Insurance and breast pumps... Very long post...

bunyaporn

Ok, I've been trying to research getting a breast pump through my insurance carrier UHC... Most posts that I have seen are from jan 2013 or older. If anyone has any updates please post them. I am sure there are other mommies out there that are tired of looking this up with no recent news.

My carrier UHC says they cover 100% of double electric pumps through a DME provider, a hospital, or doctor. Or, over the cost of a rental.

Now the rough stuff is that the three DME that UHC uses are back ordered on certain pumps.

Edge park medical:

I really have had issues with the company. The wait on the phone is long, and then the few times I did get through, the reps were kinda rude... The pumps that they offered were a playtex double and ameda which had no co pay with UHC. Through the site, the day I called, it said that UHC requires that you be a week out from your due date before ordering, or have already had the baby. When I called UHC they told me multiple times from multiple reps, that they did not have that as a prerequisite. Ok, so, fustration there... Ok, back to edge park, then I asked if they had the medela pumps available to order, the rep said yes, but UHC doesn't cover the entire cost of medela pumps, and that there might be an extra charge...

 Now I am going to jump ahead... The other company UHC uses is

 Byram healthcare:

Reps for this company are way nicer than edge park. In early Jan. their stock was on back order until the end of feb., but when I called the other day, had received some stock in. What they had now are two different ameda pumps and the low end medela pump, which according to medela is like the pump in go without the instant let down button. It still does the two cycles, but you have to wait for it... They did have an advance on the order form, but it was still on back order, this is the pump that is exactly like the pump in go in the backpack style, but in a canvas bag. These two medela pumps are not pumps sold to consumer stores like babiesrus. But all the pumps listed above for Byram were covered under UHC. Now the fustration, UHC couldn't answer this for me, but how is it that one company says that insurance covers medela, and the other doesn't? So at this point there's frustration all around.

There is a third company, gendyme. But I wasn't interested in a pump I never heard of, or can find any reviews over.

I am delivering at Baylor downtown, I tired contacting there labor and delivery, and they weren't helpful with this matter at all. I were unsure about what I was talking about, but they do have a simply moms store that sells pumps and rents the hospital grade ones, but they are not a DME or considered billable by the hospital. So dead end there...

Lastly I tired my OBs office, which looked into it since not very many people had asked them yet about it. They say that they can't do it because they would have to get a special license (something close to becoming a dme to sell the pumps.)

  Any updates, suggestions, or leads would be helpful. Even if it with other insurance carriers, I am sure other moms are hitting the same brick walls...

TX-Bride

I am going to check the store inside the Plano Presby, I have been told they carry pumps, I will let you know.

ss265

If the insurance doesn't work out, the best deal I got on my pump was by waiting for it to go on sale at BRU, getting BBB to price match and then using a 20% off coupon (either unexpired bed bath and beyond or buy buy baby) on top of the price matched price. The key is to get BBB to price match BRU because BRU only allows coupons on full priced items. I was able to get the Medela PISA for $200 using this which is the best price I could find.

melissad23

Try sterling medical (in New Jersey) and see if they are in your network.

i too, was having a heck of a time and had more or less decided to say screw it....  I have bcbs, but same situation.  I was on the phone with them for maybe 15 mins tops.  10 days from the time I called till my pump was delivered via ups.  They didn't carry the Medela, only the Ameda Purely Yours - but reviews see, pretty good and I was just happy/surprised with how smooth the process actually was. 

Hope that helps - good luck!! 

LaineyPaney

Or, at Baylor Dallas, talk to the social worker or case manager for post partum care, not Labor and Delivery. If they don't set up the pumps, perhaps their lactation consultants do.

...and in the meantime, welcome to the many loopholes under the healthcare reform from Obama! Sure, you can have a free breast pump: if you can find someone to give it to you.

...what a joke.

gheinen

I am due in June, but after reading many posts about insurance coverage for breast pumps, I thought it would be a good idea to get a jump on this. I too have UHC, from what I have been told there are only 2 companies that they now work with that actually carry breast pumps. The best luck I have had is with Bryam, that being said... they only have two pumps that are actually available to order... There order form shows they have the Medela advanced double pump model, but when I submitted the form I received a message back stating that they only had the low end Ameda and the lowest end Medela pump available for order due to manufacture supply.

It is pretty frustrating that insurance is supposed to provide coverage, but you have to go through a medical supply company, and the supply companies all seem to be "out" of the breast pumps that everyone wants. If anyone has had some better luck, please share! Thanks,

FussyFrank

Call your insurance carrier for a list of suppliers.

FussyBaby

Contact Alivio Corporation at 800-285-1025.  They are a specialty DME provider and offer the Ameda, and Medela brands and will work with your insurance and documentation.   

snmetz7

I went with the Byrun Snead purely yours. Just put the order in this past week so I have no experience on receiving it yet.
When along friends which they preferred, 4 had used both medela and ameda and they all preferred the ameda.
As far as why one carrier would have medla and the other wouldn't. The net price may be different and since you only get $200 credit with uhc (at least my plan) one company might have a different style medela that does not fit into that price point.

Designermomma

I had BCBS in Nov. 2013. They gave me a list of providers and said they would pay up to $160 for a pump. Or a hospital rental for a year. I ordered the ameda purely yours from edge park no problem, no charge, got it fast. Maybe I got in early and now they are way busy? If all else fails you should be able to rent one from the hospital. Don't worry.

Justabean3

I used aero flow with uhc

Surilove

I used a medical supply in NY & they where terrific in getting my medela pump approved by insurance within days I had it delivered at my door. There # is 845-783-6678