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Washington Babies
Medical Supply/Breast Pump
Breast pumps are covered by my insurance (luckily!) with a prescription from my doctor and prior authorization from the reseller. The trouble I'm having is finding a medical supply store that both carries breast pumps and will bill to insurance. Does anyone know of a store/pharmacy/hospital that could do so? I live in the Bothell/Mill Creek area, but travelling a bit to save a couple hundred dollars is more than worth it of course 
TIA!
ETA: My first thought was Evergreen's Baby & Family Boutique, but unfortunately they don't bill to insurance.
This discussion has been closed.
Re: Medical Supply/Breast Pump
Disregard. I got a little more information on how my insurance actually covers purchases and wasn't happy with the ethics of it (they only pay the reseller about $70 of the total, leaving them to write off the difference - even if I found a reseller willing to do that, I just couldn't ask them to bite the bullet there).
I would DD, but to maintain etiquette an update seemed sufficient.
And no, unfortunately not. Thank you though!
I can rent one through insurance as well, but there has to be a medical need. I won't know if we have a medical need until baby arrives, of course, and as someone who likes having her ducks in a row well in advance that will be difficult for me
Thanks though, I'll keep that in mind for when/if the time comes.
This is how insurance companies work... with your medical, dental, vision bills with most insurance companies if you go to an in network provider, the provider writes off the difference. The provider actually gets to decide which insurance companies they want to be in network with, so they know that they will be writing off a portion of anyone's bill in those networks. It's a good way for them to get new patients to sign up with different insurance companies. I personally would take advantage of the insurance paying for a breast pump! When I was pg with DD, I know there was a medical supply store I could have gotten a breast pump at in the southcenter area, but I didn't end up going there. I just called and got a list of places from the insurance company, just in case you change your mind!
Hm. I guess I knew the insurance company didn't cover the whole cost on things in general, but $70 out of the nearly $300 that a breast pump costs just seemed like such a, well, rip off? But you're right! So I guess my hunt is back on.
I did get a list from my insurance company though, and the first number I called turned out to be a used car dealership...
The second number was no longer in service, the third was a doctor's office specializing in hospice care, and the fourth (an actual real life medical supply store! woo, finally!) didn't carry breast pumps.
Soo, if anyone has any recs I would greatly appreciate it at this point. GREATLY. Like I might owe you a homemade batch of your favorite cookies or something...lol. TIA, again.
Once you actually have the baby, the hospital will be writing off thousands of dollars! I wasn't fully aware of all of this until I worked at a dental office and did the billing... sometimes it was ridiculous how much we wrote off for people who had insurance through the state. They'd pay something like $45 for a $350 filling, which means the dentist and her assistants just worked for 1 hour for $45! This is why providers like people without insurance... they have to pay the full amount, which also doesn't seem fair!
Wow, that definitely puts it in perspective. Neither situation seems very fair at all. I can't say it makes me feel too much better about my breast pump, but at least I know it's normal! Thanks!
Another question:
As a back up (because I hate not having a plan for this) could I get away with just using a manual pump, like the Medela Harmony? When I go back to work I'll be working about 3 days a week for 5-6 hours each day. I work for my step dad's home business so I'll basically be in the comfort of my own home (as it was such until a year ago) with the ability to pump as often as I need. What do you think?
They are actually the ones that explained my insurance to me. I loved them as well, they were super nice and very very helpful. However, they are the ones that said they just can't sell me a PISA because of the insurance issue. If I need to rent one, though, I'll definitely be back in contact with them!
I worked 3 days a week, but longer days and a long commute and pumped 4 times a day. I definitely wouldn't have lasted nearly as long with a manual pump!
My commute is just about 10 minutes each way. What are your thoughts on a single electric pump? And I'm sorry for all the questions! You are very helpful though
AHA! Thta's the place I got mine through.
And yeah, that's just how insurance works. The people who are ripped off are the people who buy them for $300 retail.
I delivered at Evergreen and they dealt with getting me a pump through insurance after my baby arrived and I had a "need".
I'm unclear why you need a back up. You're not going to need the pump the day the baby's born. And if for some reason you do, the hospital will provide one for you in the hospital and can arrange a rental through your insurance. If you want to buy one through insurance, do you also need a "need"? If so, I'm sure you can organize that quickly through the hospital. Otherwise, you can buy one easily and quickly....
Wow, somehow I missed your reply Kathzoo. Sorry for that, and thank you for the information. I'll definitely check them out!
I don't mean to pry, but what do you mean by "need"? The quotes make me wonder, but did they end up bending the "medical need" part that insurance requires? I don't feel like my question even makes sense lol, I just don't want to step on toes if you know what I mean.
What do you mean? I bought mine through them with my insurance (Regence.) It's definitely not a rental only place, unless they've changed since last fall...
In one of my previous posts I mentioned that they (Optimum Wellness) told me that my insurance (Molina) only pays them about $70 for the PISA pump, and they just can't sell one for that cheap. Sucky...Regence is no doubt better than what I have right now
Ohhhhh gotcha. I was confused that they weren't able to do it, I thought that was more of a personal ethics thing. Insurance makes my head hurt so I must not have read it right. That blows, though. And if it makes you feel better we pay for insurance out of pocket since my husband still can't find a f/t job and we have no bennies through his current job...I would gladly pay more OOP for a pump than pay all the extra for insurance!
By back up I just simply meant I'd like to have a back up plan in mind in case this doesn't work out. I have to return to work 2 weeks after delivery (I'm able to only because I work for my family's business, which is located at my parent's home) so I will need a pump of some sort relatively early on.
Also, if I want to rent through Nurturing Expressions (because they won't take my insurance for a purchase), yes, a "medical need" was required. Otherwise no, my insurance itself does not require a medical need. My problem has been finding a reseller that both bills my insurance, and sells breast pumps.
I realize I could just purchase one on my own if all else fails, but if I have to do so I would like to try something cheaper.
No no, my bad! Originally it was an ethics thing. I felt bad that they would only get reimburssed $70 from my insurance, so I wasn't going to push it anymore. But then Krista put things in perspective and I realized insurance just works that way. Lol, these people got me feeling bad for something that is just everyday business to them...
I had a medical need because my child was in the NICU... I didn't mean "need" to be like a wink at faking a need... I meant more like emphasis... but for some reason on my phone and on my laptop (using chrome) I can't bold anything. Sorry if that was unclear.
If you are going back to work 2 weeks later, you need a GOOD pump. You will still be establishing your milk supply and needing to pump every 2-3 hours. Don't do a manual or you'll be pumping all day.
Will you not buy the pump if your insurance doesn't cover it?
Just to put some timing stuff in perspective, I was able to get a prescription for my pump the day K was born, and got one from the Evergreen Store and cleared through insurance in a few days. I did just buy and was reimbursed, although I see that your insurance will not do that for you. I don't see how you would get a px for the pump until baby is here though.
I just wanted to let you know that you could probably get one within two weeks of birth as long as you did the px and order it asap. Worst case you rent a hospital pump for a few weeks and return it once you get insurance figured out. And I'm shocked your insurance won't do reimbursement - mine typically does not, but allows it for medically necessary equipment.
Good luck, I'm sure you'll figure it out. And like Jill said, if you're pumping at two weeks, you do NOT want a manual.
From personal experience, manual pumping is fine here and there - I used one on trips when family offered to take E for a few hours, and it was easier than hauling around the electric pump and/or frozen milk from my stash across the state. No way would I do it at work on a frequent basis. However, I would say that I'm very glad that I had one because it helped out in a pinch when I'd forgotten my electric pump at work and I needed to pump at home.
Also, pumping can take up a lot of time from your day. I wouldn't want to spend twice as long using a single pump. Get a double and a hands-free pumping bra!
I'm really sorry, I didn't know and I couldn't really tell from your post what was meant by the quotations. My most sincere apologizes for that...
If my insurance doesn't end up covering it, I would still buy a pump of course. Like I said above though, I would just like to go for something a little cheaper. Maybe the Medela Swing? While I haven't exhausted all my options for using insurance to cover the cost yet, I'm just looking for opinions on alternatives in case it falls through.
Again, I apologize for sounding insensitive before. I truly didn't mean to come off that way.
Thank you all for your advice. I really appreciate it, and I'll keep it in mind while sorting out this ordeal
As a side note, in case it came across any other way, I really do want to provide the best for my baby. I admit that it is frightening to know I may have to foot the bill for something I originally thought was covered, but if it comes down to it I would be more than happy to step up to the plate and take responsibility. I understand there will be a lot of unexpected expenses in my future, and I hope this one will help me prepare for those.
oh gosh not at all!!! I didn't take it that way at all. My quotes were unclear. Just explaining. Don't worry!!
Oh good! I just wanted to make sure I wasn't burning any bridges so early on!
nope. And don't worry - we're not overly sensitive freaks here on this board.