Medela insurance pumps not as powerful as retail pumps

claireloSC · November 2015

https://windsorpeak.com/babybargains/2015/11/16/medela-dropping-breast-pump-that-prompted-complaints-concerns/

https://www.bloomberg.com/news/articles/2015-10-15/making-billions-from-the-booming-breast-pump-market

Wanted to share this info. Apparently Medela pumps you get through insurance are often not as powerful as the Pump In Style or not the same, even though they may be advertised as the Pump In Style.

KFrob · November 2015

I got the In Style through my insurance and I'm super excited about it. My doctor (who is also a mom) said its the best and will "suck you dry in 15 mins", her exact words.

ambercakes92 · November 2015

Hmmm. Mine definitely says Pump In Style on the box, but also that it's not for retail sale. Now I'm curious. I didn't read the article, but I still assume it'll get the job done. I'm not buying one either way haha.

fishsticks-n-custard · November 2015

I got a pump in style thru insurance. If you look at the serial numbers, the one that is specifically labeled pump in style is (at least for me) not the same number as the pumps in question. *fingers crossed*

mamajenna_cnm · November 2015

I went through babies r us to get my medela pump from insurance. The pump that I'm getting (covered by my insurance) is the same pump I registered for at babies r us before I even knew insurance covered it. My friend who used the same service said her pump is the bomb. Here's the info: Breast Pump Solutions by Babies R Us 855.567.8669

MissMheMhe · November 2015

My insurance allows me to go to the Target pharmacy to get my pump. I was told by a coworker they just pull one off the shelf and give it to me. Hoping this is the case!

teachmegs817 · November 2015

@tgrdance05 this is who I went through too. I am ordering mine at the end of the month, but I just submitted my script from the OB office last week. My insurance doesn't cover the Pump in Style fully, but it's only $120, versus the $280 or whatever it is at full retail.

ainverso · November 2015

I have the Medela double electric pump in style and it is exactly the one you can buy in store, works amazing and I can pump in less than 15 min and get 8 oz

bo17 · November 2015

Where/how did you guys find out if pumps are covered? I've poured over our benefits booklets and can't find it. Thinking it's worth a phone call to inquire.

MissMheMhe · November 2015

@bo17 I believe all insurance is required to provide a pump in the US thanks to Obamacare. The only exceptions are Medicaid and WIC. It's listed in my maternity coverage info, but it's easy enough to just call and ask them about it.

EC2016 · November 2015

bo17 said:
Where/how did you guys find out if pumps are covered? I've poured over our benefits booklets and can't find it. Thinking it's worth a phone call to inquire.

I called my insurance and they sent me a list of approved providers I had to go through. I called the provider and they arranged everything with insurance. I should have my pump by tomorrow.

maureenmce · November 2015

@bo17 As PP said, thanks to the Affordable Care Act, all insurance companies are required to provide a pump, but the way they do it is different depending on what company you have. With my insurance, my dr had to write a prescription for the pump, then I had to call my insurance and give them the info on the prescription. Then I could choose between a couple of different options that are covered.

It would probably take a phone call to figure out the procedure with your insurance. Good luck!

ainverso · November 2015

Every insurance is required to cover a pump but it doesn't have to be electric. Just call the customer service number on the back of the insurance card.

bo17 · November 2015

Thanks everyone! I'm thinking because I'm in Canada it might not be a requirement of affordable health care, but a friend told me about it today so definitely worth a call tomorrow

fricktion · November 2015

What?? It's not like the store has a pile to sell to people who will be claiming through insurance and a pile for people who will be paying full price!! Haha this is actually ridiculous! It's the same item from the same store, whether insurance reimburses you is irrelevant!

Wicked4589 · November 2015

Canada doesn't give pumps from what ive heard.

that's just a US thing.

Keep in mind, most insurance companies require you to use their supply company and they are not giving you pumps off the shelf from a store. They are specifically made and packaged for your insurance company. My insurance told me I could buy one off the shelf but i wouldn't be reimbursed the full amount. They buy them discounted from Madela. And I've had many moms tells me they are not the same suction capacity.

fishsticks-n-custard · November 2015

fricktion said:

What?? It's not like the store has a pile to sell to people who will be claiming through insurance and a pile for people who will be paying full price!! Haha this is actually ridiculous! It's the same item from the same store, whether insurance reimburses you is irrelevant!

Um, mine has "Insurance Provided - Not for retail" all over the box.

KFrob · November 2015

Make sure when you call the medical supply company you talk to someone about what's available. I really wanted the In Style after reading reviews and talking with my Dr. but it wasn't listed as one of the pumps I could get on what my insurance provided me. Turns out I could get the "starter set" which just meant I didn't get the bag and extras, but totally worth it to get the better pump.

Achae · November 2015

ainverso said:

Every insurance is required to cover a pump but it doesn't have to be electric. Just call the customer service number on the back of the insurance card.

This is how mine is, a manual only. Electric pumps are only covered if its a "medical necessity." Such BS.

fricktion · November 2015

And mine is from a retail store fully repaid by insurance...

RunnerMeg · November 2015

If your pump is from a retail store, then yes, it's going to be the same pump whether you pay OOP for it or are reimbursed by insurance.

However, not everyone can get their insurance-covered pumps from a retail store. My Medela PIS came from one of our insurance carrier's contracted suppliers. All over the box it says "insurance provided, not for sale". I won't know until I start using it if the motor is exactly the same as the PIS I can purchase at Amazon/target. I used a PIS with DS1, purchased retail, for I'll be able to tell pretty quickly if the insurance provided pump is comparable or not.

claireloSC · November 2015

RunnerMeg said:

If your pump is from a retail store, then yes, it's going to be the same pump whether you pay OOP for it or are reimbursed by insurance. However, not everyone can get their insurance-covered pumps from a retail store. My Medela PIS came from one of our insurance carrier's contracted suppliers. All over the box it says "insurance provided, not for sale". I won't know until I start using it if the motor is exactly the same as the PIS I can purchase at Amazon/target. I used a PIS with DS1, purchased retail, for I'll be able to tell pretty quickly if the insurance provided pump is comparable or not.

Exactly. @RunnerMeg you might be able to tell from the model number.

RunnerMeg · November 2015

Thanks @claireloSC!

I'm going to check. My first PIS is now about 3 years old, but I would think the model numbers would be the same.

anightintunisia · November 2015

I got the medela double electric breast pump freestyle for free on a tv show. Do you clean them before use? Sorry if it's a dumb question.....

claireloSC · November 2015

@anightintunisia You don't have to, but Medela makes sanitizing bags you can use to nuke everything in the microwave if you want to be sure. I don't plan on cleaning mine before first use because mine uses a closed system and came all sealed up so it seems fine.

ashs88 · November 2015

Has anyone used Aeroflow Healthcare to get their pump through insurance? Several months ago I saw something on The Bump about them and sent in an inquiry. They were able to check what is covered by my insurance and they are an in-network provider for me. They said my insurance requires them to wait until closer to my due date to ship so they would contact me later to pick out a pump and they would take care of everything else. I liked that they were making everything so easy and that I didn't even have to contact insurance myself. Now I'm wondering though if I should just check with my insurance to see if I can buy retail and get reimbursed if the one Aeroflow sends isn't going to be as powerful.

Wicked4589 · November 2015

I had mine through Aeroflow and they were fantastic.

mamakculb · November 2015

Unfortunately not EVERY health insurance provider in the US has to provide pumps. My husband is a member of Teamsters (Jimmy Hoffa Union) and we have their national healthcare plan, Teamcare through BCBS. Since our plan is essentially a nationwide union plan, they are grandfathered in as not being required to provide pumps. However, we enjoy extremely low cost, high quality healthcare with extremely low deductables, so it's in our capacity to buy a retail pump. I'm not sure if any other unions have the same pump issue, but always call your insurance provider to check!

kmo8986 · November 2015

kristanoah said:
Unfortunately not EVERY health insurance provider in the US has to provide pumps. My husband is a member of Teamsters (Jimmy Hoffa Union) and we have their national healthcare plan, Teamcare through BCBS. Since our plan is essentially a nationwide union plan, they are grandfathered in as not being required to provide pumps. However, we enjoy extremely low cost, high quality healthcare with extremely low deductables, so it's in our capacity to buy a retail pump. I'm not sure if any other unions have the same pump issue, but always call your insurance provider to check!

Are you sure? I have BCBS as do many other people I know (different groups and plans) and they cover it. It can't hurt to try calling and asking if you haven't already.

emzie54 · November 2015

My PIS starter kit just shipped from yummy mummy. I hope that it'll work well!

mamakculb · November 2015

kmo8986 said:

Are you sure? I have BCBS as do many other people I know (different groups and plans) and they cover it. It can't hurt to try calling and asking if you haven't already.

Yes I'm sure. Teamcare is essentially its own insurance backed by BCBS and I've called several times during both pregnancies and they've given the grandfathered plan reason each time.

willashbaby · November 2015

kristanoah said:

Unfortunately not EVERY health insurance provider in the US has to provide pumps. My husband is a member of Teamsters (Jimmy Hoffa Union) and we have their national healthcare plan, Teamcare through BCBS. Since our plan is essentially a nationwide union plan, they are grandfathered in as not being required to provide pumps. However, we enjoy extremely low cost, high quality healthcare with extremely low deductables, so it's in our capacity to buy a retail pump. I'm not sure if any other unions have the same pump issue, but always call your insurance provider to check!

I have the same situation with my insurance, I'm a NYC teacher and the plan is "grandfathered" in. With that said, I pay literally nothing for my insurance and the entire birth will only cost me $100, I'll buy my own pump, lol.

Wicked4589 · November 2015

That's a shame that they are opting not to follow ACA regulations. Hopefully soon they do.

Theliops · November 2015

bo17 said:
Thanks everyone! I'm thinking because I'm in Canada it might not be a requirement of affordable health care, but a friend told me about it today so definitely worth a call tomorrow

I'm in Canada too and neither mine nor my husband's insurance covers a pump. Must be a US thing!

cammiedeeann · November 2015

Under the "Affordable" Care Act, my company switched from co-pay plan to a $6,500 deductible plan for employees. It will cost about $8k to have my daughter in January.

I would WAY rather have better insurance and buy my own pump!

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