Jane Dotson
The Affordable Care Act has made it possible for new mothers to be eligible for a free breast pump through their health insurance. The act mandates free breast pumps through insurance and also covers necessary supplies, support, and counseling for breastfeeding parents. To request a breast pump, one must call the phone number on their health plan ID card, or they may contact one of the national network providers. It is ideal to request a breast pump before the third trimester to ensure there is plenty of time before the baby arrives.
| Characteristics | Values |
|---|---|
| When to call insurance for a breast pump | Before your third trimester, to ensure there's plenty of time before your baby arrives |
| Who to call | Your insurance provider |
| What to ask | Whether you're eligible, what's covered, which pumps are offered, and when you can order |
| What you need | A prescription from your doctor |
| Where to get a breast pump | From a specific medical supply company designated by your insurer |
| What type of pump | A manual or standard electric pump (non-hospital grade) |
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What You'll Learn
Breast pump types covered by insurance
The cost of a breast pump may be covered by insurance under the Affordable Care Act. The act requires most health insurance plans to cover breastfeeding support, services, and supplies. This means that you could receive a top-brand breast pump at no cost to you.
Different types of breast pumps are available, and it is important to select the one that fits your needs and lifestyle. The most common type of breast pump is the double-electric breast pump, which is generally covered by Medicaid and most private insurance plans. These pumps are considered the most efficient and fastest as they allow you to pump both breasts at the same time. Single electric models are also available and are covered by insurance, but they only allow milk expression from one breast at a time.
Some other types of breast pumps include manual breast pumps, hospital-grade (multi-user) pumps, and hands-free pumps. However, these types of pumps are less commonly covered by insurance. For example, UnitedHealthcare benefit plans do not typically cover these pump types. Hospital-grade pumps are usually only available for rent when covered by insurance and require a prescription.
If you have secondary insurance, it is worth contacting the insurance provider, as this may result in the breast pump being fully covered. Additionally, some private medical insurance plans require you to obtain your breast pump from a designated medical supply company or "durable medical equipment" supplier (DME).
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Getting a prescription for a breast pump
The process of obtaining a prescription for a breast pump may vary depending on your insurance provider and your specific healthcare plan. Here is a step-by-step guide to help you navigate the process:
Step 1: Understand Your Insurance Coverage
Review your insurance plan to determine if it covers the cost of a breast pump. The Affordable Care Act (ACA) requires most health insurance plans to cover breastfeeding support and supplies. However, the extent of coverage can vary. Some plans may cover hospital-grade pumps, while others may only provide rentals or exclude them altogether. Contact your insurance provider to confirm the specifics of your coverage, including any brand restrictions, vendor limitations, and requirements for obtaining a breast pump.
Step 2: Consult Your Healthcare Provider
Get in touch with your OB/GYN, midwife, or primary care physician to discuss your needs. They can advise you on the most suitable type of breast pump and provide a prescription if necessary. Some insurance plans may require a prescription from your healthcare provider to cover the cost of the pump. Ensure that the prescription includes all the necessary information, such as your due date or delivery date, as per your insurance provider's requirements.
Step 3: Choose Your Breast Pump Supplier
Depending on your insurance plan, you may be able to purchase your breast pump from a retailer, a network-approved medical distributor, or a specific medical supply company designated by your insurer. Some insurance companies work directly with certain vendors, so it's important to verify their approved suppliers before making a purchase.
Step 4: Submit Your Prescription and Insurance Information
When you have selected your breast pump supplier, provide them with your prescription and insurance information. They will typically handle the process of obtaining approval from your insurance company and ordering the breast pump on your behalf. You may be required to upload or submit your prescription, along with your treating practitioner's contact information, during the checkout or ordering process.
Step 5: Follow Up and Receive Your Breast Pump
In some cases, the breast pump supplier may need additional information or documentation from your healthcare provider. If there are any issues or requirements, they should notify you via email or text message. Once all the necessary steps are completed, you should receive your breast pump.
Remember that the process may vary slightly depending on your insurance provider and specific plan. It is always a good idea to confirm the details of your coverage and any specific requirements they may have for obtaining a breast pump prescription.
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Ordering a breast pump online
The process of ordering a breast pump online can vary depending on your insurance provider and the company you choose to purchase from. Here is a step-by-step guide to help you navigate the process:
Step 1: Understand Your Insurance Coverage
Before placing your order, it is important to understand what your insurance plan covers. The Affordable Care Act requires most health insurance plans to cover breastfeeding services and supplies, including breast pumps. However, different insurance providers may have specific brands or suppliers that they work with. For example, some private medical insurance plans require you to obtain your breast pump from a designated medical supply company, also known as a "durable medical equipment" (DME) supplier. Contact your insurance provider or refer to your plan details to determine what is covered and if there are any restrictions or requirements.
Step 2: Choose a Reputable Online Company
Select an online company that offers breast pumps and accepts insurance coverage. Examples of such companies include Acelleron Medical Products, The Breastfeeding Shop, and BreastPumps.com. Research their websites to understand their ordering process, the brands they carry, and their experience in handling insurance claims. Reading customer testimonials can also provide valuable insights into the quality of their products and services.
Step 3: Select the Right Breast Pump
Consider your needs and lifestyle when choosing a breast pump. Different types of breast pumps are available, such as manual pumps, double-electric pumps, hospital-grade pumps, and hands-free pumps. Evaluate the features, portability, and efficiency of each option to determine which pump best suits your requirements. Keep in mind that your insurance plan may only cover certain types of breast pumps, so ensure that your chosen pump is eligible for coverage.
Step 4: Place Your Order
Once you have selected the breast pump and any necessary accessories, proceed to place your order online. You may be required to provide additional information, such as your insurance details, doctor's name and contact information, and your baby's due date or date of delivery. Some companies may also request a prescription from your physician. The online ordering process may vary slightly between different companies, so carefully follow the instructions provided on their website.
Step 5: Verify Insurance Coverage and Follow Up
After placing your order, the company you chose should handle the necessary communication and billing with your insurance company. They may verify your insurance coverage and take care of the required paperwork. However, it is important to stay informed about the status of your order. Contact the company if you have any questions or concerns, and ensure that your breast pump arrives in a timely manner.
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Breast pump suppliers
In the US, the Affordable Care Act requires most health insurance plans to cover breastfeeding services and supplies, including breast pumps. This means that you may be able to receive a breast pump at no cost to you through your insurance provider. To request a breast pump, you can call the phone number on your health plan ID card or contact one of the national network providers. You will need a prescription from your doctor to get a breast pump. If you contact a breast pump supplier directly, they may ask for your doctor's name and phone number and the baby's due date or delivery date.
Some insurance providers may require you to get your breast pump from a specific medical supply company, sometimes called a "durable medical equipment" (DME) supplier, that is designated by your insurer. For example, if you are on Medicaid, you will need to reach out to your Medicaid provider to find out what is covered and where you can get your pump. If you cannot get a breast pump from your Medicaid provider, you can get one through the Special Supplemental Nutrition Program for Women, Infants and Children (WIC).
- Acelleron Medical Products: Acelleron offers a range of top-rated breast pumps that are free with insurance. They also provide free online breastfeeding education classes and virtual consults after you receive your pump.
- Harvard Pilgrim Health Care: Harvard Pilgrim has a network of durable medical equipment/breast pump suppliers that participate in their plan networks. A list of suppliers can be found on their website, including contact information and addresses.
- UnitedHealthcare: UnitedHealthcare benefit plans include coverage for the purchase of a personal-use, double-electric breast pump at no cost. You can find out more information by calling the number on your health plan ID card or referring to your member account.
It is important to note that not all types of breast pumps are covered by insurance plans. For example, manual breast pumps, hospital-grade (multi-user) pumps, and hands-free pumps may not be covered by certain insurance providers. Additionally, you will not be reimbursed for a breast pump purchased at a retail store.
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Lactation counselling
Breastfeeding plays a crucial role in the health, growth, and development of babies and has benefits for the mother too. However, breastfeeding may not always come naturally, and many mothers face challenges such as latching difficulties, pain, or low milk production. This is where lactation counselling can be invaluable. Lactation counselling can help mothers initiate and continue breastfeeding, ensuring the well-being of both the mother and the baby.
During lactation counselling, mothers can receive support and reassurance as they learn the skill of breastfeeding. Counsellors can explain the mechanics of breastfeeding, including the actual mechanism of how babies get milk into their bodies, and correct breastfeeding techniques. They can also provide guidance on when and how long to feed, and discuss the benefits of continued breastfeeding after six months, as well as the introduction of other foods in addition to breast milk.
If necessary to express breast milk, counsellors can show mothers how to do this and how to feed expressed breast milk by cup. They can also refer mothers to a trained infant feeding counsellor if needed. Mothers can be reassured that their bodies will make enough breast milk to satisfy their babies' needs and that allowing the baby to suckle more often will increase milk production. Counsellors can also provide support for HIV-infected mothers who wish to breastfeed and improve their baby's HIV-free survival.
To access lactation counselling, you can contact your OB/GYN, pediatrician, or primary care physician to learn about the services they offer. Many health insurance plans, including UnitedHealthcare, cover lactation counselling with a network provider, so you may be able to receive this support at no additional cost.
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Frequently asked questions
It is recommended that you call your insurance company before your third trimester to allow plenty of time for your pump to arrive before your baby is born.
You will need to verify your eligibility and check which brands of breast pumps are covered by your insurance plan. You will also need a prescription from your doctor.
After you call your insurance company, you will need to choose a supplier and submit your prescription to them. The supplier can then help you select a breast pump from your covered options.
