Insurance Coverage for Breast Pump Issues

amantho · May 2013

Hi Mamas

Has anyone been able to successfully get a breast pump at no cost through insurance? I have United Health Care and spoke with a representative there. She said I needed to get it through my physician, the hospital or a local DME in order for them to cover it. None of those providers have been able to assist, as they either charge or don't have them available.

Has anyone been through this process? If yes, please offer some insight on how you went about it

Thanks!!

locksley · May 2013

I love lamp....LOUD NOISES!!!!

Kelli2507 · May 2013

I posted yesterday. I also have united. I am getting the Medela pump in style 100percent covered. So that's strange. When I called 2 months ago the insurance company gave me a list of thier contracted medical suppliers. i called one nearest to me, although some do ship internationally as well. I was told to get an RX for a double pump from my OB and to call back in may. I called yesterday, faxed over and RX and she said she shipped it yesterday and should be here today.

Something is not right with your situation. Because if you read on the Medela website it says everyone w insurance qualify for something as long as you are not wic or Medicaid.

BLT20051 · May 2013

I have United and they won't cover mine until July because that's when my policy renews but they said I just had to call back and they'd give me a list of providers to get one from.

BLT20051 · May 2013

Kelli2507:
I posted yesterday. I also have united. I am getting the Medela pump in style 100percent covered. So that's strange. When I called 2 months ago the insurance company gave me a list of thier contracted medical suppliers. i called one nearest to me, although some do ship internationally as well. I was told to get an RX for a double pump from my OB and to call back in may. I called yesterday, faxed over and RX and she said she shipped it yesterday and should be here today. Something is right with your situation. Because if you read on the Medela website it says everyone w insurance qualify for something as long as you are not wic or Medicaid.

Not every insurance will cover one. Some companies, like Tricare, are grandfathered in because they're government plans and not private companies.

NewMammaSara · May 2013

I just went through this... ask your insurance provider to provide you with a directory of DMEs in your area that they work with. Then, call each DME in your area and explain that you want a breast pump. They will be able to tell you what they need from you.

I just went through this process and I need to call the DME with my insurance info once the baby is born, (some DMEs need a Dr. prescription, but not all need it for some reason) then they will either ship the pump or you/DH will pick it up. It seems pretty easy!

Good luck!

Kelli2507 · May 2013

Also on the united website somewhere they have a list of providers in your area . Sounds like the person you spoke with was not helpful!

Kelli2507 · May 2013

Bacon+lettuce+tomato:
Kelli2507:
I posted yesterday. I also have united. I am getting the Medela pump in style 100percent covered. So that's strange. When I called 2 months ago the insurance company gave me a list of thier contracted medical suppliers. i called one nearest to me, although some do ship internationally as well. I was told to get an RX for a double pump from my OB and to call back in may. I called yesterday, faxed over and RX and she said she shipped it yesterday and should be here today.

Something is right with your situation. Because if you read on the Medela website it says everyone w insurance qualify for something as long as you are not wic or Medicaid.

Not every insurance will cover one. Some companies, like Tricare, are grandfathered in because they're government plans and not private companies.

Yea I think that goes along with the WIC program. That is also a government plan.

This is where I got my info.

https://www.medelabreastfeedingus.com/breastfeedinginsurance.

Sorry not a clicky.

amantho · May 2013

Thanks ladies. I will try the insurance company again. The DME's they gave me said they won't cover through insurance, they will only rent one to me, and I pay for it out of pocket so their stories seem conflicting. The DMEs I talked to also said they didn't know of any providers in the Central Florida area that would cover. Crazy...If you have used one that worked with United and they ship nationally, please post the store info and I will try to go through them.

Thanks!

iggles09 · May 2013

I have united and mine is only covered if there is a medical reason for it. I.e. dr will have to write an rx stating why it is necessary after the baby is born. I am hoping they will be able to determine something medically necessary for me. I am going to purchase one and not open it next week just in case

Monkeybutt80 · May 2013

I have Aetna and they gave me a list of medical equipment suppliers I can use to order my pump which would be covered 100%. but, when I called all of them, none of them had Medela PISA. they had freestyle Medela and a ton of other brands, but didnt sell the one I wanted. I think it really depends on your insurance.

RissNRuss · May 2013

Monkeybutt80:
I have Aetna and they gave me a list of medical equipment suppliers I can use to order my pump which would be covered 100%. but, when I called all of them, none of them had Medela PISA. they had freestyle Medela and a ton of other brands, but didnt sell the one I wanted. I think it really depends on your insurance.

Not sure where you are, but I have Aetna and our so called suppliers either don't supply them, or do not have the standard PISA available (the ACA has basically made it harder for them to keep them on the shelves). We are ordering through Yummy Mummy in Manhattan prior to delivery, we can get a prescription for "mother returning to work" through our doc, and we will be getting the PISA with a slight upgrade charge, for a fancier bag (that's the only difference I can gather from the info we've been given). It's still cheaper than getting it another way, so I say it's better than nothing.

AutumnOracle · May 2013

I have BCBS and mine is 100% covered. I received a list of suppliers(there were only two), one didn't have the ability to get them in stock and the other offered Ameda Purely Yours. I had to get an RX and bring it to the supply company. They said it would take 1-2 weeks depending on shipping, I am in the third week but they think they'll have one in this week.

atangiblewish · May 2013

I have BCBS and just started this process today. The lady said I'm 100% covered and gave me two companies to call. I called the first one and she said they can send a manual one out right away. I asked about the electric pump and she said I needed a script. So they will contact Dr's office and try to get one. Within 2 days if they don't hear back from the DR they will call me to get it. I'm hoping the DR does it cause I'd rather not have a manual one. My BFF is giving me her double electric, but I'd rather have a new one if possible. So we shall see if it all works out. I will get the manual one if I have to

flcountrygirl · May 2013

My insurance (AvMed) is covering a pump 100% with a prescripition from my OB's office.

flcountrygirl · May 2013

amantho:
Thanks ladies. I will try the insurance company again. The DME's they gave me said they won't cover through insurance, they will only rent one to me, and I pay for it out of pocket so their stories seem conflicting. The DMEs I talked to also said they didn't know of any providers in the Central Florida area that would cover. Crazy...If you have used one that worked with United and they ship nationally, please post the store info and I will try to go through them.
Thanks!

I live in Central Florida and mine is covered under AvMed (State of Florida Employee Insurance). Although I think the company they use to send the pump is in South Florida.

jennOK · May 2013

Mine is supposed to be covered 100 percent through my insurance. I have to order through a network medical supply company with a doctor's prescription. I just got the script at my appointment today, so I'll take it over and get the process started later this week. We'll see if it works like it should.

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