Will breast pumps still be fully covered by insurance?

heatherlynn321 · March 2017

I'm not trying to start any sort of political debate, I just honestly want to know. I know as part of the Affordable Care Act insurance companies had to provide you a free breast pump, and because of that I was able to get a nice Medela pump. Now that the Affordable Care Act, or parts of it, are getting repealed and replaced, will I still get a free breast pump in September, or will I need to save up or register for one? I couldn't find a clear answer online, or maybe it's too early to know still.

wyomama0427 · March 2017

Nobody really knows what the plan for the replacement will be, and trump hasn't really given many concrete details so it's hard to tell what's going to be changed. I'm planning on getting the breastpump ASAP before the repeal/replace nonsense happens.

wyomama0427 · March 2017

Then again I don't know how that works with my insurance, I don't know if you can apply while pregnant or if you have to have the baby first? Not really sure.

DPandMB · March 2017

I think it all depends on insurance, even before under the ACA. Call your benefit line tomorrow. They will tell you exactly what you get and how to handle it.

kelseyrayay · March 2017

Even under the affordable care act before it was revised some insurances didn't give them away. My friend had Medicare and her insurance wouldn't cover a pump for her. It really just depends on what insurance you have. If you got it before I'm sure you can get it again. No harm in trying anyways.

heatherlynn321 · March 2017

I know with mine I had to wait till the baby was born and get a prescription for a breast pump before we left the hospital, so I'm worried it might change before September.

Becky012016 · March 2017

Short answer: no. There's been talk of having pregnancy be a preexisting condition again. Nothing has ACTUALLY happened yet legally so until that happens, we cannot know for sure. My insurance never covered a breast pump anyway so you're already lucky your insurance currently does.

wyomama0427 · March 2017

I am learning so much here. I had no idea so many insurances didn't cover breastpumps..

heatherlynn321 · March 2017

I thought they all had to, it just greatly differed in the quality they were required to provide. My insurance covered a double electric, but I remember a fellow teacher who had her baby the same time as me, her insurance only provided a manual single breast pump.

LuckyPenny1231 · March 2017

My insurance only covers one every 3 years. Since my youngest will be 2y 9m in September, I won't be covered anyway either.

Becky012016 · March 2017

I'm not trying to be a dick but why do you guys who already have a pump previously from insurance neeeeeed a new one? Couldn't just clean the one you have a replace the little plastic pieces/tubes if they've gone bad since the last time you used it?

heatherlynn321 · March 2017

They're really only good for one year, after that, the quality of the suction greatly decreases and you won't get as much milk, which hurts your supply.

DPandMB · March 2017

With my first (3 years ago) I had an allowance. It wasn't very high so I still payed majority out of pocket.

wyomama0427 · March 2017

I never got one through insurance, I had a little cheap battery operated one that was $40 and was a piece of crap.. I was going to see about getting one through insurance this time.

kelseyrayay · March 2017

@Becky012016 I never got a pump either. And I just plan on using the one I had. Because I only used it like 3 times. It's practically brand new

BookitBoo · March 2017

Mine died. I responded most to the hand pump anyway

Texafornian · March 2017

daniellelynette said:

Then again I don't know how that works with my insurance, I don't know if you can apply while pregnant or if you have to have the baby first? Not really sure.

You can contact your insurance company...you have to be a certain way along into your pregnancy before you can submit for the Pump. I want to say late 2nd tri. The insurance company will let you know what website to go to or which number yo call so you can find out which pumps you have available to choose from...then I think the pump arrives about 4 or so weeks prior to birth if I recall correctly.

@Becky012016 the pumps get used A LOT for some ladies...they start to lose their sucking power so you would need a new one. Especially if it's been a few years as the tubes and stuff start to go (you can order pieces but it's a pain).

wineren · March 2017

After you check with your insurance I'd see if there is a good nursing supply shop or support center in your area, especially if it's not covered. WIC or the health department will often help with one, at least where I live. I'm lucky and my insurance covers any breast pump I want up to $450, but I have to purchase it through someone who accepts the insurance. Luckily there is also a nursing center in my town that orders and build insurance!

ColoradoHiker · March 2017

@Becky012016 I need a new one bc I EPd for a year and my machine is about shot. It will be fine for a backup, but I'm planning on EPing again and will definitely need a new one if I want it to last that long. And having a pump die when you're engorged in the beginning would be a total nightmare.

LuckyPenny1231 · March 2017

For as expensive as they are, I don't think the motors last very long. I can definitely tell a difference after a year so I'd imagine after 3 years there is a difference in suction. And if you're struggling to pump as much as possible, that matters.

zetega · March 2017

FYI I just called my insurance (UHC but it might depend on plan), and they told me I can't order a pump until 30 days before my scheduled due date. Hope we still have coverage in August!

gryffindorable · March 2017

I applied through the Aeroflow website and with my insurance I can get my breastpump now with a prescription- or 30 days before my due date without. I'm getting mine now just to be safe; maybe that's an option for some others?

ColoradoHiker · March 2017

With my previous insurance, it was easiest to get the Rx from the midwife/ OB and submit it to the company I planned on getting it from early. This was bc my insurance did not allow it to be shipped until after the baby was born. I found a company that would do next day delivery, since I was EPing, and they were the ones I used. Other ladies could do it whenever, or 30 days or less before due date. It very much depends on insurance company.

Sprite2012 · March 2017

My insurance company covers a breast pump 30 days or less before due date. I'm skeptical to order one though. All of the pumps covered by my old insurance were models 3-5 years old and single electric. So, I passed and purchased one of my liking with my first baby. I sold it when I was done BFing because I couldn't look at it anymore (definitely a love/hate relationship with that thing). I see that Medela has a new, super quiet double-electric on the market, which looks absolutely spectacular. In the end, I'll buy the one I want. If insurance covers it, great. It's too important to depend on an insurance company to decide for me, IMO.

jlf1019 · March 2017

I was able to get mine prior to delivery -- pretty early on I think. I got the Medela Pump In Style Advanced double electric. My insurance covered just the basic pump/starter kit free of charge. But I paid an upgrade fee in order to get the pump bag and some other extra accessories.

Once I get past my 16 week appt next week (PGAL fears) then I'm going to look into going ahead and getting another one. I EP'ed for a year with my daughter so I could use a new one. Plus -- if it's free/deeply discounted, why not? It's nice to have a back up. My sister in law ended up giving me her basic PISA after she never even used it, and I kept it at my office. So I had one at home and one at work. Only had to worry about bringing storage bottles back and forth.

mamakculb · March 2017

I'm just guessing, but I would also think that any legal changes would affect plans starting next year and not this year maybe? Still probably a good idea to get it asap. My husband's insurance was grandfathered in the ACA and with my first two pregnancies I didn't get a free pump. My SIL had babies just before me and got two pumps and gave me her old one. It definitely wore out after a few months of pumping. I called a few weeks ago and found out I can finally get one through our insurance, like others I need an RX or they will reimburse me near the due date.

vfarland22 · March 2017

I had similar concerns and opted to order my pump ASAP through the Target breast pump program. Since my insurance had no restriction on when I could have my pump covered during my pregnancy, I was lucky enough to fulfill my order at 13 weeks. I have to say, I was really impressed with the whole process... from the time of my first phone call, to the time I picked up my chosen pump at my local Target, was three business days. I needed to obtain a prescription for my pump, but I was able to send it via email, so that was easy (the other option was to have my doctor fax it). There were a few brands to choose from, as well as upgrade options. I'm not sure how this compares to other providers, in terms of convenience, but I wanted to share my experience in case anyone is looking for an easy place to get their pump.

heatherlynn321 · March 2017

@vfarland22 I'm definitely going to look into this!

Basherbaby · March 2017

It's not likely that you will see a change in your plan benefits until 2018. As of right now insurance companies are not supposed to change plan benefits mid year. That is subject to change under potential ACA modifications of course. I wouldn't be concerned because it's no easy task for insurance companies to change benefits suddenly. I feel like 2017 mom's will be safe with their current coverage but who knows what will happen in 2018.

SuperKristy85 · March 2017

I thought I had to wait until within 30 days of my due date but then a friend sent me a link to a website where you enter your Dr's contact info and insurance information and they handle everything for you. They just emailed me back that I was covered 100% and they let me know when it shipped!

I had a few to chose from at 100% coverage including the spectra s2 double electric and Medela pump in style double. I went with Spectrum but had a hard time choosing between the 2.

hatrats · March 2017

@vfarland22 what is this Target program you speak of? I got my pump last time around at Target, but I just sent my husband to get it after DD was born bc my insurance at the time made you wait until after birth. I'm on DH's (better) insurance now, so I'll have to check into the rules this time around.

vfarland22 · March 2017

This is where I got started with initiating the process through the Target Breast Pump Program!

https://www.target.com/c/target-breast-pump-program/-/N-4yqby

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Will breast pumps still be fully covered by insurance?

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