Is your insurance company covering a breast pump?

albowman1984 · July 2012

Hi Ladies!

Just contacted my insurance company and can hardly believe they'll be covering a pump! While I know not every insurance is the same, I have to go through a durable medical equipment company. I've been searching online for companies (of course ones that are covered) but I'm wondering if you had to go a similar route which company did you use? Good or bad experience? Any recs on a pump? I'm thinking I want Medela from previous reviews and friend's experiences but I'm open to suggestions. TIA!

MomtobeNJ · July 2012

Nope. Sad

Mine will only cover it if you meet certain criteria: a premature baby, some kind of swallowing disorder, milk allergy, etc.

LyndseylovesHugh · July 2012

I have read that starting in August all insurances will need to cover either the purchase or rental of a breast pump (not sure which). I am sure someone else on here has more info on it, but I know my insurance currently does not unless for a medical necessity, but starting in August they will regardless of the reason.

mommybear77 · July 2012

That is the same thing I was told by my insurance, I am going to call after August and see if it is diffrent.

MomtobeNJ:
Nope.
Mine will only cover it if you meet certain criteria: a premature baby, some kind of swallowing disorder, milk allergy, etc.

MomtobeNJ · July 2012

I heard this too...I will definitely call again in August.

Grins04 · July 2012

No (not unless there's issues), and I think it depends when your insurance starts over again for the new policy guidelines. For us I believe it's January (DH handles that). So I'm not sure I'll be eligible then?

sourapplemartini · July 2012

Grins04:
No (not unless there's issues), and I think it depends when your insurance starts over again for the new policy guidelines. For us I believe it's January (DH handles that). So I'm not sure I'll be eligible then?

Yup, the insurance laws state that policies will be required to cover them after the open enrollment period following August 1st. So, our OEP is Feb 1-28, so I can't be covered with it until then.

My old insurance did, which is when I got mine. New one doesn't.

MichelleL1118 · July 2012

LyndseylovesHugh:
I have read that starting in August all insurances will need to cover either the purchase or rental of a breast pump (not sure which). I am sure someone else on here has more info on it, but I know my insurance currently does not unless for a medical necessity, but starting in August they will regardless of the reason.

This is true, it's part of the "Obamacare" law. But they don't have to start covering it until the plan renews, which for most people will be January 1. I believe they only have to cover rentals, but I'm not positive - it might be up to the discretion of the company (a purchase is cheaper in the long run than a rental, for anyone who lasts more than 3-4 months nursing/pumping).

rdgove · July 2012

Yup, mine covers any pump I want at 100% as long as I buy from a medical supply company. Try edgepark.com. They were fantastic for me.

jenner77 · July 2012

Mine covers it, but only after the baby is born. I have BCBS.

Anoe1113 · July 2012

For those of you saying u will be covered or that u'll b covered after August, what insurance do you have?

Worcbride · July 2012

you're lucky--mine didnt

Zippomissmaggie · July 2012

If you have a health savings account or flex spending account, you may be able to use those funds too. I know there was a change that I saw sometime last year

bsschroeder · July 2012

sourapplemartini:

Grins04:
No (not unless there's issues), and I think it depends when your insurance starts over again for the new policy guidelines. For us I believe it's January (DH handles that). So I'm not sure I'll be eligible then?

Yup, the insurance laws state that policies will be required to cover them after the open enrollment period following August 1st. So, our OEP is Feb 1-28, so I can't be covered with it until then.

My old insurance did, which is when I got mine. New one doesn't.

this could quite possibly be the bet news i have heard all day!!!

piper09 · July 2012

My insurance covers a manual pump only, not electric. Apparently this is what a lot of companies will be covering.

mindymaske · July 2012

mine will not cover

JayandEmm · July 2012

MomtobeNJ:
Nope.
Mine will only cover it if you meet certain criteria: a premature baby, some kind of swallowing disorder, milk allergy, etc.

Yep. So does mine. :[

ETA: My open enrollment is in Feb., so I wont be covered for a pump until then. That's too late, so I just went ahead and bought one. I dont need anything special anyways, since Im SAH.

apardy131 · July 2012

rdgove:
Yup, mine covers any pump I want at 100% as long as I buy from a medical supply company. Try edgepark.com. They were fantastic for me.

I actually just called my insurance yesterday and they gave me Edgepark as the company to call. I ordered one and it will be here soon I am glad I called the insurance company - I heard through the grapevine they may cover it. Does not hurt to check! Mine covers 100% too - I have Empire Bluce Cross

cedenton · July 2012

Mine doesn't currently cover it. BUT as of August 1st ALL insurance companies will be required to cover RENTAL fees on breastpumps.

When your insurance renews on or after Aug. 1st (for me it's not until January) it will then be covered.

I had planned to rent in the beginning, anyway, so now I will just continue renting and in January it will be covered. The rental ones are usually higher quality so I'm okay with that.

mrsjenni · July 2012

Mine will only reimburse $50. Sigh. But hey, at least it's something, I guess.

I'll probably rent until my plan renews in November and then hopefully my insurance will cover the costs from there, per the new law. I'll call and double check next month.

workingmama · July 2012

cedenton:
Mine doesn't currently cover it. BUT as of August 1st ALL insurance companies will be required to cover RENTAL fees on breastpumps.
When your insurance renews on or after Aug. 1st (for me it's not until January) it will then be covered.
I had planned to rent in the beginning, anyway, so now I will just continue renting and in January it will be covered. The rental ones are usually higher quality so I'm okay with that.

I am not sure where you got this information, but I believe it to be false. The IOM recommended something like this, but the final rule gives insurance companies more room than that. Most are offering partial reimbursement for purchases and free rentals when approved for medical necessity. Check with your individual insurance company before taking this thread to the bank.

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Is your insurance company covering a breast pump?

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