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Before you spend money on a breast pump, read!

greenmama2013greenmama2013 member
in Georgia Babies
Just wanted to let everyone know, before you buy a breast pump CALL YOUR INSURANCE COMPANY! Under the Affordable Care Act, breast pumps are now covered by insurance companies. I called mine today and they told me I could get a free Ameda double electric pump, or a manual pump--AND accessories (such as freezer bags/storage containers, plus any additional freezer bags I could re-order every 90 days, around a $300 value). Needless to say, I ordered mine ASAP  So before laying out all that money or putting it on your registry, give your insurance company a call and see what they'll offer you. I'm letting everyone know because none of my pregnant friends knew, and I only just learned of this last week. The savings is a big help in the time of a new baby.
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Re: Before you spend money on a breast pump, read!

  • Mwalte4Mwalte4 member
    It depends on your insurance company and what your company has agreed to. I called mine and a pump is only covered if there are feeding issues diagnosed, for example latch issues, NICU, or feeding issues.
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  • Mrs. TheobaldMrs. Theobald member
    When did you call? Was it prior to January 2013 when this went into effect. I have read that Tricare doesn't offer the pump and some other companies were "grandfathered" in and didn't have to offer it. But for the most part most insurances should offer a pump or a rental of a pump. If they tell you they aren't, I'd ask for an explanation as it is a mandate not an option.
    I also wanted to mention LC services are also covered under this not just pumps! I was surprised the number of people who didn't know this too. I got my pump with no problems. The HME company did all the work.
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  • greenmama2013greenmama2013 member
    Yes some companies were grandfathered in :/ but for the most part insurance companies should now be offering pumps. Mine also said they'd provide lactation consulting, etc. It may change though in 2014 when the law goes into full effect! Tricare was still one of the ones that didn't. 
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  • Mwalte4Mwalte4 member
    I called Aetna this past Wednesday and that is what they said. It does seem easy enough to get the pediatrician to write a script for feeding issues, which was one of necessary qualifications under my insurance policy (Cox Inc) to get a pump. Also, I was able to get lactation 2 years ago without any issues with a script from the pediatrician.
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  • Mrs. TheobaldMrs. Theobald member
    Atena is usually one of the better insurances. I'm surprised to hear that. I'd call back and ask why they are not complying with the mandate. I had a friend who had to fight to get hers but after 4-5 calls to her insurance company they finally complied.
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  • RainbowbabyblessingRainbowbabyblessing member
    I had no idea about this.  Thanks for the info!
    Married July 2008
    IVF started Jan. 2013, 14 retrieved, 9 mature, 6 fertilized
    BFP #1: 3/18/13 MMC at 5 weeks
    BFP #2: 6/10/13  Thank God for our precious daughter! She's more than I could have asked for!
     
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  • slwprincessslwprincess member
    Mwalte4 said:
    I called Aetna this past Wednesday and that is what they said. It does seem easy enough to get the pediatrician to write a script for feeding issues, which was one of necessary qualifications under my insurance policy (Cox Inc) to get a pump. Also, I was able to get lactation 2 years ago without any issues with a script from the pediatrician.
    DH just started at Cox and I am beyond disappointed with our coverage under them with Aetna!  We will be switching back to my insurance during Open Enrollment this year.  Their maternity coverage is pathetic- I can't even believe they are getting away with selling this as a "competitive" coverage plan.  He came from Delta and it was WAY better.  I honestly feel like he should have negotiated higher pay if we had known how sh!tty this coverage is.  Of course, we couldn't see the details of the plan until after he started.  And I called and talked to Aetna- they were "grandfathered" in on a lot of bs and it's really pissing me off.  I'm no fan of Obamacare but if the stuff is supposed to be covered, its total bs that they can get out of it.  This pregnancy is costing way more than either of my previous ones.  I'm just glad we'll be able to switch before the birth b/c I don't even want to know what that hospital bill will be after a c/s and tubal!

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  • Mwalte4Mwalte4 member
    slwprincess said:
    Mwalte4 said:
    I called Aetna this past Wednesday and that is what they said. It does seem easy enough to get the pediatrician to write a script for feeding issues, which was one of necessary qualifications under my insurance policy (Cox Inc) to get a pump. Also, I was able to get lactation 2 years ago without any issues with a script from the pediatrician.
    DH just started at Cox and I am beyond disappointed with our coverage under them with Aetna!  We will be switching back to my insurance during Open Enrollment this year.  Their maternity coverage is pathetic- I can't even believe they are getting away with selling this as a "competitive" coverage plan.  He came from Delta and it was WAY better.  I honestly feel like he should have negotiated higher pay if we had known how sh!tty this coverage is.  Of course, we couldn't see the details of the plan until after he started.  And I called and talked to Aetna- they were "grandfathered" in on a lot of bs and it's really pissing me off.  I'm no fan of Obamacare but if the stuff is supposed to be covered, its total bs that they can get out of it.  This pregnancy is costing way more than either of my previous ones.  I'm just glad we'll be able to switch before the birth b/c I don't even want to know what that hospital bill will be after a c/s and tubal!
    Yes, unfortunately the insurance does suck. For my first child I worked for The Weather Channel and the insurance was expensive but out of pocket the birth (which started as an induction, ended as a CS, 5 days at Northside) only cost $250. Fast forward to my second child at Cox and it was about $2500 OOP, along with random bills for my daughter that came after the fact which weren't covered. Disappointing from a family owned company, but a more stable company than TWC, so the trade-off was worth it.
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  • newinhoustonnewinhouston member
    I got my pump from Aetna in May of this year, and we didn't have any feeding issues. 
    I didn't need a prescription form the pediatrician either. 
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  • greenmama2013greenmama2013 member
    Seems like if they at first are trying to deny you a pump, you need to speak up and argue it out with them. Reminds me of my last birth two years ago- I had made sure my Dr.'s and everyone were covered by my insurance; then at the birth, the anesthesiologist just so happened to be "out of network", and insurance sent me a $2,000 bill. I called up, fought, and won- didn't have to pay a dime. I'm glad we are finally seeing some changes that benefit mothers & babies; at this point, anything is something given the hassles private insurance companies can be! Don't be afraid to call and get what you want, and if all else fails, get something from your pediatrician. 
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