March 2012 Moms

Breast Pumps and Insurance

I had a few friends of mine have their Breast Pumps covered by their insurance as durable medical equpiment. Since my insurance company covers 80% of the cost of durable medical equpiment I decided to call to see if they covered the breast pumps as durable medical equipment. I was not expecting a yes or no, I was ok with whatever answer she gave me. I know I can go buy my own breast pump and thats what I was expecting to have to do in the first place.

 

Their exact answer was, "You do not HAVE to breast feed your baby, so we do not consider this as medically neccessary and will not cover it. You do not have to to breast feed, you can formula feed"

(My insurance packet goes into detail on non essential medical equipment so I didn't think someting had to be medically neccessary to be covered)

I then said "I understand that breast feeding is a choice. Is there any programs or options for women chosing to breast feed" she said "No, but you can formula feed"

Honestly I kept getting triggered when she said that. I have no problem with formula feeding, and open to it if I find that breast feeding  is not for me and my baby, but I really felt like she was reccomending that I formula feed and I was not calling for advice!  I know I am probably just hormonal, and I am sure she did not intend to offend me. ( I am easily offended these days) I just think a better response would have been, "unfortunatly at this time breast pumps are not considered durable medical equipment."  ok vent over

 

But I did want to offer the suggestion to everyone else to check with their insurance companies since I have had some of my friends have theirs covered :)

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Re: Breast Pumps and Insurance

  • Yeah, she definitely could have responded in a little nicer way.  But thanks for the info, I will be calling my insurance later today!

     

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  • A friend told us that MH's insurance (my secondary) covers 100% of the cost of a breast pump so I checked into it.  Apparently it's considered "preventative care" for the child if the mother breastfeeds by our insurance, so equipment and I think even breastfeeding classes and support are covered 100%.  I thought that was really great. 

    They don't require it, they don't push it, it doesn't change your coverage one way or the other if you don't breastfeed.  That would be the only thing I would worry about when they consider it preventative care...

    Lots of love to my BFPB, Squishy622 <3

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  • imagetash_rn:

    Yeah, she definitely could have responded in a little nicer way.  But thanks for the info, I will be calling my insurance later today!

     

    Totally agree with this!

    Lots of love to my BFPB, Squishy622 <3

    photo 544b4365-b9ee-4805-ba08-f19896d25dae_zpsd8a0debb.jpgphoto ed61c23b-2bf9-4622-b870-072ac0970775_zpsa90b2a73.jpg
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  • imagepsychgirl33:

    A friend told us that MH's insurance (my secondary) covers 100% of the cost of a breast pump so I checked into it.  Apparently it's considered "preventative care" for the child if the mother breastfeeds by our insurance, so equipment and I think even breastfeeding classes and support are covered 100%.  I thought that was really great. 

    They don't require it, they don't push it, it doesn't change your coverage one way or the other if you don't breastfeed.  That would be the only thing I would worry about when they consider it preventative care...

    That is amazing! I hate having to call my insurance co, but I'm going to have to find out if they offer any of these benefits!

  • I called my insurance and they told me a pump would only be covered if baby and I needed to be separated for medical reasons (baby needs to stay in hospital and I'm discharged).  This actually was the case for me when I had my DD, so I wish I had known then.  DD had to stay under the billi lights for jaundice and I was discharged.  Fortunately, at the time we lived a block from the hospital in NYC, so I could walk back to nurse or pump with the hospital pump when I needed.  Now we live a 20 minute drive from where I'll be delivering, so I'll keep this info in mind.
  • Wow... I do not like the way she responded either.
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  • Sometimes insurance companies are so ridiculous in what they choose to cover.  There are medical benefits to breastfeeding for both mom and baby: heaven forbid we be proactive about our health!

    1. The new guidelines have approved FSA funds to be used for the purchase of breast pumps and breastfeeding supplies so if you have a flexible spending account this can be one way to go.

    2. I suggest the website www.awaybabyessentials.com  It is run by a group of lactation consultants/nurses on the east coast. They sell their pumps (medela and ameda) at near cost to encourage breastfeeding. I paid $278 for my freestyle when BRU gets $379 for it. Free shipping, no tax.  They also offer 24 hour phone assistance. Great organization and who doesn't love saving money?

  • imageheatheroo:
    imagepsychgirl33:

    A friend told us that MH's insurance (my secondary) covers 100% of the cost of a breast pump so I checked into it.  Apparently it's considered "preventative care" for the child if the mother breastfeeds by our insurance, so equipment and I think even breastfeeding classes and support are covered 100%.  I thought that was really great. 

    They don't require it, they don't push it, it doesn't change your coverage one way or the other if you don't breastfeed.  That would be the only thing I would worry about when they consider it preventative care...

    That is amazing! I hate having to call my insurance co, but I'm going to have to find out if they offer any of these benefits!

    That's thanks to the Health Care Affordability Act.  (Yay Obamacare!)  Unfortunately, this provision isn't required to be added in for non-grandfathered plans until August 2012, and not at all for grandfathered plans.

  • imageguppysown@yahoo.com:

    Sometimes insurance companies are so ridiculous in what they choose to cover.  There are medical benefits to breastfeeding for both mom and baby: heaven forbid we be proactive about our health!

    1. The new guidelines have approved FSA funds to be used for the purchase of breast pumps and breastfeeding supplies so if you have a flexible spending account this can be one way to go.

    2. I suggest the website www.awaybabyessentials.com  It is run by a group of lactation consultants/nurses on the east coast. They sell their pumps (medela and ameda) at near cost to encourage breastfeeding. I paid $278 for my freestyle when BRU gets $379 for it. Free shipping, no tax.  They also offer 24 hour phone assistance. Great organization and who doesn't love saving money?

    Oooh, good point -- my insurance does not cover pumps, but I will wait to buy mine until January when my FSA funds start over (already used them all up this year!)!

  • I called my insurance and they cover it only if its medically necessary so I ask what would be considered medicinally necessary?  They said if baby was not willing to nurse from the breast but willing to take a pumped bottle. so glad I have this info thanks fir the post and sorry it did not work out for you!!!

    P.S I have Premera blue cross blue shild 

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  • My breast pump was covered 100 percent last time by insurance. The medical reasoning was "separation from baby due to return to work". Apparently that was enough!
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