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Another insurance covering pump question

jiffy-popjiffy-pop member
in Breastfeeding

How can I find out if my insurance covers a pump? And would it cover a PISA? That's the one I want. I used a PISA for my first DD but it was my sisters.

I work at a college so I have state teacher's insurance through Blue Cross/Blue Shield.

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Re: Another insurance covering pump question

  • purple4upurple4u member
    Call your insurance and ask if they cover and all of the necessary details. 
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  • kem717kem717 member
    Yeah, just call BC and ask if they cover it.  Mine was covered through a DME and they needed specifics on the script.  We just have to pay a 20% copay.
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  • boogerbearoriginalboogerbearoriginal member

    Ditto PP - call and ask.

    FWIW, mine covered 80%, but it wasn't the PISA and required a script from the Dr.



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  • apardy131apardy131
    I have Blue Cross NY and they covered 100% - Call your insurance company - Mine was really nice and answered my questions. I got the Medela FreeStyle. I had to order from a company they work with - Edgepark I think. It was delivered to my house in less than a week.
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  • sjuncfansjuncfan
    FYI pump rental or purchase is covered for everyone under the new healthcare reform law as of 8/1 (along with lactation consultant) but it won't go into effect until your coverage is renewed. Would recommend calling your insurance company and asking specifically about the coverage under health care reform.
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  • letitbe3letitbe3
    Yes, to what everyone said. I just called my isurance yesterday (Blue Cross CA) and she said it is covered at 100%, but because my plan doesn't "renew" until next month, she couldn't give me specifics as to which one, etc., and I think she was still learning the specifics of the new plan. She said some doctors will write a Rx for the pump and you get it at a Med. Supply or sent to you, or you can purchase it at the store and submit a form from your dr. and reciept for a reimbursement.
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  • mamakbackmamakback
    Could you elaborate on this a little bit? I'm looking for more information on it so I don't call my insurance company without any knowledge on the subject but can't find too much! I called insurance when I first found out I was pregnant with baby #2 and she said they only cover if baby is in the NICU and that only covers a rental.. that was 4 months ago and with a reform obviously everything has been changed and stirred up. Do you know of a website I could check out or anything? Any more info would be greatly appreciated! Thank you!!
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  • sjuncfansjuncfan

    imagemamakback:
    Could you elaborate on this a little bit? I'm looking for more information on it so I don't call my insurance company without any knowledge on the subject but can't find too much! I called insurance when I first found out I was pregnant with baby #2 and she said they only cover if baby is in the NICU and that only covers a rental.. that was 4 months ago and with a reform obviously everything has been changed and stirred up. Do you know of a website I could check out or anything? Any more info would be greatly appreciated! Thank you!!

    https://www.healthcare.gov/news/factsheets/2011/08/womensprevention08012011a.html

    About halfway down, under "New Comprehensive Coverage for Women?s Preventive Care"

    But your insurance company is going to know better than anyone so you really need to call them. But they very well may say that you don't have coverage for a pump because when they look up your account in it's current state, that's what it's going to say. You will have coverage for a pump, but not until the policy renews. They likely won't be able to tell you exactly what the coverage will look like when your policy renews, because they can only see what you have now.

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  • mamakbackmamakback
    I called and got the scoop... of course my health care plan would be "grandfathered" in and old so in order for any of the reform to take place for my specific plan my husband's company would have to change their policy and lose the positive benefits of said "grandfathered" plan. Ugh! I can never win when it comes to insurance companies!! 
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  • livinrealitylivinreality member

    imagemamakback:
    I called and got the scoop... of course my health care plan would be "grandfathered" in and old so in order for any of the reform to take place for my specific plan my husband's company would have to change their policy and lose the positive benefits of said "grandfathered" plan. Ugh! I can never win when it comes to insurance companies!! 

    Mine is the same.  Although I was told they do cover it if medically necessary... the rep could not define that for me so next week when I have time I am going to sit on the phone and find someone who does, because my pedi can write a script that it is medically needed for LO if i know what reasons/ code he needs to put down.  

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