December 2015 Moms

Insurance covering breast pump

Hey ladies, just wanted to share what I learned today.

As expensive as breast pumps are, I called my insurance company to see the process of them covering a breast pump. They will cover it as long as your OB writes you a script and you purchase it from an actual medical equipment store, NOT from a baby store. But the thing is, the baby has to be born first before they'll cover it. That confused me because id like to have it at the hospital I think. So I went to a medical equipment store and they told me that at the hospital, once baby is born they'll write you a script and the hospital has an equipment store there that you can get the pump at and it'll be covered. I thought that was interesting.

Any STMs that bf and used a pump that can shed light on this and how the process worked for you? Our blue cross blue shield covers a basic Medela model with dual electric pumps. Will that be sufficient for my needs? Id really rather not have to spend $300+ on one from the store, but if I have to I will.

Re: Insurance covering breast pump

  • Also Tricare members..!

    If you'd like to purchase your own breast pump you can do so whenever, just save the receipt and take it to the tricare building. They will reimburse you. :) I'm not sure what the wait is on that but that is what my OB explained to me! It will start in July!
  • Loading the player...
  • I have the Madela and it works great. A ton of girls I work with have the same one. Check with your doctor and hospital to make sure they can get your pump before you leave, but for the first few days you may not use it for a while after you get home.
  • I also have BCBS insurance, but I don't have to wait until I'm in the hospital and I don't need a prescription. I'm going to buy it from a medical store and I just have to fill out paperwork. My insurance only covers a single pump and they gave me upgrade paperwork, along with how much it will be to do so. I would at least figure out which one you want so you can get accessories, etc.
  • laura6006 said:

    I also have BCBS insurance, but I don't have to wait until I'm in the hospital and I don't need a prescription. I'm going to buy it from a medical store and I just have to fill out paperwork. My insurance only covers a single pump and they gave me upgrade paperwork, along with how much it will be to do so. I would at least figure out which one you want so you can get accessories, etc.

    Interesting, my BCBS only covers one specific brand and model, so I don't really have a choice. But it's actually the same brand I wanted anyways. I do plan to register for or purchase the accessories to have before baby comes. I was surprised the baby has to be born first, but I guess from an insurance/financial stand point it makes sense. That's nice yours will cover any one though!
  • The Madela is a great brand. They use it in the hospitals with mother's who have premies. My sister had her baby at 26 weeks and she pumped using the Madela for a long time. Insurance should give it to you within 30 days of your due date. I work in insurance, but California may be different. 
  • That post that had that link where you can select what brands your insurance covers. Getting it that way won't get it covered? I quickly browsed on the site when it was posted and figured I can do it later. I may have to call my insurance company.
    Due 11.16.17
    Baby Girl 12.9.15
    MC 2.1.15 @ 5 W - Chemical
    MC 4.7.14 @ 21 W - Turners Syndrome

  • Call your specific company and ask first! I thought I'd have a few choices but apparently I only have one option. So I'm not sure how that works.
  • I called my company (BCBS) a couple weeks ago to get the process started. They gave me two DME companies that I could work with that would be covered. Both companies had a number of choices to choose from and one of the companies had an "upgrade" that I could do if decided to want all the accessories.  I just got the call from the DME company that my pump shipped today and will be here within 1-3 days. They took care of requesting the script from the doctor and everything - I just had to let them know what pump that I wanted. 

    Honestly, though, I wouldn't pack it in your hospital bag - there's really no reason for it.  When I had my daughter and they wanted to try and get my supply to come in faster they provided a pump for me and all new tubing etc.. Just take what you'll need to the hospital, it's just one more thing to take up space and have to pack up to bring back home. :)
  • I think how it works depends on your health insurance company. For my last pregnancy my doctor wrote the prescription and I did have to get it from a medical supply store. But I was able to get it before the baby was born. Also I was only eligible for a certain one but I really wanted the Medala Pump in style so I was able to upgrade and only pay $50.00 which I was ok with. So I would ask your insurance if you can upgrade to what youw ant.
    Baby Birthday Ticker Ticker}
  • I agree that you won't need it at the hospital.  My hospital provided a hospital grade pump to use when my first born wouldn't latch at first.  

    I will be calling my insurance company soon.  I know BCBS has different policies in different states to it all depends on what coverage you have on how they deal with it.  

    Medela is a good brand.  I had a Ameda pump with my last three and it quit working mid breastfeeding with my third (I just rented one from the medical supply store because I didn't know if I would have anymore children so I didn't want to buy a new one.)  I now need a new one but I think the Ameda pumps are loud.  The Medela is pretty quiet.  

    Erin

    Mom to 3 Boys (Ages 10, 8 & 3)

    Mom to 3 Angels





    BabyFruit Ticker
  • My insurance through BCBS actually doesn't cover my breast pump at all. I am on an OLD grandfathered plan through my company and since it's grandfathered, it does not have to be compliant with the new health care laws. If I shopped around and got on any other plan now, it would have to cover it. Luckily, my sister just gave birth last year, so I will be using her awesome pump and just get new accessories. I don't have the best insurance, but my company pays 100% right now, with living paycheck to paycheck, I get what I can take right now. 
  • For my BCBS I just called a number and told them my due date... they shipped it to me yesterday. No rX or anything, just needed my policy number


    SaveSave
  • With my first, I was on a Humana plan and I just had to tell them my due date, they gave me two pump choices (hygeia or medela), and shipped it two weeks later. I think I called about 3 months prior to due date. No rx needed. The medela one I received worked great. You don't need it in the hospital though, if you're interested in increasing your supply or if there are latch issues, the hospital will provide you with one.
  • CMDDCMDD member
    (i haven't read all of the responses) but this isn't true for my insurance, and i know others who were able to order them through insurance the moment they got pregnant. 
  • My insurance covers breast pump 100%. Call them beyond 28w and they fax a form to OB for approval, and ship within 10 days. They cover the Medela Instyle Advanced or Ameda Purely Yours.
  • CMDDCMDD member
    Also @embuzz247 i love how on top of everything you are! I figure i'll think about breast pumps in 3-4 months :P
  • hardlyhannahhardlyhannah member
    edited June 2015
    I have united health care and they cover it starting 30 days out from your due date and up to a year after baby is born. You have to order from a DME store, there are 4 to choose from, or you can go to the target pharmacy. The store you get it from is responsible for reaching out to the doctor to get the info needed - I.e. The prescription

    August '18 March Siggy Challenge - You had ONE JOB

    Pregnancy Ticker


  • With my insurance I got it before I delivered, I got my script around 36 weeks, called a DMS and faxed my script and I picked it up the next day! Probably the easiest thing I did during my last pregnancy lol.
  • My insurance plan (Humana) covers pumps and I will qualify for it when I'm about a month out. I have a nurse that calls every so often to check in and answer questions and she told me that they encourage breastfeeding and want moms to be able to take a new pump with them to the hospital so that you have help learning to use it if needed.
  • I have united health care and they cover it starting 30 days out from your due date and up to a year after baby is born. You have to order from a DME store, there are 4 to choose from, or you can go to the target pharmacy. The store you get it from is responsible for reaching out to the doctor to get the info needed - I.e. The prescription

    I also have uhc and have been wanting to contact them. Do I just call the number on the back of the card? By chance do you know which 4 you can choose from? Thank you!
  • My insurance covers the breast pump 100%. Some insurances make you wait until the baby is actually born, but mine will let you order it about 6-8 weeks before delivery so you can receive it before baby comes
  • I have Medicaid and asked for a pump while in the hospital, the day after my son was born. It was covered by my insurance.
  • LC122LC122 member
    Everyone should contact their own insurance company to see what is covered and the process for obtaining it.

    Random Story: my husband was sitting next to an Ameda corporate guy in an airport and he claimed Ameda and Medela used to be the same company and then all the marketing team split off to make Medela and left all the engineers at Ameda. He said Medela had the edge in the consumer market but Ameda has the advantage in the hospital market. Of course, consider the source and I'm sure Medela found some engineers. I've only had Medela, as have most people I know, so I think they are winning. /end tangent.
  • What about for those that need hospital grade pumps? I know some mothers have a hard time getting milk in the supply that they need.
  • nik6499nik6499 member
    edited July 2015
    Most of these pumps are considered hospital grade, just depends on the model and the insurance company
    BabyFetus Ticker

    DD May 2005 MC Nov. 2012
    MC Aug. 2014
    Chemical Feb. 2015
  • nik6499 said:

    Most of these pumps are considered hospital grade, just depends on the model and the insurance company

    Thank you!!!
  • My doctor faxed my insurance Tuesday and my insurance mailed me a breast bump Friday, covered. I think it would just your insurance saying that the baby had to be born first. Mine obviously won't be here til December! Good luck!
  • I also have BCBS and they covered my breast pump 100%. See if Edgepark is considered in-network for you (check Edgepark.com) I was amazed at how quickly they sent me a pump. I called this Tuesday around 4pm and they were able to verify with my insurance and called my doctor to get a prescription. I just had to provide my insurance info and pick from about 6 pumps. I chose the Medela pump in style and I kid you not, it was on my doorstep by noon the next day! They didn't mind that I'm not due for a while. Good luck!

    BabyFruit Ticker
  • I'm curious as to when I can get mine!!! I'm afraid I'm on one of those older grandfathered health plans. I know I can buy with my fsa as well
    BabyFetus Ticker

    DD May 2005 MC Nov. 2012
    MC Aug. 2014
    Chemical Feb. 2015
  • I already received mine. I was able to get the Medela covered under insurance.
    Due 11.16.17
    Baby Girl 12.9.15
    MC 2.1.15 @ 5 W - Chemical
    MC 4.7.14 @ 21 W - Turners Syndrome

  • LC122LC122 member

    What about for those that need hospital grade pumps? I know some mothers have a hard time getting milk in the supply that they need.

    We have BCBS and the instructions I was given for getting the pump only applied to hospital-grade pumps available to order through 2 specific websites.
    I think it all varies depending on your insurance company and your plan.
  • kdp430kdp430 member
    Mine was like a few others, and I have BCBS. You really don't have to even be pregnant to order one through mine (though I don't know why you would otherwise.) Through mine, you're entitled to one free breast pump and 750 bags a year. You just call and confirm your address, they ask if you want the electric or the manual, decide how fast of shipping you need, and that's it. They didn't ask for due date, anything from the doctor, nada. I chose the free shipping that took a few weeks since obviously there is time before December, and it still arrived in about 3 or 4 days. I like that mine is one a year, I chose the electric one, but I'll probably call back in the beginning of January and order the manual one just in case I like it better, or it's better for some situations.
  • amye02amye02 member
    I asked my OB about this today they actually handle everything they had me sign a form will contact my insurance company and the pump will be delivered to me at around 36 weeks. I suggest everyone ask their doctor maybe they have a procedure in place to help you get the pump covered by insurance
  • I asked our member services and Kaiser northwest covers the ameda double pump once my ob writes a prescription. There was no time restrictions on when it could be ordered and can be shipped before delivery
  • I have BCBS also. They told me to contact 2 medical supply companies Edge park and Byram Healthcare. I didn't even call. I just went on their websites and entered my insurance info in and each site showed me like 8 different pumps I could choose from. I picked the Medela. I didn't have to wait till the baby is born (due 12/24). The pump arrived in 2 days! I am a STM and used the Medela before. I had no problems with it.
    Lilypie Third Birthday tickers

    Daisypath Christmas tickers
Sign In or Register to comment.
Choose Another Board
Search Boards
"
"