ins covered breast pumps

Klafountain · December 2013

I contacted my insurance company regarding what pumps are covered and of course didn't get very far.

Apparently, i have to go to a medical supply store and they will submit claim and then i will know how much it will cost. Well that doesn't work for me cause I want to know upfront how much will be my portion cause it may determine which one i get.

Has anyone else had this issue? I have Blue Cross/Blue Shield

angelsnight · December 2013

I have BCBS, they were kinda vague saying I'll have to submit the claim to a medical supply (Bynam Healthcare I think)....but they did say they cover pretty much anything except the heavy duty, which I took to mean as hospital grade, not the double electric I want.

angelsnight · December 2013

Klafountain said:

I contacted my insurance company regarding what pumps are covered and of course didn't get very far.

Apparently, i have to go to a medical supply store and they will submit claim and then i will know how much it will cost. Well that doesn't work for me cause I want to know upfront how much will be my portion cause it may determine which one i get.

Has anyone else had this issue? I have Blue Cross/Blue Shield

Also, they'll tell you what your portion will be before they fulfill the order, so I would submit the claim for the best one you want....then if your portion were to be too much you could always submit a claim for a cheaper one.

They'll start accepting claims 30 days before the due date, and you really shouldn't introduce a bottle (if you are nursing) until at least 2-3 weeks of nursing, so you should have plenty of time to get it in even if you have to resubmit the claim.

dannie2011 · December 2013

We have BCBS also but they cover crap. Decent manual pumps if you want to call it that. Crappy electric pumps, if I was a returning to work mom these pump would not work at all. I found their list on their website.

awhitworth926 · December 2013

We have BSBC but my husband works for State Farm, and the plan is apparently grandfathered ... they don't cover a breast pump of any kind.

jennbaylor12 · December 2013

We have Aetna and they cover 100%, we just game to send in a prescription within 30 days of birth

fish8412 · December 2013

I have BCBS and they will only cover a rental.

nblondheim · December 2013

I have BCBS and they only cover $120.

TradeMama · December 2013

I have BCBS and got a medela PISA (double electric) fully covered.

twinlove314 · December 2013

I have to go through a medical supply company too. My insurance is through Cigna, and they said they covered 100% and that I could order with a prescription when I'm 28 weeks. I'm not sure what my choices will be though

htn1763 · December 2013

I have bcbs and I have to go through one of their preferred provider medical supply stores but any pump I want is covered 100%

CruiseGirl28 · December 2013

Ugh I will have BCBS starting Feb 1. Since I don't have a policy number yet, I can't research this yet. I just wanna know what I can get!!!!

kaking78 · December 2013

I've got United Healthcare and I can either buy off the shelf and get reimbursed or go through a medical supply company. Supposedly they cover any pump I want 100%.

kat4905 · December 2013

I have Cigna and was told it's covered 100%. They gave me the contact number for their supply company, Carecentrix, and they said I could get the Ameda 'Purely Yours' pump. I would just need a prescription filled out.

LolaBelle11 · December 2013

I have BCBS IL HMO and I was told today they will cover an electric pump that I keep up to $150 dollars or they will pay for me to rent a Symphony Medela hospital grade pump up to $1000 or 12 months, which ever comes first. The cost to rent per month is from $50-$75 per month and I only plan on needing the pump for a year, so that option works for me!

LittlePigeon · December 2013

I also have BCBS, but it is a weird plan as it is tied to a teaching insurance group. They gave me really vague answers when I called. I am hoping at my next midwife appointment they are able to help me get a more clear idea on what is covered.

miramirror · December 2013

OP: I would recommend contacting a participating medical supply company. I found the medical supply company to be way more helpful than insurance last time around because they want to hook you up with something and start getting paid asap! They immediately pointed me toward the best pump I could get with my plan was--a Medela Lactina rental, which is an older version of the Symphony. It was not sexy, but it did the job and I kept it for 14 months, no problem.

Oh, and I had Blue Shield and just had to pay for the pump accessories (tubing etc).

theluckiest9 · December 2013

I emailed BCBS customer service about this and they told me a pump was only covered if I had preterm labor or multiples. Now, I haven't done a lot of research, but isn't the ACA making it so that ins companies have to cover them? (Again, I haven't looked into this thoroughly)

delucake · December 2013

I have BCBS and I had to get a script and call one of the three medical supply companies that they work with. Only one of the companies wanted to work with me regarding the type of breast pump I could get. I ended up getting the Pump in Style and I should only have to pay 20% as per my plan. I already received the pump and the receipt states that I don't owe anything but we will see if my insurance sends that lovely claim summary. I might end up getting a bill in a month for the 20%.

KTdid81 · December 2013

We have BCBS. They told me to get a script, go to a particular website - I think it was BetterLivingNow.com, and pick out what I wanted. The OB won't give me the script until I'm 7 months. So I've just been researching for now.

mah0113 · December 2013

We have bcbs and I was told I have to get a script from the doctor AFTER birth and then I can purchase it from one of their medicinal suppliers. They told me which supplier has which pump and I remember a few medela pumps as choices so I felt satisfied with the options but thoroughly annoyed with the fact that it will be a few weeks until I get my pump and I am concerned about supply. I wish they would let me get it before the baby is born! My drs office also really really sucks at sending information to insurance so I am not sure how speedy they will be with sending the script to insurance and I will not really be all that available to call and nag them to do it

YankeePeach08 · December 2013

FarmBoysWife said:

I have BSBC. Under my plan I get a script and go to a medical supply store and I'm covered 100% up to $1,500. It's all plan based I think

Dang for $1500 you could probably hire a wet nurse! What kinda pump costs that much???

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