Breast pump insurance coverage

kmc84 · April 2014

Asking for a friend.....

Is it possible that her insurance doesn't cover pumps as they were 'grandfathered' in? I thought ALL insurance had to cover pumps now??? Thanks ladies!

cnctf · April 2014

Yes, my insurance is one of them

kmc84 · April 2014

So, I guess they told her that you needed to enroll after 1/1/13 to qualify and they entilled in 2012. We have the same exact insurance and I have been enrolled since 2007 and they covered mine with no issue. So frustrating!!

hopefuldog · April 2014

While I agree they don't have to cover it, I would recommend she call back one more time to ask a different person. Unfortunately/fortunately sometimes you can different answers. If she has the time, can't hurt to take 5 minutes to call again and double check.

amichelle723 · April 2014

hopeful0328 said:

While I agree they don't have to cover it, I would recommend she call back one more time to ask a different person. Unfortunately/fortunately sometimes you can different answers. If she has the time, can't hurt to take 5 minutes to call again and double check.

This. Also depending on how far she is from her due date the coverage could change. I first called my insurance early in my pregnancy and was told they would only cover the cost of a manual pump. Three months later they changed their policy and covered both a double electric and a manual pump.

hopefuldog · April 2014

amichelle723 said:

hopeful0328 said:

While I agree they don't have to cover it, I would recommend she call back one more time to ask a different person. Unfortunately/fortunately sometimes you can different answers. If she has the time, can't hurt to take 5 minutes to call again and double check.

This. Also depending on how far she is from her due date the coverage could change. I first called my insurance early in my pregnancy and was told they would only cover the cost of a manual pump. Three months later they changed their policy and covered both a double electric and a manual pump.

Very true. My pump coverage didn't change, but when I could receive it did. Originally it was after LO was born. I called closer to due date to double check/confirm things and was told I could order 30 days before due date. So I was able have it prior to LOs arrival.

Rrrrrachel · April 2014

It willbe recharge unless they switch to new plans. My employer added a new plan option and we switched to it but the old ones are still grandfathered and always will be. They can change rates, copays, etc and still be considered grandfathered.

melaport · April 2014

Tricare and many federal plans to not have to follow that requirement of the ACA.

Designermomma · April 2014

I had BCBS and they covered a pump up to $130 (or a rental for a year) before the baby was born. Then my insurance switched to Aetna in January and they said they only partially cover Pumps if medically necessary with note from doctor. Glad I got one before the switch!

Asivec · April 2014

Check again. I know there was laws passed in feb. 2014 that could have changed things.

Envy1328 · April 2014

It all depends on the employer plan... Just because you have the same insurance company doesn't mean it is covered... I t is all based on the employer's benefit option. For all group renewals in 2014, grandfathering will be discontinued.. So if the group renews in July, she would be eligible as of July this year, but not before then if they were truly grandfathered...

spartybride3 · April 2014

I had that issue too. I talked to HR about it and I was directed to our insurance consultant. They just amended our plan to cover them and I was all set.