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Breast pumps & insurance coverage


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  • 1 Post By tela

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  #1  
January 16th, 2013, 06:45 AM
ThaiSpice's Avatar Platinum Supermommy
Join Date: May 2009
Location: AR
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Anyone's insurance policy now cover a breast pump thanks to the Affordable Care Act changes?

Anybody take advantage of it?

If so, what kind of pump was covered, and was it for purchase or rental?
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  #2  
January 17th, 2013, 09:05 AM
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Join Date: Mar 2012
Location: Chicago
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Mine is pretty sucky. Its blue cross blue shield of illinois and they are covering a purchased manual breast pump provided its from a designated medical supplier. manual....blah
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  #3  
January 17th, 2013, 12:57 PM
ThaiSpice's Avatar Platinum Supermommy
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Location: AR
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Yeah...that is blah. If it were me, I'd probably skip it if manual was all they covered. My insurance covers a breast pump 100% if purchased from a covered supplier, but I need to call still and get the specifics (manual vs. electric, purchase vs. rental, etc). I have a Medela PIS Advanced, but if I could get another one, I would, so that I wouldn't have to lug one to work and back every day. One for work, one for home. But if I can't get another one, no big deal. It would just be nice!
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  #4  
February 27th, 2013, 09:01 AM
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Posts: 110
My gilsbar insurance says that it is a convience item. So its not covered at all. Even for medical reasons such as baby in nicu unable to nurse, dr recomended/prescribed. Extended separation from newborn, low supply. Nothing. I will call again in a few months to re-check as my policy is up for open enrolment right now. I'm hoping this aspect changes. I'm a nurse so i work 13 hour shifts most days. There is no way to bf my little one without supplememting if i can't pump at work.
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  #5  
February 27th, 2013, 09:36 AM
ThaiSpice's Avatar Platinum Supermommy
Join Date: May 2009
Location: AR
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Oh wow...I thought all policies that were new or renewed after August of 2012 HAD to cover breast pumps in some way or another (at least rental). I would definitely call again. Maybe the plan just hasn't gotten up to speed with the new regulation.
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  #6  
February 27th, 2013, 05:06 PM
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Mine covered 100% a new Medela pump in style double electric....i am so happy about this!
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  #7  
February 28th, 2013, 01:05 PM
manda622's Avatar First Time Mommy-To-Be
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Location: Beverly, MA
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I'm researching this really early (just trying to get a budget for saving for baby purchases!) but I called my insurance company yesterday. I have Blue Cross PPO of MA. They told me it's covered up to 230.00 for a double electric. I have to buy it through one of their medical suppliers, and it has to be after the baby and my doc will need to fax over an order or a letter. I looked at the suppliers and a few carry medela and a few carry ameda. The ones who carry medela seem to be further away from me, but one of them offers UPS shipping, so I think we will be all set!
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  #8  
March 1st, 2013, 05:29 PM
ThaiSpice's Avatar Platinum Supermommy
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That's great!
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  #9  
April 25th, 2013, 07:00 PM
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Posts: 3
I just got a Medela pump in style advance for $25. Insurance covered the rest!
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  #10  
May 1st, 2013, 09:10 AM
sandel07's Avatar Veteran
Join Date: Oct 2010
Location: Wisconsin
Posts: 403
Anthem BC covered my Medela double pump 100%. Since the designated ornetwork providers were out of stock I ws able to purchase mine at any retail store, I just had to buy and submit a claim to be reimbursed.
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  #11  
May 29th, 2013, 08:51 AM
tela's Avatar Platinum Supermommy
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i am due in 5 weeks and have been frustrated for months trying to figure this out! i have UHC, and basically - they suck! i can order from 3 national DMEs, but they only cover basic electric pumps for UHC members. i know from pumping with DS that i NEED a medela PIS or equivalent. i can also order from a local DME. i called over 30 places last week and not one works with UHC. some of them were very honest on the phone and said they choose not to work with UHC b/c of their crappy coverage! i do have my OLD PIS (it was used from a family friend, so it's now 10 years old), but i need to dig it out of the basement and see if it still works. at this point i've given up and will purchase a PISA or freestyle. i BF my son for over 2 years and pumped at work for the entire 1st year, so i know it's a good investment.

so, yay for the affordable health care act. boo for insurance companies making it so difficult that people can't take advantage of this great benefit.
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  #12  
June 5th, 2013, 07:39 AM
ThaiSpice's Avatar Platinum Supermommy
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I still haven't tried yet, but it seems like a lot of people have had similar experiences, unfortunately.
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  #13  
June 17th, 2013, 07:10 AM
juleeannk's Avatar Mega Super Mommy
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tela, I own a DME that specializes in maternal and pediatric equipment (we sell a lot of breast pumps) and we just worked with several claims with UHC. If you can't find any local DME that they are in network with, you can purchase through an out of network DME with a temporary gap extension claim. They don't tell you that so you have to know to ask for it. Ask them for a gap extension since you can't find a DME that has the supplies you need
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  #14  
June 20th, 2013, 06:01 AM
tela's Avatar Platinum Supermommy
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Quote:
Originally Posted by juleeannk View Post
tela, I own a DME that specializes in maternal and pediatric equipment (we sell a lot of breast pumps) and we just worked with several claims with UHC. If you can't find any local DME that they are in network with, you can purchase through an out of network DME with a temporary gap extension claim. They don't tell you that so you have to know to ask for it. Ask them for a gap extension since you can't find a DME that has the supplies you need
thank you for that information! i am due in a week or so, but i decided to wait until the baby is born to order a pump. my son had severe jaundice from ABO incompatibility that kept us in the hospital for a week. if this baby has the same issues, i will get a rental (UHC said they would cover it if medically necessary). that will give me more time on mat leave to figure out this insurance stuff! i will def look into a gap extension claim!
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