How to Get a Breast Pump Through Insurance

One of the great things about the Affordable Care Act (or Obamacare) is the fact that breastfeeding support, counseling, and equipment must be covered under health insurance plans at not additional cost to you. There are a few limitations on plans that have been grandfathered, but most cover it. Breastfeeding support and counseling includes lactation services, equipment refers to breast pumps. What a great benefit! I wish I had support covered after my first baby was born and I struggled to pump while she was in the NICU.

The ACA was signed in March 2010 and the benefits have been phased in since. I am not sure when the breastfeeding coverage started exactly, I know back in 2012 I bought my pump at retail spending close to $300 on it. When I had my second baby I did not bother buying a pump at all since my first one still worked fine.

For my third baby I decided I was ready to upgrade. It's been four years since I first used my Ameda Purely Yours Ultra  pump and I was ready to replace it. I admit though, I had no idea how it worked to get one through insurance. I try to avoid contacting insurance companies as much as possible. I seriously hate spending time waiting on a phone.

How to get a breast pump through insurance:

First item to do:

Call or contact your insurance company and find out what coverage you have. I did not want to call as I mentioned above, so I decided to try the online chat feature on my insurance company's website. Guess what? It worked great and I got all the information I needed via the chat feature.

I learned there were three in network breast pump providers/medical supply companies I could contact to receive my pump. I also learned that I would need a prescription or order from my OB. It was also mentioned that only certain pumps were covered and if I wanted an upgrade I would have to pay the difference. That part is a little confusing since most double electric pumps should be similar. I did not ask for specifics so we'll see if there is any follow up later on the pump I chose. Each insurance company works differently on which pumps they will cover, and the options of where to get to them. That's why calling or contacting is definitely the first and most important step.

Second:

Check out where you will get your pump and see what kind of paperwork they require. After I got off chat with my insurance company I went and found the websites of the in network providers I was given. I chose the one that looked the easiest to deal with and started my online paperwork. I realized I would need my doctor order to complete anything so I decided to wait until after my next appointment to finish it up.

A side note - there are so many pumps to choose from now! I am so glad we have this many choices. When my daughter was born, I had two choices; Ameda or Medela. I was a little overwhelmed picking one. I loved my Ameda Purely Yours Ultra, and it lasted through two babies, but I admit I wanted to try something different. I will write a round up of all the pump options in a future post.

Third:

Once I had the prescription from my OB (she wrote a regular paper prescription) I went back to the website of the company providing the pump. I narrowed down my pump choices and ended up picking the Spectra Baby USA S2 pump. I have been wanting to check out this pump and have heard nothing but great things about it. Again, much more information on the pump itself in a future post. Going through the process on the website to order it was incredibly easy. I finished the paperwork and submitted it.

Finally:

The doctor order or prescription must be mailed, or scanned and emailed to the company. After finishing my online order they provided me an email to scan and send it to. I went ahead and did this and my pump was on its way.

I received my pump a few days later.

Now that is easy! I am within 60 days of my due date and that is probably a good time to do this. Some insurance companies have rules about how close you must be to your due date before you can order.

My breast pump package included paperwork for me to sign and return for insurance purposes. The company also emailed me the paperwork and let me sign it digitally. Again, super easy.

Conclusion

So, I have to say my experience was pleasant, stress free, and I never had to speak to an actual person ha. Now, I know that the breast pump provider will be contacting my insurance company for payment so hopefully that goes smoothly. If I run into any hiccups I will be sure to update this post with any new information.

This is a wonderful benefit for breastfeeding and pumping mothers so be sure to spread the word and take advantage.

Please let me know if you have any questions about ordering a breast pump through insurance at all!

Update for 2017:

I recently became aware of an even easier way to get a breast pump through insurance using Aeroflow Breast Pumps. You can read more about the process here at my newest blog post.

You can also use this tool to see which Durable Medical Equipment provider is in network with your insurance provider so you can get a breast pump at little-to-no cost.