Breast Pump - Blue Cross Blue Shield Insurance

slenrow · January 2013

I was wondering if any of you have had success in finding a DME supplier that is currently carrying Breast Pumps and is part of the Anthem BCBS network? I have reached out to Anthem and they can't even help me! I would love to have insurance cover my breast pump, however I have already spent far too much time searching for a place that carries them!

andyyougoonie · January 2013

I actually just got the info today that breast pump rentals are covered under my BCBS insurance plan, as of 1/1/13. I have a private network since I work at a hospital, but I think it's a BCBS wide thing. Call the Customer Service department at the number on the back of your insurance card and ask about Women's Preventive benefits.

Corey-chick · January 2013

Not sure why they couldn't help??? I have Anthem Blue Cross, they said that a pump was 100% covered and sent me a list of thier approved Medical equiptment suppliers. I am waiting for the supplier to return my call now so that I can see which ones they carry.

starrjelly · January 2013

We have the same insurance, how do you find it online? I can't navigate Anthem's webpage to save my life. Do I have to literally call?

gfam23 · January 2013

andyyougoonie:
I actually just got the info today that breast pump rentals are covered under my BCBS insurance plan, as of 1/1/13. I have a private network since I work at a hospital, but I think it's a BCBS wide thing. Call the Customer Service department at the number on the back of your insurance card and ask about Women's Preventive benefits.

Awesome info! thanks for the info.

TnArichmond · January 2013

I have BCBS Federal. I called the number on the back of my card. The only place I could get my pump through was CVS Caremark, and they also have a mail order system in case there is no location near you. It didn't start until 1-1-13, but I happened to call asking about it the week before. I was given the number for CVS/Caremark to call, and they set up my order to process after the 1st. I received my double electric pump yesterday! And you are also eligible to re-order storage bags every 3 months!!

Becky D. · January 2013

RedheadBaker:
You need to get this info through your insurance -- just because someone has the same insurance carrier doesn't mean they have the same policy. Your breast pump coverage and that of everyone else who responded here will likely be different.

This! I have BCBS of IL and they only cover manual pumps! Sad

Amanda2034 · March 2013

Just want to clarify some on this as I work for a dme company in rochester ny. When calling your insurance company about the pumps, most customer service reps will quickly tell you they are covered only when medically necessary, which is part of their old coverage criteria. Ask to speak with a supervisor. They will tell you they are covered in full, not even subject to a deductible or c/p as the pumps are now mandatory. They used to only cover manuals unless proven by your doc that it wasn?t working. No script needed, no c/p, no deductible! Yayyy

585-227-8750 call if you need a supplier and ask for Amanda. Or email acnettnin@wmsupply.com

VeronicaCollins · February 2014

I just found one after calling 20 places for anyone that's in the LA area. They are located in Woodland Hills CA. It's called Apguard Med 818-713-0202. I was told by them that anthem only partially covers it. For example, they told me that the Medela electric double breast pump will cost me out of pocket $100. (It's still better than paying $300 for it!) But I do need a prescription from my doctor and it also must be "medically necessary" or they won't cover it - at least in Los Angeles. This is what the person at the med supply place told me and he bills the ins co.

chicagobride_07 · February 2014

I needed a prescription from my doctor. I have BCBS of Illinois, they covered an electric pump with no copay. Customer service for BCBS gave me a listing of DME suppliers and I needed to call around to get one to work with me. Definitely call and verify your benefits on your specific plan.

whoberry · March 2014

I have Anthem Healthkeepers and asked about pumps through their website. They sent me to the following DME providers:

https://www.byramhealthcare.com/breastpumps/index.php

Edgepark

LittleApple · March 2014

Amanda2034 said:

Just want to clarify some on this as I work for a dme company in rochester ny. When calling your insurance company about the pumps, most customer service reps will quickly tell you they are covered only when medically necessary, which is part of their old coverage criteria. Ask to speak with a supervisor. They will tell you they are covered in full, not even subject to a deductible or c/p as the pumps are now mandatory. They used to only cover manuals unless proven by your doc that it wasn?t working. No script needed, no c/p, no deductible! Yayyy 585-227-8750 call if you need a supplier and ask for Amanda. Or email acnettnin@wmsupply.com

Yay! Another Rochester NY person

MrsJetSet · March 2014

Amanda2034 said:
Just want to clarify some on this as I work for a dme company in rochester ny. When calling your insurance company about the pumps, most customer service reps will quickly tell you they are covered only when medically necessary, which is part of their old coverage criteria. Ask to speak with a supervisor. They will tell you they are covered in full, not even subject to a deductible or c/p as the pumps are now mandatory. They used to only cover manuals unless proven by your doc that it wasn?t working. No script needed, no c/p, no deductible! Yayyy 585-227-8750 call if you need a supplier and ask for Amanda. Or email acnettnin@wmsupply.com

This is not true. I run a primary care clinic and very recently worked for a large insurer. Manual pumps meet the minimum standard. If insurance decides that is what they cover, that is what you get. Additionally, plans can be grandfathered out of the requirement altogether. Don't believe anything unless it is from your insurance company. I do agree to talk with a supervisor if the first rep tells you no.

hollygb22 · March 2014

I just got on this this week.

We have Federal BCBS...either a manual or double electric Ameda. The choice was mine both came with a yr supply of storage bags and a carrying case.

I chose the double electric and they said it will arrive within 14 days. No cost.

laurel22 · March 2014

MrsJetSet said:

Just want to clarify some on this as I work for a dme company in rochester ny. When calling your insurance company about the pumps, most customer service reps will quickly tell you they are covered only when medically necessary, which is part of their old coverage criteria. Ask to speak with a supervisor. They will tell you they are covered in full, not even subject to a deductible or c/p as the pumps are now mandatory. They used to only cover manuals unless proven by your doc that it wasn?t working. No script needed, no c/p, no deductible! Yayyy 585-227-8750 call if you need a supplier and ask for Amanda. Or email acnettnin@wmsupply.com
This is not true. I run a primary care clinic and very recently worked for a large insurer. Manual pumps meet the minimum standard. If insurance decides that is what they cover, that is what you get. Additionally, plans can be grandfathered out of the requirement altogether. Don't believe anything unless it is from your insurance company. I do agree to talk with a supervisor if the first rep tells you no.

Yep, ditto this. The law only applies to "private and commerical insurance carriers", which means that a lot of government insurance plans are exempt from it (the irony that this government exemption is part of an Obamacare law totally kills me). I had no problem getting a pump because I have private insurance, but my friend who is an NYC teacher and has insurance through NY State's GHI plan was not covered AT ALL for anything, unless it was deemed "medically necessary" (the definition of which also varies from plan to plan - some just require a script from your OB, others require a script from a pediatrician that can only be written if the baby is in the NICU or has nursing problems).

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Breast Pump - Blue Cross Blue Shield Insurance

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