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What I learned getting a pump through insurance...

cynthiarenecynthiarene member
in May 2014 Moms
I spent the morning dealing with insurance and medical suppliers to figure out the breast pump coverage situation, and thought I might save some of you some time if I shared... If this has come up already, mea culpa - I did a quick search and didn't see anything.

Start with your health plan - they will confirm coverage and they can tell you what suppliers are in-network for you and give you contact information for them.  I have Anthem BCBS and they gave me three suppliers.  One of the three suppliers could tell me options for my specific insurance company online; I had to call for the other two.  Ameda Purely Yours and a version of a Medela were offered on all three.  Hygeia Q and a First Years one were offered by one of the three.  

You can't get the Medela Pump In Style covered - that is the retail version.  The insurance version is called the Medela Double Pump or something like that.  It seems they were all offering that with a tote bag/cooler combo (in a horrible tan color rather than the black retail version) but all are in the process of switching over to a model that does not include a tote bag.

When you figure out what you want, the supplier will take your info and contact your doctor for the appropriate Rx to get the process going.  Some health plans won't let it ship until after the baby is born, some ship within 30 days of the due date, some ship whenever they get the Rx from your OB.  

I hope that helps someone out there save some time!
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Re: What I learned getting a pump through insurance...

  • kramja01kramja01 member
    cynthiarene said:
    I spent the morning dealing with insurance and medical suppliers to figure out the breast pump coverage situation, and thought I might save some of you some time if I shared... If this has come up already, mea culpa - I did a quick search and didn't see anything.

    Start with your health plan - they will confirm coverage and they can tell you what suppliers are in-network for you and give you contact information for them.  I have Anthem BCBS and they gave me three suppliers.  One of the three suppliers could tell me options for my specific insurance company online; I had to call for the other two.  Ameda Purely Yours and a version of a Medela were offered on all three.  Hygeia Q and a First Years one were offered by one of the three.  

    You can't get the Medela Pump In Style covered - that is the retail version.  The insurance version is called the Medela Double Pump or something like that.  It seems they were all offering that with a tote bag/cooler combo (in a horrible tan color rather than the black retail version) but all are in the process of switching over to a model that does not include a tote bag.

    When you figure out what you want, the supplier will take your info and contact your doctor for the appropriate Rx to get the process going.  Some health plans won't let it ship until after the baby is born, some ship within 30 days of the due date, some ship whenever they get the Rx from your OB.  

    I hope that helps someone out there save some time!
    This is not necessarily true. It depends on your insurance--mine covers it.
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  • motoLynmotoLyn member
    I just called the supplier a few minutes ago before seeing this post.  I called insurance first in my case Cigna Select and they gave me the number for a second source party called carecentrix to order my pump from them.  I need a Rx from my MW to be faxed in and then they will send out the Ameda Purely Yours.  That's the only model they have covered for me.  Medela they will only cover as a rental.  The service rep said the pump will be sent out 5-7 business days after they receive thr Rx from the Dr.  It was fairly easy process. 
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  • NorthernGal248NorthernGal248 member
    Def depends insurance to insurance. Glad you got yours figured out!

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  • talkthewholetimetalkthewholetime member
    kramja01 said:
    cynthiarene said:
    I spent the morning dealing with insurance and medical suppliers to figure out the breast pump coverage situation, and thought I might save some of you some time if I shared... If this has come up already, mea culpa - I did a quick search and didn't see anything.

    Start with your health plan - they will confirm coverage and they can tell you what suppliers are in-network for you and give you contact information for them.  I have Anthem BCBS and they gave me three suppliers.  One of the three suppliers could tell me options for my specific insurance company online; I had to call for the other two.  Ameda Purely Yours and a version of a Medela were offered on all three.  Hygeia Q and a First Years one were offered by one of the three.  

    You can't get the Medela Pump In Style covered - that is the retail version.  The insurance version is called the Medela Double Pump or something like that.  It seems they were all offering that with a tote bag/cooler combo (in a horrible tan color rather than the black retail version) but all are in the process of switching over to a model that does not include a tote bag.

    When you figure out what you want, the supplier will take your info and contact your doctor for the appropriate Rx to get the process going.  Some health plans won't let it ship until after the baby is born, some ship within 30 days of the due date, some ship whenever they get the Rx from your OB.  

    I hope that helps someone out there save some time!
    This is not necessarily true. It depends on your insurance--mine covers it.
    ...mine too.
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  • Preggerswitnum3Preggerswitnum3 member
    I have Cigna insurance. They offered the Ameda purely yours double electric pump fully covered. I just received it in the mail after the midwives faxed the prescription to care centrix.
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  • kalettekalette member
    kramja01 said:
    cynthiarene said:
    I spent the morning dealing with insurance and medical suppliers to figure out the breast pump coverage situation, and thought I might save some of you some time if I shared... If this has come up already, mea culpa - I did a quick search and didn't see anything.

    Start with your health plan - they will confirm coverage and they can tell you what suppliers are in-network for you and give you contact information for them.  I have Anthem BCBS and they gave me three suppliers.  One of the three suppliers could tell me options for my specific insurance company online; I had to call for the other two.  Ameda Purely Yours and a version of a Medela were offered on all three.  Hygeia Q and a First Years one were offered by one of the three.  

    You can't get the Medela Pump In Style covered - that is the retail version.  The insurance version is called the Medela Double Pump or something like that.  It seems they were all offering that with a tote bag/cooler combo (in a horrible tan color rather than the black retail version) but all are in the process of switching over to a model that does not include a tote bag.

    When you figure out what you want, the supplier will take your info and contact your doctor for the appropriate Rx to get the process going.  Some health plans won't let it ship until after the baby is born, some ship within 30 days of the due date, some ship whenever they get the Rx from your OB.  

    I hope that helps someone out there save some time!
    This is not necessarily true. It depends on your insurance--mine covers it.
    Mine also covers the PISA, and I also have BCBS (of MN).
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  • chillypenguinchillypenguin member
    Mine offers the Medela Pump in Style Advanced also, so definitely check with your insurance.
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  • KBowen715KBowen715 member
    cynthiarene said:

    I spent the morning dealing with insurance and medical suppliers to figure out the breast pump coverage situation, and thought I might save some of you some time if I shared... If this has come up already, mea culpa - I did a quick search and didn't see anything.


    Start with your health plan - they will confirm coverage and they can tell you what suppliers are in-network for you and give you contact information for them.  I have Anthem BCBS and they gave me three suppliers.  One of the three suppliers could tell me options for my specific insurance company online; I had to call for the other two.  Ameda Purely Yours and a version of a Medela were offered on all three.  Hygeia Q and a First Years one were offered by one of the three.  

    You can't get the Medela Pump In Style covered - that is the retail version.  The insurance version is called the Medela Double Pump or something like that.  It seems they were all offering that with a tote bag/cooler combo (in a horrible tan color rather than the black retail version) but all are in the process of switching over to a model that does not include a tote bag.

    When you figure out what you want, the supplier will take your info and contact your doctor for the appropriate Rx to get the process going.  Some health plans won't let it ship until after the baby is born, some ship within 30 days of the due date, some ship whenever they get the Rx from your OB.  

    I hope that helps
    someone out there save some time!

    You= savior!
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  • softservecitysoftservecity member
    Be careful with it shows online on suppliers websites. They're not accurate for every plan type even if its your insurance company. I checked and had 6 options shown but when I called I only had 3 choices (one of which wasn't even shown online).
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  • Lauren5905Lauren5905 member
    I filled my prescription for a breastpump last Friday with BCBS of Michigan. My only option at the medical supply store was Medela pump in style advanced, which my doctor prescribed. It was 100% covered for me. The only bummer was that because of the new ACA, the PISA no longer comes with the bag. Just the actual pump and the tubes etc in a cardboard box. So unpaid $99 to get the tote bag that has a cooler and extra parts but used my medical Flex account.
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  • momo214momo214 member
    I also have federal BCBS, called one number provided by the insurance company, said "I'm pregnant and plan to breastfeed," they gave me the option of manual vs electric and in 3 weeks my Ameda electric pump and one year of bags was on my door step along with a tote bag. Like others said, everyone's different (even with BCBS).
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  • ohwhynot85ohwhynot85 member
    Not 100% accurate for everyone on the coverage of the Medela Electric In Style Pump. I have Anthem BCBS of CT. I went through this headache yesterday. It went like this:

    • 1.5 hour phone call with insurance. They provided me a list of in network medical supply companies that carry breast pumps. Which ones they cover, a mystery. You must call and see.
    • I was told months ago that the Medela Electric is covered. I need a Rx from my OBGYN, in which I obtained at my last appt. 
    • Call 3 places on the list that are local to me and NOT ONE of them carried this pump. FML.
    • Insert insurance info - state and TADA it provides you with in network suppliers. 
    In the end I went with Acelleron (which was one of the places my insurance company suggested but is out of state). Within 15 mins I had my info printed out and faxed to them. They called me today to verify my insurance info and said my pump will be in the mail today and in my hands tomorrow. I didn't have to wait 30 days before or even wait until birth. Whew. Glad that's taken care of. 
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