Orlando Harmon
Breast pumps can be expensive, but the good news is that there are several ways to get one at a low cost. One way is through insurance, such as Medicaid, which covers the cost of a breast pump for many new and expectant mothers. However, the type of pump covered and the process for obtaining one may vary depending on state policies and the specific Medicaid plan. It is important to contact your insurance provider to understand your specific plan's coverage and requirements, such as a prescription from a medical professional. Additionally, organizations like WIC and Pumps for Mom offer support and resources to help mothers obtain breast pumps and navigate the insurance process.
| Characteristics | Values |
|---|---|
| Cost | Free |
| Medicaid Coverage | Differs from state to state |
| Prescription | Required |
| Medicaid as Primary Insurance | Required in most cases |
| Medicaid as Secondary Insurance | If covered by another insurance provider |
| Medicaid Coverage Timeframe | Throughout pregnancy and up to 12 months postpartum |
| Additional Benefits | Pregnancy support bands, maternity compression stockings, lactation counselling services |
| Pump Types | Manual, personal double-electric, hospital-grade electric |
| Pump Options | Owning, renting |
| Pump Brands | Spectra, Medela, Ameda, Lansinoh, Motif, Freemie, Elvie |
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What You'll Learn
Medicaid coverage varies by state
Medicaid is a major source of funding for hospitals, community health centers, physicians, and nursing homes. It provides health and long-term care coverage to almost 82 million people in the United States, including low-income children, pregnant women, adults, seniors, and people with disabilities.
Each state operates its Medicaid programs within federal standards, with a wide range of state-specific options, to receive federal matching funds. For example, in some states, Medicaid can be used as secondary insurance if you have another insurance provider. However, if your primary insurance does not provide coverage for a breast pump, you may be eligible to receive one through Medicaid.
To obtain a breast pump through Medicaid, you will typically need a prescription from your physician. You can then submit your prescription and Medicaid plan information to a contracted Medicaid provider to receive your covered breast pump.
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Medicaid may not cover hospital-grade pumps
Medicaid typically covers the cost of a breast pump, but the type of pump and the extent of coverage vary depending on state policies and the specific Medicaid plan. While Medicaid may not cover hospital-grade breast pumps, many plans will cover the cost of owning or renting a personal double electric breast pump.
Hospital-grade breast pumps are multi-user pumps typically used in hospitals. They are designed for long-term, frequent use and often have more powerful motors and higher-grade materials. These pumps are often more expensive than personal-use pumps, and as such, Medicaid plans may not cover them.
In most cases, Medicaid requires a prescription from a medical professional to cover the cost of a breast pump. This prescription can be obtained through your physician's office, and some organizations, like Pumps for Mom, can help you get a prescription if needed. It is important to note that Medicaid plans accepted by different suppliers may vary, so it is recommended to verify your coverage and the specific breast pumps covered by your plan.
If your Medicaid plan does not cover a hospital-grade pump, you may still be able to obtain one through other means. Some mothers rent their pumps while breastfeeding, and in some cases, Medicaid may cover the cost of renting a pump if it is deemed medically necessary. Additionally, you can reach out to your local WIC clinic to see if they have a breast pump program or work with organizations like Pumps for Mom to explore alternative options for obtaining a breast pump.
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A prescription is usually required
If you don't already have a prescription, some companies can work with your physician's office to obtain one for you. You can also get help with your prescription from companies like Pumps for Mom, who can also verify your insurance coverage and track your breast pump delivery.
The process of obtaining a prescription may be easier than you expect. For example, the Lansinoh Insurance Locator tool allows you to choose a supplier and breast pump before prompting you to submit more detailed information. The supplier will then verify the information with your doctor before shipping your breast pump.
It is important to note that every state's Medicaid program is different, so it is recommended that you check with your Medicaid provider to find out what is covered before your baby arrives.
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You can rent or buy a pump
If you're looking to get a breast pump through insurance Medicaid, you may be able to rent or buy a pump. This is because every state's Medicaid program is different, and each plan has different rules. The best way to find out what's covered is to call your insurance provider before you have your baby.
If you have Medicaid and another insurance provider, your Medicaid will be used as your secondary insurance. If your primary insurance does not provide any coverage for a breast pump, you may be eligible to receive one through Medicaid. However, Medicaid may not cover hospital-grade breast pumps.
If you don't have insurance, you may be able to get or rent a pump through WIC. Reach out to your WIC clinic to find out if you're eligible and what other services may be available to you.
If you're looking to buy a pump, you can get top-quality breast pumps from leading brands through your insurance. These items are typically partially covered by your insurance, and a small co-pay or deductible will be due at checkout. If you have secondary insurance, this may cover the remaining cost.
If you're looking to rent a pump, hospital-grade breast pumps are available for rent when covered by insurance and require a prescription. These pumps are designed for multiple users, with a special closed system that makes them safe to share.
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Additional support is available
Pumps for Mom is a service that helps new and expectant moms get their breast pumps through insurance. They can help you verify your insurance coverage, assist you in getting a prescription, and keep track of your breast pump when it’s on the way to you. They offer a range of breast pump brands and insurance-covered maternity compression garments. They also provide a qualification form that makes it easy for moms to browse breast pumps covered by their Medicaid plan and order their pump when they are ready.
1 Natural Way is a contracted Medicaid provider in Alaska, Indiana, Kansas, Kentucky, Louisiana, New Jersey, Ohio, Oregon, Pennsylvania, and Texas. They offer a simple intake form that you can fill out to verify your Medicaid coverage and find out what breast pumps and related products are covered by your plan. They also provide support via email, text, and phone.
WIC (Women, Infants, and Children) clinics may be able to provide you with a breast pump or rental if you can't get one through Medicaid or you don't have insurance. Reach out to your local WIC clinic to find out if you're eligible and what other services may be available to you.
It's important to remember that Medicaid coverage differs from state to state, and many Medicaid plans will only process payment and ship your pump when the baby is born. The best way to find out what's covered is to call your insurance provider before you have your baby and ask about your options.
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Frequently asked questions
You can get a breast pump through Medicaid by submitting a prescription for your pump to your insurance provider. You can also get help from services like Pumps for Mom, which can help you verify your insurance coverage, get a prescription, and keep track of your breast pump delivery.
The type of breast pump covered by Medicaid will depend on your state and insurance plan. Some Medicaid plans cover hospital-grade electric pumps, while others may only cover personal double electric pumps or manual pumps. Some plans may also offer breast pump "upgrades" for an additional price.
It is recommended that you order your breast pump during pregnancy so that you are ready to breastfeed when your baby arrives. Many Medicaid plans will only process payment and ship your pump when the baby is born.
