Breast Pump and Insurance *Rant/vent!

lisamahrt · June 2014

To everyone who is interested in breastfeeding and thinking you might need a breastpump. Please start researching now and get all the specific information. So I have Blue Cross Blue Shield- they will pay for a manual or electric 100% or a rental for 12 months/or up to $1200. Here is the catch. You have to find out on your own the medical supply company from their bcbs website. But there is no filter for breastpumps. So basically I got a list of 50 places and just had to start calling around. Out of 50 only 2 did, and none were rentals and none were manual. So I contacted them again and then they gave me to website suppliers that had some better BP selections but still no manual or rentals. So then I contacted them again regarding where to get a manual pump, they then said I could go to any retailer that sold them and just submit the receipt and a prescription from doctor. I was like What, a prescription? Out of the 3 or 4 times I have spoken with someone no one has said a thing about prescription. Then, I ask them now about well what about rentals. They tell me" well you can try the hospital you will deliver" So I did. They do rent but they will not submit the amount to the insurance company I have to do that on my own. Its 75 bucks a month! Then that is not even for sure the insurance company will pay me back. I will say I with my last baby, we had United and they just said pay for it and submit the receipt and prescription. Well we got it from the hospital pharmacy, a year later they denied it saying it was out of network when in fact we spoke with the insurance company when we were in hospital and ended up having to supplement.

My sis in law is has the same insurance and just had a baby and found it to be just too time consuming and She just gave up. It is sad that they make this so difficult. I hope you do not have the same issue as me! Luckily I already have one and just want a manual one for my beside and they are 30 bucks.

If you got this far, thanks for listening!

haboobjob · June 2014

I'm so sorry to hear that you're having such difficulties with the insurance company! I have UHC and when I asked questions regarding the pump and when I could get it he really couldn't answer anything. Just referred me to their partners, where you order the pump. He also said I could go to target but when I asked him how that works, he said he didn't know and to ask someone at target. So frustrating!

MrMrsandBaby · June 2014

Oh that sucks! I have BCBS too and when I called they were super helpful! I have to call back for more details but I got good information from them. Maybe it is the state thing? I'm in IL and BCBSIL has always been awesome with customer service.

lisamahrt · June 2014

MrMrsandBaby said:

Oh that sucks! I have BCBS too and when I called they were super helpful! I have to call back for more details but I got good information from them. Maybe it is the state thing? I'm in IL and BCBSIL has always been awesome with customer service.

I have BCBSIL - but live in MO. So maybe that makes a big difference. You are one of the lucky ones!

Justabean3 · June 2014

I have had some issues but not that many. Sorry

Leysin97 · June 2014

I have BCBS and the first time I called I got phone numbers. I called back because I misplaced the number and they gave me this website https://www.byramhealthcare.com/breastpumps/index.php . There is a link to initiate the order. You then choose your insurer. If you've already had the baby ( your sister) they will immediately initiate the order which includes them calling your doc if a prescription is required by your insurance. If you have not yet gad baby they initiate it within 30 days of delivery. It was really easy. I have BCBS TX so I just chose that. Clicked the pump I wanted, filled out a form, amd got confirmation email.

JessAnnJ · June 2014

I have BCBS federal and they told me the company they go through. I don't get the choice of rental vs double electric. I would call back and ask to speak to a supervisor because nobody has been able to help you. Just explain that you have already spoken to multiple people and you want to speak to a supervisor right away.

If I were you rather than getting a manual that is very inexpensive to buy yourself I would get a another double electric in case yours breaks or a rental.

MrMrsandBaby · June 2014

Leysin97 said:

I have BCBS and the first time I called I got phone numbers. I called back because I misplaced the number and they gave me this website https://www.byramhealthcare.com/breastpumps/index.php . There is a link to initiate the order. You then choose your insurer. If you've already had the baby ( your sister) they will immediately initiate the order which includes them calling your doc if a prescription is required by your insurance. If you have not yet gad baby they initiate it within 30 days of delivery. It was really easy. I have BCBS TX so I just chose that. Clicked the pump I wanted, filled out a form, amd got confirmation email.

Holy crap that site is gold! Great link! I'm bookmarking this in case I want to just do it the easy way!

lisamahrt · June 2014

SaraML13 said:

Yeah, I'm going through the same thing where BCBS just told me to get one through one of their listed medical equipment supplier, but 95% of the companies on their list don't carry breast pumps.

I made more progress by googling "medical equipment supplier" and the name of the breast pump I want to buy. If you go to those websites, a lot of them offer to call your insurance company on your behalf and confirm that the insurance company will cover you buying the pump from that company. I'm in the process of this now, and it looks like I will just have to send one of the medical suppliers a prescription from my doctor and they will take care of the paperwork.

Good luck!

Leysin97 posted this website! Hopefully this can help you as well : https://www.byramhealthcare.com/breastpumps/index.php

cmcookaln · June 2014

I called the insurance company and apparently my insurance doesn't cover any kind of breast pump. I'm a little disappointed though because I have BCBS and so many of you do too and it's covered. I may call back again just to check because some people at my husband's work also said it is covered.

MrsTinMKE · June 2014

Sorry to hear this! I have BCBS and when I called an inquired about a pump, they were going to give me a list of providers in my area that I could contact.... Maybe try to call back, maybe you got a lazy person on the line that didn't want to help you look! only issue I ran into is that I can not order my pump until the baby is born

lisamahrt · June 2014

cmcookaln said:

I called the insurance company and apparently my insurance doesn't cover any kind of breast pump. I'm a little disappointed though because I have BCBS and so many of you do too and it's covered. I may call back again just to check because some people at my husband's work also said it is covered.

Good luck and hopefully they are wrong and you get one covered!

fireflyrebirth · June 2014

We have BCBS Federal and our policy states we can get one Ameda Manual kit or Double Electric pump kit at no cost per calendar year in addition to milk storage bags, and we order through CVS Caremark. I haven't initiated this process yet (waiting till after we move) but hopefully it'll be as straightforward as it sounds!

atraveller · June 2014

Sorry you're dealing with that. I have MVP - and their policy is you can get one double electric pump through their lactation services (they do give you all the information to contact that company and get it all ordered- so that made it easy) and they will pay in full OR you can get one from any local retailer and submit the receipt for refund - but I figured why bother doing that if the service just gets it all set up for me and then sends me the pump - plus they offer me a discount on additional things needed (like breast pads, etc....). The catch with MVP is they only offer coverage for rentals if it is deemed medically necessary - re: you have lactation problems that dictate a need for a hospital grade pump. Of course who knows if one will have that kind of situation, so I just ordered the Medela electric pump and moved on.

[Deleted User] · June 2014

I'm sorry you are having issues, OP.

This thread made me bite the bullet and call my insurance to get information. The guy laughed when I asked about breast pump coverage. I would think that is a common (and not awkward) question?

JessAnnJ · June 2014

@fireflyrebirth‌ - yes, the process is very easy. I haven't gotten one for this pregnancy yet, but I did last time and that was the first week that the federal plan started covering pumps. Even with it being new it was easy.

lisamahrt · June 2014

fireflyrebirth said:

We have BCBS Federal and our policy states we can get one Ameda Manual kit or Double Electric pump kit at no cost per calendar year in addition to milk storage bags, and we order through CVS Caremark. I haven't initiated this process yet (waiting till after we move) but hopefully it'll be as straightforward as it sounds!

A year of Milk storage bags! I am jealous. Not like they are that expensive but every little bit helps.

ibrude13 · July 2014

I totally think it's the type of BCBS insurance you have. I have Federal Employee BCBS and it's wonderful. I called and inquired about the pump, they gave me the # for the distributor. I called them, they asked which pump I wanted and I received it in 2 wks. She was very helpful and answered any question I had about the pump. They even explained the process of re-ordering storage bags... All at no cost.. Sorry you're having to go through this.. Maybe call back to get another rep?

ibrude13 · July 2014

JessAnnJ said:
@fireflyrebirth‌ - yes, the process is very easy. I haven't gotten one for this pregnancy yet, but I did last time and that was the first week that the federal plan started covering pumps. Even with it being new it was easy.

Agreed! --I have federal BCBS and is that simple! I ordered and received my Ameda dual pump in 2 wks! I love that insurance company.

lotsobabies · July 2014

I was going through the same thing and my doctors wouldn't write a prescription until baby was born. However in the last month or so BCBS added Aeroflow to their network and I was able to get the Medela PNSA double with for free and recieved it in 3 days. Check their website

KariAnnM 23 · July 2014

BabiesRUs will help walk you through the whole process. This is the link my insurance company gave me. https://www.toysrus.com/shop/index.jsp?categoryId=22729026

MrsSarahRenee · July 2014

MrMrsandBaby said:
Oh that sucks! I have BCBS too and when I called they were super helpful! I have to call back for more details but I got good information from them. Maybe it is the state thing? I'm in IL and BCBSIL has always been awesome with customer service.

Yeah I had a good experience too! They sent me the list of suppliers and the "prescription" was just a note from the doctor with my due date and the name of the doctor etc. pretty basic info. They also sent me the reimbursement form if I wanted to buy it at target or babies r us. Mine only covers four specific choices though... Good ones from the reviews I read.
I live in MA though.

I echo the just purchase the manual pump the one I want is $40 and not worth all that hassle! Good luck

sorry it is stressful!

lisamahrt · July 2014

TicketTuesday said:

I agree with @theresat858‌ - my manual pump was $25, all the work you're going through would not be worth it to me just for a manual pump. But maybe I misunderstood your post?

That is exactly what i am doing. The price is just not worth the time and energy dealing with these guys anymore.

ariel06 · July 2014

I can get mine at the hospital or with a prescription with Target's pharmacy. It covers any double manual or electric, but some "premium" models require an upgrade fee. I've called several times to clarify which models are available, but the reps claim not to have model numbers.

dana2die4 · July 2014

This sounds horrible. I actually called my insurance yesterday, and they cover a dual electric breast pump at 100% and we get to keep it. I was actually very surprised by this, but hey I'll take it.

Dubsgirlie · July 2014

At least yours covers something! Mine doesn't cover anything. I guess that saves me this hassle at least!

kgrisham18 · July 2014

I have BCBS IL and my policy doesn't cover pumps. At least not until January. We're grandfathered in to an old policy so they don't cover them. Thinking of renting one until January. Sucks though.

mlhw NH · July 2014

I just got paperwork from my OB office to fill out for a free breast pump. It said that all insurances must cover breast pumps according to the affordable care act. I just need to fill out this form, have the doctor sign it ,and fax it in to the number they provided.
My insurance covered them anyway, but good to know.

kyashley1227 · July 2014

My insurance is grandfathered in with BCBS and I was told they won't even cover the cost of a breast pump

MuffinMom14 · July 2014

MrMrsandBaby said:

Oh that sucks! I have BCBS too and when I called they were super helpful! I have to call back for more details but I got good information from them. Maybe it is the state thing? I'm in IL and BCBSIL has always been awesome with customer service.

I'm in WV, but have BCBSIL (my company is based out of Chicago). They gave me three links to online places to get it, I contacted one, and I know I have to place my order 30 days before my due date. No big deal.

jillas1105 · July 2014

Baby's R Us has a great program- they handle all if the insurance filing & ship the breast pump directly to you within 5-10 business days. The program is call Breastpump Solutions. I have FL Blue and my insurance covered the basic Medella model 100%. I did opt to get the better model that comes with a tote, cooler, bottles etc for just $95.
Just google baby's r us insurance covered breast pump.

lisamahrt · July 2014

jillas1105 said:

Baby's R Us has a great program- they handle all if the insurance filing & ship the breast pump directly to you within 5-10 business days. The program is call Breastpump Solutions. I have FL Blue and my insurance covered the basic Medella model 100%. I did opt to get the better model that comes with a tote, cooler, bottles etc for just $95. Just google baby's r us insurance covered breast pump.

Thanks!

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