Jane Dotson
Since the implementation of the Affordable Care Act, most insurance plans are required to cover the cost of breast pumps. Breast pumps are considered an essential component of preventive healthcare, providing benefits for both mothers and babies. While insurance coverage for breast pumps can vary, many plans cover a new double electric breast pump for each pregnancy, ensuring mothers can access the most up-to-date equipment. It is recommended to consult with a healthcare provider to determine the specific coverage available and explore options for obtaining a breast pump, whether through insurance or other programs such as WIC.
| Characteristics | Values |
|---|---|
| Insurance coverage | Breast pumps are covered by most insurance plans under the Affordable Care Act (ACA) |
| Type of pump | Insurance plans may cover either manual or electric pumps, and some may offer hospital-grade pumps |
| Timing | Some insurance plans may provide a breast pump several weeks before the due date, while others provide it closer to the due date |
| Specifics | Some insurance plans require purchasing the pump from specific medical supply companies or durable medical equipment (DME) suppliers |
| Multiple pumps | Insurance plans typically cover one pump per pregnancy, but some may allow for a second pump in certain circumstances |
| Cost | Most insurance plans cover the full cost of the breast pump, but some may require a copay or deductible |
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What You'll Learn
Breast pump insurance coverage
Breast pumps can be expensive, but the good news is that insurance coverage can help with the cost. In the US, the Affordable Care Act (ACA) mandates that private insurance companies must provide free breast pumps to pregnant people and new parents who are nursing. This means that most insurance plans are required to cover the cost of a breast pump, although there may be some variation in what is covered and when.
Firstly, it's important to note that different insurance plans cover different breast pumps. Some common brands covered by insurance include Medela, Ameda, Spectra, and Lansinoh. Most plans cover the cost of a double electric breast pump, and some may offer complete coverage even if you haven't met your deductible. However, it's worth noting that some insurers may only cover a new breast pump every year or every other year, so check your coverage before ordering. Additionally, insurers typically will not cover a second breast pump if they have already covered one.
The timing of when insurance will cover a breast pump can also vary. Some plans may ship the pump several weeks before the due date, while others will only cover the pump within a few days of the due date. It's recommended to order the pump around the 30-week mark to allow for processing and shipping time.
To find out more about your specific coverage, you can fill out an insurance eligibility form or contact your insurance provider directly. You may also need a prescription from your OB/GYN to get a breast pump through insurance.
In addition to the pump itself, the ACA also covers necessary supplies, support, and counseling for breastfeeding parents. This includes milk storage bags, nursing pads, and other maternity compression products.
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Breast pump types
In the United States, the cost of a breast pump may be covered by insurance under the Affordable Care Act (ACA). Since the passage of the ACA, insurers are required to cover breastfeeding support. However, the specific coverage provided depends on the insurance plan. Some plans cover hospital-grade pumps, while others only allow their rental.
Now, let's delve into the different types of breast pumps available:
Manual Breast Pumps
Manual breast pumps are a more affordable option, but they require more effort and time for milk expression. They are typically single pumps, meaning milk is extracted from one breast at a time. With a manual pump, you squeeze a lever to create suction, allowing you to control the pace and rhythm of pumping. They are highly portable as they don't require electricity or batteries. Examples of manual pumps include the bicycle horn pump, which consists of a hollow rubber ball attached to a breast shield, and the basic pump, which has a small tube that is pumped in and out of a larger tube to create a vacuum.
Powered Breast Pumps
Powered breast pumps use a motor to create suction and remove milk more efficiently than manual pumps. They can be electric or battery-powered, offering greater flexibility for on-the-go pumping. Electric pumps need to be plugged into a wall outlet, while battery-powered pumps offer more mobility. Some powered pumps are double pumps, allowing milk extraction from both breasts simultaneously. This type of pump can be tucked into a bra, allowing for discreet pumping in public. Powered pumps feature a control panel to adjust the degree of suction.
Hospital-Grade Breast Pumps
Hospital-grade breast pumps are designed for multiple users, featuring a closed system that ensures safety for sharing among mothers. They are typically rented out under insurance coverage and require a prescription. An example of a hospital-grade pump is the Medela Symphony.
When choosing a breast pump, it's essential to consider factors such as cost, portability, ease of use, and milk expression efficiency to find the best option for your needs.
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Breast pump suppliers
Breast pumps can be expensive, but thankfully, new mothers in the US can often get them covered by their health insurance. The Affordable Care Act (ACA) mandates that insurers cover breastfeeding support, which includes breast pumps. However, the specific coverage depends on the insurance plan, with some covering hospital-grade pumps and others only allowing rentals.
If you're on Medicaid, contact your provider to understand your coverage. If they don't provide a breast pump, you can get one through the Special Supplemental Nutrition Program for Women, Infants and Children (WIC). Some private medical insurance plans require you to source your breast pump from a designated durable medical equipment (DME) supplier.
Aeroflow Breastpumps
Aeroflow Breastpumps offer some of the most popular breast pumps on the market, including hospital-grade pumps. They currently offer the Medela Symphony, which is only available for rent with a prescription when covered by insurance.
Pumps for Mom
Pumps for Mom is another supplier that helps new and expecting mothers obtain breast pumps through their insurance. They offer a range of insurance breast pumps and upgrade pumps for purchase.
Acelleron Medical Products
Acelleron Medical Products provide top-rated breast pumps that are free with insurance. If you don't have insurance, you can still purchase a breast pump by calling them directly.
Harvard Pilgrim Health Care
Harvard Pilgrim Health Care maintains a list of breast pump suppliers, including:
- New Bedford Enos Home Oxygen & Medical Supply Incorporated
- North Andover Acelleron Medical Products
- North Dartmouth Dartmouth Medical Equipment Incorporated
- Norwood Reliable Respiratory | Reliable Maternity
- Plymouth Dartmouth Medical Equipment Incorporated
- South Deerfield SunMED Medical Systems
- Weymouth Clinical 1 Home Medical, Inc
- M+M Medical Supply
- Worcester Byram Healthcare
- Merrimack Reliable Respiratory | Reliable Maternity
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Breast pump costs
The cost of a breast pump can vary depending on the type and brand of the pump. Single, manually operated breast pumps are generally the most affordable option, with prices ranging from $20 to $60. Battery-operated or electric pumps are more expensive, ranging from $40 to $185 for a single pump and $60 to $3500 for a double pump. Hospital-grade breast pumps, which are designed for multiple users and are often rented out, can cost over $2000.
When it comes to insurance coverage for breast pumps, the situation can be more complicated. In the United States, the Affordable Care Act (ACA) requires insurers to cover breastfeeding support, including the cost of breast pumps. However, the specific coverage can vary depending on the insurance plan. Some plans may only cover certain brands or types of breast pumps, and some may have restrictions on when the pump can be obtained during pregnancy. Additionally, some plans may require the pump to be obtained from a specific medical supply company.
To determine the cost of a breast pump with insurance, it is important to review the specific coverage of your insurance plan. Contacting an insurance representative or working with a company that specializes in providing breast pumps through insurance, such as Pumps for Mom, can help clarify what is covered and how to obtain the pump.
For those without insurance coverage, the cost of a breast pump can be a significant expense. In addition to the pump itself, there may be additional costs for accessories such as bottles, storage bags, and collection cups. However, some companies offer bundles that include the pump and accessories, which may provide some cost savings. Overall, the cost of a breast pump can vary widely depending on the type, brand, and insurance coverage, so it is important to carefully consider these factors when making a purchase decision.
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Breast pump delivery
Since the passage of the Patient Protection and Affordable Care Act (ACA), insurance companies are required to cover breastfeeding support. This means that most insurance plans will cover the cost of a breast pump. However, the type of pump covered (manual or electric) and the timing of the coverage (before or after birth) may vary depending on the insurance plan. Some plans may only cover the cost of renting a breast pump, while others may provide a new pump for each pregnancy.
To get a breast pump through insurance, the first step is to find out what your specific insurance plan covers. This can be done by filling out an insurance eligibility form, calling the number on the back of your insurance card, or referring to the benefits section of your member account. It is also a good idea to consult with a healthcare professional to determine which type of pump is most suitable for your needs. Once you have this information, you can contact a breast pump supplier or your insurance company to start the process of ordering or delivering the pump.
It is worth noting that some insurance plans require pre-authorization from a healthcare provider and may only cover pumps from specific medical supply companies. Additionally, the timing of when the pump is covered may vary, with some plans covering the cost several weeks before the due date and others only covering it within a few days of the due date. Most moms tend to order their breast pump around the 30-week mark to ensure they receive it on time.
For those on Medicaid, it is recommended to reach out to the Medicaid provider to understand the coverage options. If a breast pump is not covered by Medicaid, it can be obtained through the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
Overall, while the process of obtaining a breast pump through insurance can be confusing and stressful, it is a benefit that many new moms are eligible for. By understanding the coverage provided by your specific insurance plan and working with healthcare professionals and suppliers, you can ensure that you receive the support and equipment needed for a successful breastfeeding journey.
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Frequently asked questions
Yes, thanks to the Affordable Care Act, many new moms are eligible for a free breast pump through their health insurance.
Most moms tend to order their breast pump around the 30-week mark, which leaves plenty of time for insurance, processing, shipping, and delivery.
You can call the number on your insurance card, chat with an insurance representative, or work with a company that specializes in helping moms get breast pumps through insurance.
The breast pump you choose depends on your unique coverage. Some insurance plans may only cover the cost of a breast pump if it is medically necessary, so be sure to check with your insurance provider.
