Breast Pump covered by insurance — The Bump
March 2014 Moms

Breast Pump covered by insurance

Just wanted to share because I just read about this over the weekend- some breast pumps are now covered by insurance. I called my insurance company today and they told me I would be covered but there's only one specific brand covered and that is the Ameda Purely Yours but it is electric. I would have to pay out of pocket but then with a doctors script it would all be reimbursed. Anyone else's insurance covering or does anyone have any comments on that brand of pump? I've got some research to do I guess. Thanks for any thoughts!
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mamamia866

Re: Breast Pump covered by insurance

  • I haven't thought that far ahead lol! You're on top of things!!!
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  • I work for the government and mine is not covered probably because my plan was grandfathered in....boo
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  • I found a company online that works out the details with my insurance, premera blue cross. They get all of the authorizations and then ship it to me. I need to ask ob next appointment when I should order it.
      
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  • codec said:
    I found a company online that works out the details with my insurance, premera blue cross. They get all of the authorizations and then ship it to me. I need to ask ob next appointment when I should order it.
    They likely won't let you order it until at least 24 weeks or more.  They won't want to pay $250 until they can be sure the pregnancy is viable.
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  • I was able to be reimbursed. I got an Ameda. The perk of most Ameda systems is that it is a closed system and all of the parts are removable and there is a slim to none chance of the milk touching the motor, so it can be 100% sterilized if you rent it/buy it used.
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  • Mine did. I believe they have to do it now by law.
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  • Mine didn't the first time around. . . but I believe they do now.  I'm going to check the details when it gets closer and might get a 2nd~ one for home and one for work.
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  • I want a Medela. Anyone know about humana insurance?
  • I have medical.mutual and they will cover 100 percent purchase of double electric Medela breast pump with doctor script and I can pick it up from my pharmacy :)
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  • I was told by my doctor that all insurance has to cover at least some kind of breast pump now. It's the (newish) law! :)

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  • jh&khjh&kh member
    edited August 2013
    Tricare will not cover a breast pump unless your child is a premie. So unfortunately, I do not get a free breast pump.
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  • I work for a medical supplies company and insurance companies are legally obligated to cover the pumps but its at their discretion what brand, style, and in what time frame of when of they can be ordered. Example 30 days before or after your due date.
    Also just be aware that most manufactures have MAJOR issues. They were not expecting such an influx of orders and are having trouble keeping up with the demand. They are not giving out back order release dates, or how many will be coming out. Can you tell that I answer these questions a lot? :)

    Hope that helps!!
  • I ordered mine already and I have premera blue cross. The guy told me you could order it at any point during your pregnancy and I didn't have to pay anything at all.
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  • codeccodec member
    edited August 2013
    I ordered mine already and I have premera blue cross. The guy told me you could order it at any point during your pregnancy and I didn't have to pay anything at all.
    @parrishfam5 This is good to hear. We just got premera earlier this year. 
    If you don't mind me asking have you aid any co-pays for office visits or meds? I have not paid anything to date I was just curious if it was because of insurance or DHs employer. 
      
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  • jh&kh said:

    Tricare will not cover a breast pump unless your child is a premie. So unfortunately, I do not get a free breast pump.

    This. It sucks that the law doesnt apply to. gov. Health insurance. But also not really surprising...

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  • BCBS FEP covers ameda manual and electric.
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  • I have bcbs and got the medela pisa, no out of pocket cost, with DS. I had to have a script from my OB and couldn't get it til he was born.

  • Question to STM:

    OK with all this talk about breast pumps, STM...... What is a good brand to get for a pump. My insurance covers it, but was told the brand we are approved for is horrible, and we can try to get a better brand. What brand do you recommend?

     

  • I got a free Medela double electric pump (just like the pump in style advanced but it came in a different bag) free through Aetna last year. It had to be ordered through a durable medical supplier within 60 days of giving birth. It was a huge frustrating pain to order it because not many places had them and both the insurance company and the supplier were still learning the new law/terms (my son was born Jan. 6 and the new law went into effect in Jan. 1). It took about a month to come in but it was def. worth all the hassle to save the money. I used a Medela manual pump from the hospital until I received my free one and it took forever and was a pain. Our insurance will give you a new free one if you give birth again two years or more after the birth of your previous child or they will replace the parts (tubing, etc.) if you give birth before the two years.
  • Tricare will not cover a breast pump unless your child is a premie. So unfortunately, I do not get a free breast pump.
    This. It sucks that the law doesnt apply to. gov. Health insurance. But also not really surprising...
    I have Tricare Prime too and just looked today and wasn't the least bit surprised that they don't cover breast pumps unless you have a premie.  It doesn't make sense to me that the government in willing to pay for formula through the WIC program when offering a low income family a breast pump could save the government so much money!

    Once Obamacare kicks in I think people are going to be really disappointed with the level of care that comes with no cost/low cost health care.   :-/
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  • AKPuffin said:
    Tricare will not cover a breast pump unless your child is a premie. So unfortunately, I do not get a free breast pump.
    This. It sucks that the law doesnt apply to. gov. Health insurance. But also not really surprising...
    I have Tricare Prime too and just looked today and wasn't the least bit surprised that they don't cover breast pumps unless you have a premie.  It doesn't make sense to me that the government in willing to pay for formula through the WIC program when offering a low income family a breast pump could save the government so much money!

    Once Obamacare kicks in I think people are going to be really disappointed with the level of care that comes with no cost/low cost health care.   :-/

    I'm not even going to get into ObamaCare but seems like we have similar views. It's not just Prime either, I'm on Reserve Select for this pregnancy since my husband is going to school (its the same as Tricare Standard) and I pay a monthly premium and its not covered. We also don't get a NT scan covered. I do know that most military families under E-5 pay qualify for WIC so I guess you could always get a breast pump that way if you want. I choose not to use WIC though.
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  • Hi, I too have medmutual but I haven't been able to find a DME that carries the medela double electric breast pump. can you tell me the name of the pharmacy that carries it?
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