Breast Pump through Insurance

happylife7 · May 2015

Has anyone else ordered their breast pump yet through their insurance? I ordered mine 2 weeks ago and it already came it. I'm 13w today and know I'm probably super early ordering but I like doing things early and checking them off. I was shocked it shipped so soon as I have heard some insurance companies won't ship until so many days before baby is born. Also, did your insurance let you know that they covered it 100%? The company told me they would contact me if insurance would not cover 100% of the cost but they never did and it came in so I am guessing they covered it all.

Another thing i'm confused about is, I have BCBS of TX and they told me they cover most electric pumps 100% as long as they are from a DME but they will only cover the rental of a hospital grade pump. I ordered/and they covered the Spectra S2 (which is advertised as a hospital grade pump). Not complaining as it is the pump I wanted and I was willing to pay for whatever wasn't covered but just a little confused. Guess I will wait and see!

AshenSky · May 2015

Ooh! I have BCBS of Tx also! I need to do some research into this. I was going to wait until I was farther along.
So far I have been very pleased with the insurance company!

nessytessy · May 2015

I also received mine, several weeks ago. I would say I was around 7 or 8 weeks. It was also covered 100% by my insurance. I used the Aeroflow site to order mine. They offered Medela, Ameda, Hygeia Q and Tomy. I opted for the Ameda set.

wedding crazed · May 2015

Did any of you have to pay if you hadn't met your deductible yet? Or is it really free regardless?

smnewby · May 2015

Many insurances will not send until baby is born.

ash413 · May 2015

wedding crazed said:
Did any of you have to pay if you hadn't met your deductible yet? Or is it really free regardless?

Should be covered regardless of deductible, but you can call insurance and check.

nessytessy · May 2015

I hadn't reached my deductible yet before they sent it.

MES2009 · May 2015

I also have BCBS of TX. I talked to someone in customer service a few weeks ago. She told me that all but one or two of the pumps are covered 100% if ordered from a specific medical supply website. I have been looking into all the different brands and models that the site lists. From what I can tell, the Spectra S2 is a great quality pump, but not actually "hospital grade". I have found it on amazon.com for less than $200, while most "hospital grade" pumps sell for thousands.

happylife7 · May 2015

@AshenSky, the hardest thing for me is 1) they give you a list of DME's but don't tell you which ones carry breast pumps so you kinda have to just go to each ones website and see what they carry. 2) I have BCBS of TX but live in Louisiana so, a lot of the ones that took BCBS TX wouldn't accept it for me b/c it was not shipping to TX. Idk what the reason was for but I ordered through Byram Medical and had no problems at all! Shipped very quickly, within 2 weeks and if you email them, they reply fairly quickly.

@wedding crazed, I don't think you have to meet your deductible for it to be covered as I know I haven't.

@MES2009, that's what I'm thinking is that it is not actually a hospital grade pump but runs as well as one. That is good to know and makes sense as to why it covered. Thank you!

hanray2010 · May 2015

I got mine through aero flow I got the Medela starter kit and 8 bottles free it shipped in 2 days

smnewby · May 2015

https://www.medelabreastfeedingus.com/insurance-pump-lookup

This website is helpful.

ElRuby · May 2015

I just ordered mine through yummymummystore.com. I also added the accessories since they said they were $0... I am really hoping it is legit because it seemed way to easy and I am expecting some sort of bill! Has anyone else received their items yet?

happylife7 · May 2015

ElRuby I checked them out but they were out of network for me. Hope all goes well and you get your order at $0 cost. My friends insurance worked differently from mine. They told her to purchase any pump she wanted and then to send the receipt in and they would reimburse. I like the idea of not having to put money up front but I'm just like you…I keep feeling like a bill is going to come in the mail. The receipt that came with my pump from Byram didn't say anything about coverage or cost. It just said "THIS IS NOT A BILL".

Kitta+1 · May 2015

how do you get started on this? Do you call the insurance, or the breastpump people first?

Pontot31 · May 2015

Kitta+1 said:
how do you get started on this? Do you call the insurance, or the breastpump people first?

Cal you insurance. They will direct you. Every company has it's own way of doing things.

Kitta+1 · May 2015

thanks, I didn't know I could get on that this early. I'd like to have it before delivery so I can bring it and if I have trouble maybe they can help me get started

happylife7 · May 2015

@Kitta+1, some insurance companies will allow it to ship to you at any point in your pregnancy while others won't until you are within so many days of your due date. If you call your insurance benefits dept and ask them, they will tell you what they cover and should put you in contact with companies you can order through. Mine confirmed my coverage before it shipped but others ship to you and then you send your receipt in to you insurance and they will reimburse you. Good luck!

tmandato1234 · May 2015

Does anyone know if Medicaid covers ? I have Humana through Medicaid.

britnys · May 2015

We're military and tricare won't cover one. I'm so bummed. Mine is 5 years old and really needs to be replaced. I'm just not sure I'll be able to swing a new one since we are paying out of pocket for our midwife since they don't cover that either.

mag9812 · May 2015

Another thing to look into/think about if ordering this early is how long the warranty is. In doing research on the pumps my insurance will cover, most only have a 1 year warranty on the motor and 9 months on the parts, which starts the day you receive it. So if you order and receive now, by the time baby comes your warranty may be expired and you have to pay out of pocket if anything breaks or the pump doesn't work.

Just something I learned so I think I'm going to wait til closer to baby to actually order. But definitely call your insurance to see what they will cover!

Pontot31 · May 2015

britnys said:
We're military and tricare won't cover one. I'm so bummed. Mine is 5 years old and really needs to be replaced. I'm just not sure I'll be able to swing a new one since we are paying out of pocket for our midwife since they don't cover that either.

I swear I just saw something recently that moms fought for the benefit since it's part of Obama care and tricare changed the rules. Might be worth a call. Sad that they could get around it!

elittler · May 2015

tmandato1234 said:
Does anyone know if Medicaid covers ? I have Humana through Medicaid.

I heard that medicaid doesn't cover breastpumps, but I think Wic covers a manual pump, or electric if you have a preemie or some other condition?

jessicapfaltzgraff · May 2015

I have both kansas state insurance as well as insurance through my work and both have the same life with baby program. They will send a free breast pump after baby is born.

folandwifey · May 2015

Kansas state health insurance covers the pump as long as your obgyn writes a prescription for it

kmd91 · May 2015

Pontot31 said:

britnys said:
We're military and tricare won't cover one. I'm so bummed. Mine is 5 years old and really needs to be replaced. I'm just not sure I'll be able to swing a new one since we are paying out of pocket for our midwife since they don't cover that either.
I swear I just saw something recently that moms fought for the benefit since it's part of Obama care and tricare changed the rules. Might be worth a call. Sad that they could get around it!

They're in the process of creating regulations for what they will provide for breast feeding support. There's no set deadline on when they'll make any decisions or when things will be put in place so you can actually benefit from it. The current suggestion is "if you buy a breast pump, save your receipt in case you may be able to get some reimbursement." But really it's just a waiting game to see if it's a benefit we will get, and what exactly they would cover.

katmcgrath92 · May 2015

My insurance (BC/BS of Mississippi for Federal Employees) sent me an Ameda double electric pump. No script required. I was 8 weeks pregnant and it arrived at my door 4 days after I ordered it via phone. Ameda pumps are the only ones they cover, but it was covered 100%. They also send me 150 milk bags every 90 days I believe. It's a pretty sweet deal. I did think it was odd that I didn't even have to prove that I was pregnant. I mean, for all they know I could be ordering this for a friend and "gifting" it. I'm sure they will get stricter as the years go on.

katmcgrath92 · May 2015

tmandato1234 said:
Does anyone know if Medicaid covers ? I have Humana through Medicaid.

https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Quality-of-Care/Downloads/Lactation_Services_IssueBrief_01102012.pdf

@tmandato1234

tmandato1234 · May 2015

katmcgrath92 said:

tmandato1234 said:
Does anyone know if Medicaid covers ? I have Humana through Medicaid.
https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Quality-of-Care/Downloads/Lactation_Services_IssueBrief_01102012.pdf

@tmandato1234

Thank you so much for the information . I never realized how much Medicaid has changed within the past three years. I have Humana Medicaid now.

eskimoluv · May 2015

what man I have bcbs tx and i can't order my pump until October! ugh perhaps it the website I was ordering off of that wouldn't let me.

happylife7 · May 2015

@eskimoluv, I would recommend trying the byram healthcare website. They accept BCBS TX and I had no problems. They will call your doctors office to verify pregnancy and then as soon as your insurance is approved, they ship. They offer a variety of great pumps.

jesshock22 · June 2015

kmd91 said:

Pontot31 said:

britnys said:
We're military and tricare won't cover one. I'm so bummed. Mine is 5 years old and really needs to be replaced. I'm just not sure I'll be able to swing a new one since we are paying out of pocket for our midwife since they don't cover that either.
I swear I just saw something recently that moms fought for the benefit since it's part of Obama care and tricare changed the rules. Might be worth a call. Sad that they could get around it!
They're in the process of creating regulations for what they will provide for breast feeding support. There's no set deadline on when they'll make any decisions or when things will be put in place so you can actually benefit from it. The current suggestion is "if you buy a breast pump, save your receipt in case you may be able to get some reimbursement." But really it's just a waiting game to see if it's a benefit we will get, and what exactly they would cover.

https://m.military.com/daily-news/2015/06/05/new-tricare-policy-gives-free-breast-pumps.html?comp=700001075741&rank=2

Falchas · June 2015

I called my insurance (BCBS South Carolina) and was told that we don't qualify because our insurance was grandfathered into not having to pay prior to new laws. But I keep on hearing about how much success people seem to be having with their coverage. Has anyone else received the grandfathered-in answer and pushed for more information? It seems like insurance is one of those things that answers can change depending on who you get on the phone.

ash413 · June 2015

eskimoluv said:
what man I have bcbs tx and i can't order my pump until October! ugh perhaps it the website I was ordering off of that wouldn't let me.

I also have BCBS NJ through my employer and I cannot get until 30 days prior to my due date. That being said the nurse at my OB office said that if I go early or haven't received my pump yet when I deliver the hospital will loan me one for 30 days at no charge.

MargaretC5 · June 2015

The hospital I delivered at actually gave me a breast pump and took care of everything thru the insurance. It was super easy.

Babypeach2015 · June 2015

Mine won't send it until baby is born!! that sucks!

turkeybabt · June 2015

I asked my doctor about it during my intake and she recommended me to wait closer to birth, because depending on how close to birth, the later I wait, better the chance of me being able to get super nice ones.

dannie134 · June 2015

Falchas said:
I called my insurance (BCBS South Carolina) and was told that we don't qualify because our insurance was grandfathered into not having to pay prior to new laws. But I keep on hearing about how much success people seem to be having with their coverage. Has anyone else received the grandfathered-in answer and pushed for more information? It seems like insurance is one of those things that answers can change depending on who you get on the phone.

@Falchas I have the SC state BCBS as well and they told me the same thing. I think it's sad but true. Let me know if you manage to get a better answer!

lally6168 · June 2015

I have Humana and they said to wait until I was 30 weeks to apply for the breast pump.

mmk29 · June 2015

I have Aetna and mine has already been delivered.

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