ACA possible repeal - breast pump through insurance

Yiggle09 · January 2017

Hi ladies,
I am totally not trying to get into a political debate or whether this could or is happening. I am only expressing a concern and if others can get their pump through insurance sooner rather than later it would be best. I am suggesting this just as I recently heard there is strong sentiments to repeal the affordable care act which is what gives us the ability to get out breast pumps free from insurance. I also just found out the ACA is also the act forcing employers to allow breaks to pump as well and this could get dicey for us going back to work after having the baby. I am just trying to bring this thought of breast pumps to the front of our long list of things to think about just in case you can get yours earlier than when you deliver. I know my insurance will send me one now as soon as I have my prescription from my OB office.

nda_roxybabe · January 2017

I've been wondering if this possibly would change. My insurance was saying only 30 days prior to delivery, but I'll chat with them today and see if they can do anything else. I'll let you guys know

kat81 · January 2017

I wrote a post about asking how to do this process because of the same concern you have. Then I forgot to ask the midwife at my last appointment, but I will NOT forget this time. I want a prescription, and I want to start this process immediately. My pump from 2010 eventually pooped out with baby #2 so we need a new one (incidentally, I'm regretting not getting one that I was entitled to for baby #2...just thought I didn't want to be wasteful when I had a pump that worked!)

We're reasonably well-off financially so paying for a whole pump out of pocket won't ruin us. But I want to get one while I can; I still LIKE to save money if possible--I'd put that money toward college textbooks for my children! And this whole thing makes me all the more angry on behalf of people who would be ruined by having to pay for a whole pump out of pocket.

BeachMommy2B · January 2017

I believe it was brought up before. "most" insurance policies are written on a yearly basis. So I believe that even if something did come about changing, insurance companies would have to do major reissuing of their policies/benefits. So I don't believe anyone will have a problem getting their pump. Now, I guess it's always possible that they could change the policy mid year, but I would be very surprised. I called and they made it very clear that they will not approve one prior to 30 days before my delivery date or up to 1 year after my delivery date.

As far as the breaks at work to pump I believe that is the one that would be the most cause for concern. I'm lucky to work in an environment and be salaried that it will not make a difference for me, but I believe that is something to take up with your HR department.

At this point everything is going to be speculation.

Yiggle09 · January 2017

@BeachMommy2B i agree this is all speculation and I am not trying to be a fear monger or anything.
@kat81 with anthem I got a prescription for the pump called the anthem phone number they gave me phone numbers to the suppliers they work with and then I called them to see what pumps were available. After I sent them an email of the prescription and chose my pump I had my pump in 2 days.

nda_roxybabe · January 2017

@BeachMommy2B I just found out that while we're staying with the new carrier/ plan idea we are having open enrollment for the next 2 weeks that will become effective April 1st. I'm wondering if that's at risk of changing?

nda_roxybabe · January 2017

Okay, just got done chatting with them. They wont approve more than 30 days before my due date (so dumb). They gave me the DME website's and I was able to place the order for the one I want (Spectra S2) and they'll start the process and once 30 days hits they will ship it.

PghMom412 · January 2017

I ordered through medela on Monday and my pump should be waiting for me when I get home from work today.

I am definitely more concerned with losing the pump time/space at work. it was already a struggle last time finding space to pump.

BabyMC517 · January 2017

I went through https://www.breastpumps.aeroflowinc.com/breast-pumps/ to determine if I qualify for a breast pump through insurance. Once someone contacted me I asked about if it would change once the new President came into office. She checked and said no and that they have my back lol this is what she said:

"Great question. We have been reassured that it will take much longer than 4 years to undo ACA. It would have to be approved as a bill and passed down through senate. There are many hoops to jump through to undo that, and it’s simply not happening any time soon. We were also worried but are no longer concerned."

I'm hoping it stays true...She said she would contact me in April to go over which ones I qualify for and order one. They sent a fax to my dr for the prescription, but I should probably check on that at my next appointment.

Yiggle09 · January 2017

@BabyMC517 relieved to hear that!

RainyDays86 · January 2017

Regarding the ACA, I have been very worried about its potential repeal because I was planning on quitting my job at the end of the school year and I can't go on DH's insurance until June. I now have a major pre-existing condition and would absolutely be denied insurance if the ACA went away. I have spoken to several people who understand insurance much better than I do including the insurance broker for our school and they have all assured me that things don't move that fast - ever. Even with the recent vote to move toward a repeal, everyone I have talked to says that nothing will have changed by June.

JCWhitey · January 2017

Technically they are repealing the ACA to do away with certain mandates, like that requiring coverage and allowing for a more free drug market. Their plan, on paper, actually seems really nice for anyone who caught the short end of the ACA stick. The problem is, they are repealing ACA without another plan in place. Estimates of 2-3 years before a new plan goes in are floating around. But this does not mean that health care will be in limbo. It's just unclear right now what will be in place while we await the GOP plan to roll out. It's a bit early to really know what's going to happen. I believe the vote will take place on the 27th, but things won't happen instantly.

For anyone really concerned you do have many options to get a pump. This isn't some horrible dire situation where breast pumps will disappear off shelves, never to be seen again. If you get a prescription from your doctor you will most likely be covered, even without the mandate, through your insurance if you have prescription coverage. You can also get a free pump from WIC if you receive WIC. Should you have a preemie you may also be able to get a hospital rental for free. And then there's the good old fashioned way of getting a pump... go out and buy one. Many insurances only cover manual pumps or not the pump you want, so you may find yourself having to fork over for the pump you want/need, anyway. I know I want the Spectra 1 this time and it looks like I'll have to buy it because it doesn't seem to be available with my coverage.

Oh, also, if the coverage does go away and you have an eye on a specific pump email the company. They may have programs set up to help you get a pump at a price you can afford. Medela had something like this prior to the ACA. I'm sure others did, too, and they will come back if this happens.

BeachMommy2B · January 2017

Not to mention... if you go on yard sale/swip swap/etc sites there are always a ton of breast pumps for sale. I know not all are close system, etc, but even the PISA is very unlikely to get milk in the pump itself. So you can always find them 2nd hand.

I got one 2nd hand PISA that the lady literally used 3 times, but since she decided to be a SAHM and her daughter won't take a bottle she sold it. It was still in the box. She also sold it with 10 brand new madella bottles, cooler, pump in the tote bag, etc. This way it or the insurance can be back up. I was going to have to purchase all the extra stuff anyways. Just another option just in case

Yiggle09 · January 2017

@BeachMommy2B I got a freestyle for 80 bucks from a ep trade sell fb group and I got the 80 bucks for selling a spectra which I got for trading my metro bag pisa all from the same fb group

blueberry312 · January 2017

Just a note to everyone--in California, time/space to pump was protected by state law before ACA went into effect. If you are worried that this might affect you, check to see if a state law will still cover you. Then you can rest easy no matter what happens in Washington.

RainyDays86: Make sure you sign up for ACA coverage before the 1/31 deadline so you are covered between now and June when you can go on your hub's plan. Depending on when you quit your job, you don't want to be left with a gap in insurance. You can also make changes to your insurance after a major life event (birth of your LO), but that won't help you with any costs incurred before your LO arrives. Go to healthcare.gov or the site for your state's exchange, if you have one. (You could also look at COBRA from your employer, but I'm pretty sure ACA is almost always the better buy.)

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