October 2014 Moms

While we are on the topic of breastfeeding

Please make sure you check your insurance for coverage. No breastfeeding supplies were covered for me last year.

I called again and this year they cover up to $1000.00 without authorization and I pay 20%. I have to order it through a medical supply so I just got my very own Medela Metro Bag advanced for 60.00 from Aeroflow!

Of course all coverage is different and some insurances companies send you a specific one.

So excited!

Re: While we are on the topic of breastfeeding

  • Yes but that doesn't mean it is free. When I called they said it was covered under my deductible. I still had to pay but it was under my insurance.
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  • Yes but that doesn't mean it is free. When I called they said it was covered under my deductible. I still had to pay but it was under my insurance.

    That stinks! I was pretty sure that no portion of pump cost could count toward your deductible. Will have to go back and double check - gotta make sure I haven't been telling moms the wrong thing!
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  • Emerald27 said:

    Yes but that doesn't mean it is free. When I called they said it was covered under my deductible. I still had to pay but it was under my insurance.

    That stinks! I was pretty sure that no portion of pump cost could count toward your deductible. Will have to go back and double check - gotta make sure I haven't been telling moms the wrong thing!
    That's what I was told as well, but now that I think about it, I'm not sure where that information comes from.

    My insurance won't cover a pump until I'm 28 weeks, and I get no choice in the type. Whatever's on the shelf when I call, that's what I get. Sounds like every company handles it a bit differently, so call your insurance company!

    n Chart</a>"http://www.fertilityfriend.com" style="font-size:smaller;" >Ovulation Charww.fertilityfriend.com" style="font-size:smaller;" >Ovulation Chart</a>

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  • This too which is how they get around it

    Grandfathered plans are exempt: If your health insurance plan was in place before March 23, 2010 when the Affordable Care Act was signed, it is not required to comply with the new breast pump and breastfeeding support provisions. That said, you may still have some coverage, and will only have to come up with a co-pay or deductible out of pocket. Not sure if your plan is grandfathered? Call and ask.
  • My insurance only covers the 
    • Ameda Manual pump kit
    • Ameda Double Electric pump kit

    Be sure to check before you buy.
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  • Honestly the deductible and coverage didn't matter to me since I will use all my out of pocket and deduct anyway. The fact after I have the baby any supplies I need will be covered at 100 percent where before I couldn't claim insurance so I paid for all of that.
  • Mine covers either the medela pump in style,aand a double pump, or hygeia q pump, but not the accessories that come with them

     

  • DiannaVB said:

    My insurance only covers the 

    • Ameda Manual pump kit
    • Ameda Double Electric pump kit

    Be sure to check before you buy.
    Some insurance companies require you to go through a specific retailer too, and won't reimburse you if you buy yours at BRU or Target or something...even if it's the brand in your plan. So it's definitely important to contact them for info about both what brand of pump they cover and how to get it. :)
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  • Emerald27 said:
    My insurance only covers the 
    • Ameda Manual pump kit
    • Ameda Double Electric pump kit

    Be sure to check before you buy.
    Some insurance companies require you to go through a specific retailer too, and won't reimburse you if you buy yours at BRU or Target or something...even if it's the brand in your plan. So it's definitely important to contact them for info about both what brand of pump they cover and how to get it. :)
    Correct. It's CVS Caremark only for my plan. Milk storage bags are also covered.
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  • Emerald27 said:

    DiannaVB said:

    My insurance only covers the 

    • Ameda Manual pump kit
    • Ameda Double Electric pump kit

    Be sure to check before you buy.
    Some insurance companies require you to go through a specific retailer too, and won't reimburse you if you buy yours at BRU or Target or something...even if it's the brand in your plan. So it's definitely important to contact them for info about both what brand of pump they cover and how to get it. :)
    ------------------

    On mine I have to go through any medical supply listed under out coverage. It was pretty cool they filed it for me and everything
  • There is also yummymummystore.com. theyhave a lot of insurance companies listedthey take an you don't have to pay and get reimbursed. They bill the company.

     

  • I wish I would've known about this BEFORE I spent the $280 on my double electric breast pump when I had LO #1. Ugh. They wouldn't reimburse me either. Bastards. :-q
                                                 
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  • Has anyone had an Ameda double electric breastpump? My Caremark covers it 100% but I want to be sure it's good before I cross my medela off the baby list.

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    Baby Gibson is due October 8th! (Bfp: January 29th)

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    Noah 12.26.2008

    6 lbs 6 oz / 19.5 inches long

  • They were talking about it in trimester 3 board @BabyGibsonsIncubator‌ and they were giving good reviews

    I personally haven't tried it.
  • jalara48 said:

    Good tip. You reminded me to do this right now.

    ETA: So, if any other Canadians are with PSHCP then this might help: I called and the only way they would cover a breast pump is if the baby
    was born before 37 weeks and either baby or me had a medical condition
    to not breast feed. In that case a doctors note would be required and they will cover 80%.

    So for me, this means I *should* qualify since I can't carry my own baby - it's worth a shot! If we're lucky, they'll cover it and I can then put the remaining 20% through my husbands plan and shouldn't have to pay anything. Fingers crossed! August is coming up quickly!

    But you will probably be lactating if all goes well. I think you have a good chance!!
  • Justabean3 !! I was googling some reviews and most seem good, depending on the model. One con they said it was loud when making personal calls, but eh I don't plan to pump and talk. Ill have to go check out that board.

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    BabyFetus Ticker

    Baby Gibson is due October 8th! (Bfp: January 29th)

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    Noah 12.26.2008

    6 lbs 6 oz / 19.5 inches long

  • Justabean3 !! I was googling some reviews and most seem good, depending on the model. One con they said it was loud when making personal calls, but eh I don't plan to pump and talk. Ill have to go check out that board.

    The Medela is loud too (I think they all are fairly loud). I used to feel my cheeks turning red when coworkers would walk by my office door, wondering if they could hear my pump. In hindsight I was completely silly. I'm sure they were oblivious, and if not, who cares! Your kid's gotta eat. ;)
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  • I just checked and since our plan was grandfathered in, it does not cover breastpumps. Bummer :(
  • @anjb43 - even if your plan has been grandfathered, sometimes the plans will cover pumps under the durable medical equipment provisions of your insurance plan.  My employer has grandfathered insurance plans as well, but I was able to get my breast pump covered with my daughter as durable medical equipment.  Because of that, pursuant to my plan, I only had to pay 10% of the price of the pump.



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  • My insurance states on their website that they cover a rental of a breast pump under a prescription from my doctor or hospital.  I'm assuming the parts you have to buy for the rental are not covered, but I'll definitely call as I get further along to get the details.
  • @anjb43 - even if your plan has been grandfathered, sometimes the plans will cover pumps under the durable medical equipment provisions of your insurance plan.  My employer has grandfathered insurance plans as well, but I was able to get my breast pump covered with my daughter as durable medical equipment.  Because of that, pursuant to my plan, I only had to pay 10% of the price of the pump.
    I emailed them so hopefully there is some coverage. Thanks!
  • My insurance states on their website that they cover a rental of a breast pump under a prescription from my doctor or hospital.  I'm assuming the parts you have to buy for the rental are not covered, but I'll definitely call as I get further along to get the details.

    You might check with your hospital for the parts. All of the hospitals in our area provide a complete Medela Part kit.

  • I just called, mine covers 100% of a manual and I can buy it anywhere.  They also cover 100% of an electric pump (up to two a year?!) and 12 months or $1,000 for a hospital grade rental as long as I go through a DME provider - and there is one right inside the hospital I'm delivering at!

    I'm pretty stoked about this...mine has been through three different people and basically the other two treated it like crap.
    Lilypie - (JrNi)

    Lilypie - (y35Q)

  • Are the hospital rentals the same portability/ease as something like a Medea?

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  • Yes. The ones I have seen don't have a bag or anything.
  • ADH0906 said:

    Are the hospital rentals the same portability/ease as something like a Medea?

    I rented a symphony for a while and it is not portable at all. It's heavy and had a big bulky hard case. My PISA is much smaller and lighter weight.

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  • Emerald27 said:

    Under the Affordable Care Act, all Americans are provided a free, double electric breast pump. Ask your insurance company if you should pick yours up from the hospital or retailer, or order it in advance of delivery.

    Actually, this is not true. Ours does not cover it (not even partially), and I know ours isn't the only insurance carrier that doesn't. :-/


    Fall 2013: Fertility treatments = first BFP!!
    07/23/2013 Drew Steven born at 5lb 12oz

    02/10/14: Surprise, spontaneous BFP!
    EDD: 10/11/2014 Stick, baby, stick!!


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