Getting pump through insurance?

MBush4 · October 2012

I've heard a few times on several different boards of women getting quality breast pumps through their insurance by having their doctor write a prescription for it. Does that sound right to anyone else? Do any of you have experience with that? My work is switching insurance providers to United Healthcare and I'm curious as to whether or not they would do that also...

Meagan0528 · October 2012

A lot of insurances do cover them at 100% these days, you just have to have a rx and make sure you get it through them. I saw a post earlier from someone who has UHC and said beginning in January 2013, they will be covered. Let me see if I can find it....

Meagan0528 · October 2012

Here it is...

https://community.thebump.com/cs/ks/forums/thread/69512189.aspx

MBush4 · October 2012

Thank you so much!

chitowndcbride · October 2012

Yes!! I called my insurance (Aetna) and starting January 2013, under Obamacare, breastpumps will be covered at 100% whether they are rented from a hospital or bought at retail. I was so excited. I will need to start pumping right around that timeframe.

MrsJetSet · October 2012

chitowndcbride:
Yes!! I called my insurance Aetna and starting January 2013, under Obamacare, breastpumps will be covered at 100 whether they are rented from a hospital or bought at retail. I was so excited. I will need to start pumping right around that timeframe.

They have to be covered but it is up to the company to decide what covered means. My insurance will give you a standard Medela PISA but other pumps or rentals are NOT covered.

jakesgirl2 · October 2012

I work for the insurance company mentioned and a lot of the posters have given good advice- It is something you would need an RX for, have to get from an in network DME supplier and it is not required to be covered 100% until plan renewal- also grandfathered plans would be exempt as are self insured plans so be sure to ask those questions when calling UHC.

MBush4 · October 2012

jakesgirl2:
I work for the insurance company mentioned and a lot of the posters have given good advice- It is something you would need an RX for, have to get from an in network DME supplier and it is not required to be covered 100% until plan renewal- also grandfathered plans would be exempt as are self insured plans so be sure to ask those questions when calling UHC.

Well, I work for a university that is switching back to UHC after using Cigna for a year so I'm not self-insured and it's not really a renewal.. At least, not to my understanding. Granted, half of the time I read through insurance stuff it makes absolutely no sense to me. But oh well. I'll definitely give the insurance a call... Would I have to wait until the beginning of the year when I am covered, or could I call now?

Shawnee11507 · October 2012

I would wait until you're covered because the insurance probably has several different policies.

However, make your doctor write your Rx early! I called my insurance around 6-7 months pregnant and they said they would cover the purchase of a pump, I just needed an Rx. I asked my doctor for one and he said "we'll take care of that when the baby gets here". So I asked him again in the hospital. Then I had latch issues and needed the pump- like right away- and the insurance company gave me the run around for at least two weeks. I was using a single manual pump the hospital gave me and was getting desperate (that thing was so much work and I have a cyst in the wrist of my primary hand). So finally the insurance says that they will reimburse me for a hospital rental for up to 1 year. I knew I was moving out of state in a month and my insurance would drop after that, so it was a no-go. Big waste of time and frustration!

kelle017 · October 2012

I just picked one up for my sil who just had a baby 2 weeks ago. Her insuance covered the medela pump in style with the on the go tote. She had to have the perscription and it had to be from a medical supply place. Other than that I don't think there were any other issues.

They asked me when I picked it up, when she had the baby or if she was still pregnant, bu other than that t I just showed them the perscription and that was it. She had called ahead and given the information to make it easier for me though.

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