Help - how to get insurance to cover a breast pump

KaraMG35 · February 2017

My insurance company is refusing to cover anything but a manual pump, and I'm having issues getting that covered. Isn't it the law to cover that? Has anyone succeeded in getting it deemed "medically necessary" and getting covered?

Beckyf321 · February 2017

Did your doctor write you a prescription? I know that's how Tricare works.

Virginialeigh · February 2017

My insurance won't cover a pump at all. According to the ACA you should get a pump but my plan was grandfathered in so the rules don't apply.

schef070911 · February 2017

I didn't know that insurance plans being "grandfathered" in was a thing either until recently thanks to A17 ladies, plus I recently found out one of my very good friends who works in a school had a "grandfathered" insurance plan and wasn't able to get her breast pump through them. More information here on which ACA rules do and don't apply (I looked it up because I was curious): https://www.healthcare.gov/health-care-law-protections/grandfathered-plans/

Sorry you have to deal with this!

MWoodside · February 2017

some only cover a manual. it's still a pump so it meets the requirement.

jennielynn+ · February 2017

Sheesh that blows. Can you get a voucher for the price of a manual and put that towards a different pump? Or maybe have them reimburse you a portion for the one you like? There have to be more options than "nope".

catem07 · February 2017

Do you have an FSA? You can buy them from the FSA store--obviously you're still paying but at least it isn't coming directly out of pocket and you're getting a discount from the tax savings.

KaraMG35 · February 2017

Yes, I can purchase with my HSA, but I have a pretty high deductible so I've already budgeted the $5000 I have saved over the last two years there for birth

Fortunately, I work in a company of 150,000+ employees so I posted the same question on our inter company social media and someone is giving me the pump they no longer need! I will just buy the tubing and attachments new. $50 vs $250 is a relief.

MrsBakes · February 2017

The insurance does not have to cover it at all, unfortunately it's not mandatory. Also, a lot has changed and they have gotten super strict on what you can use your FSA or HSA for. If you get an Rx you should be able to get it through FSA/HSA

catem07 · February 2017

For my FSA you can buy anything you can find at fsastore.com and pumps are on there. No Rx needed.

SnarkasaurusRex · February 2017

@KaraMG35 Check on Amazon to see if you can get your accessories kit cheaper there; a lot of times it's a little bit cheaper than buying direct from the manufacturer. Glad you found a solution!

Cook3133 · February 2017

My first one was used and I bought new parts, worked great! If it's a madela I found Amazon to be the best place to get tubes and then babies Rus and target have everything else you need!

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Help - how to get insurance to cover a breast pump

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