment after we leave the hospital, but I guess I don't have to! I really want to get it ahead of time so I know what type of storage bags to get. Do you get any say in the brand or is it all up to insurance?

Thank you so much!! 

Cailin+Deas+Rua

I'd say start with calling your insurance company, hopefully they will be better informed than mine was!  If they aren't helpful, check at your next appointment to see if your office has any suggestions.  I got in contact with a lactation consultant who works with the LLLI, she was great.  They were able to help me work with the insurance company, and the medical supply company was able to bill the insurance company.  Just check with your insurance first to see what they cover- some only cover rentals, some cover the cost (or part of the cost) of purchasing a pump. 

The LC also told me that if the insurance company tried to deny me LC services or anything that is supposed to be covered, to contact the banking and insurance department to let them know- with the new laws a lot of companies have had a hard time catching up.  Reporting the issues helps to get everyone on track, and helps to get you what you are supposed to be getting. 

svanjicki

LanaLewis:

What would you recommend doing first if I want to try to do this? We have United Health Care. Should I call my insurance, if so, who do I ask to talk to? Or should I ask my OB next week at my 32 week appt? I was gonna wait until the baby's first pediatric appointment after we leave the hospital, but I guess I don't have to! I really want to get it ahead of time so I know what type of storage bags to get. Do you get any say in the brand or is it all up to insurance?

Thank you so much!! 

I have United Healthcare and called last week...the girl didn't seem to know too much but finally found some phone #s to call companies to see what they have to offer. From what I understand, they cover the cost of the pump to rent or buy from these places, but I won't get it until after I have the baby and have a note from my dr. & it's deemed medically necessary.  The girl I talked to said they are having a shortage so hopefully I can get one.  Gee, thanks!  I haven't called the #s yet, though.  It might depend on the plan you have (like the grandfathered, non-grandfathered) so just call the phone # on the back of your insurance card.