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Insurance Question ChubbyCheekers 2 kids; New York 3117 posts
18th Oct '12

I was talking to a friend the other day about breast pumps...I no longer have the one I used with my son so I'll need to buy a new one for when I go back to work. Hubby and I are in a tight spot financially because he lost his job, and she told me that she's heard that insurance companies have to cover breast pumps now. I've tried looking into this and found surprisingly little information, so I just wondered if anyone else knew if this was true and if so, how it works. I suppose I could call my insurance company and ask but I wanted to check the validity of this information first.

UhmAmber 1 child; Texas 2415 posts
18th Oct '12

Watching!!

Kristin & Baby Katelyn Due February 12 (girl); Jacksonville, Florida 82 posts
18th Oct '12

I have been told nearly the same thing. A friend of mine said when you go to L&D to have the baby you can ask the nurses about a hospital grade pump and that they are usually fully covered by insurance. I haven't checked into this yet but I'm sure your insurance company could probably give you a pretty good idea of what they cover or if they do at all.

ChubbyCheekers 2 kids; New York 3117 posts
18th Oct '12

I did find a couple places where people said it has to be "medically necessary", like your baby can't latch on for whatever reason or something like that. But I did see somewhere that working outside the home was considered a valid reason.

ChubbyCheekers 2 kids; New York 3117 posts
18th Oct '12
Quoting Kristin & Baby Katelyn:" I have been told nearly the same thing. A friend of mine said when you go to L&D to have the baby ... [snip!] ... yet but I'm sure your insurance company could probably give you a pretty good idea of what they cover or if they do at all. "

I read that you can get any kind of commercially available pump, you just have to get it through a medical supply store.

Kristin & Baby Katelyn Due February 12 (girl); Jacksonville, Florida 82 posts
18th Oct '12
Quoting Lizzle06:" I did find a couple places where people said it has to be "medically necessary", like your baby can't ... [snip!] ... whatever reason or something like that. But I did see somewhere that working outside the home was considered a valid reason."

I would say your best bet is probably to call your insurance company or maybe ask an OB? I am not sure if they would know or not but they might.. This is my first pregnancy and I plan to BF but I don't want to buy one before the baby comes just in case I cant BF or have a different problem..

ChubbyCheekers 2 kids; New York 3117 posts
18th Oct '12
Quoting Kristin & Baby Katelyn:" I would say your best bet is probably to call your insurance company or maybe ask an OB? I am not sure ... [snip!] ... and I plan to BF but I don't want to buy one before the baby comes just in case I cant BF or have a different problem.. "


Don't blame you - they're definitely too expensive to buy and end up not using! Almost $200 for a double electric one...jeez. But I have to go back to work so I'm gonna need one...maybe just a single one but they're still expensive. Manual seems like it would be a pain in the ass.

taking a look at life Palm beach gardens, FL, United States 49151 posts
18th Oct '12

There not covered this year..it starts next year and right now most of them only cover it for nicu babies

ChubbyCheekers 2 kids; New York 3117 posts
18th Oct '12

Really? I just Googled it and found a couple stories from people who said theirs was covered 100% with no issue...I will call MVP tomorrow and ask them.

Kristin & Baby Katelyn Due February 12 (girl); Jacksonville, Florida 82 posts
18th Oct '12
Quoting Lizzle06:" Really? I just Googled it and found a couple stories from people who said theirs was covered 100% with no issue...I will call MVP tomorrow and ask them."

I think that would probably be the best idea! (:

LittleTiger 2 kids; Azeroth, .., United States Minor Outlying Islands 11431 posts
status 18th Oct '12
Quoting Click Me Click Me!!!:" There not covered this year..it starts next year and right now most of them only cover it for nicu babies"


Not true!!



They are covered this year. Blue Cross paid for my Medela pump and my baby was not a nicu baby. All you need is a prescription from a doctor. Call your OB and tell him that insurance pays for a pump and that you need a prescription. He or she should write you up one. If not, you can ask your pediatrician. We had to order it through a medical supply company that was in network. Our pump cost $493 but we only paid $39 :D However, the catch is that you get the pump that the medical supply gives you. You can put what one you would like but they can only give you what they have in stock.

ChubbyCheekers 2 kids; New York 3117 posts
18th Oct '12
Quoting LittleTiger:" Not true!! They are covered this year. Blue Cross paid for my Medela pump and my baby was not a nicu ... [snip!] ... pump that the medical supply gives you. You can put what one you would like but they can only give you what they have in stock."

Thank you so much! I will call my insurance company in the morning (I have MVP) and ask them about the specifics. I used an Avent pump last time and loved it so I would like another one but I guess beggars can't be choosers...

BastiansMommy 1 child; Lacey, WA, United States 2433 posts
19th Oct '12
Quoting LittleTiger:" Not true!! They are covered this year. Blue Cross paid for my Medela pump and my baby was not a nicu ... [snip!] ... pump that the medical supply gives you. You can put what one you would like but they can only give you what they have in stock."

I have Premera Blue Cross and DSHS...would those help me get a breast pump? I honestly have no idea how to go about contacting them about if they will or not :oops:

ChubbyCheekers 2 kids; New York 3117 posts
19th Oct '12

Alright so I called MVP and the guy told me that under the new Affordable Health Care Act, they do have to cover breast pumps as part of women's preventative care or something...but not until my plan renews on January 1st. Basically how it works is I send them my receipt and they will reimburse me for up to $75, no prescription needed. I would like one before January 1st seeing as how I'm due Dec 10th...although I guess I don't really need one until I go back to work.



I'm still gonna ask my OB at my next appointment and see if they know anything about it...like maybe if they write me a prescription I can get it for cheaper.

taking a look at life Palm beach gardens, FL, United States 49151 posts
19th Oct '12
Quoting Lizzle06:" Alright so I called MVP and the guy told me that under the new Affordable Health Care Act, they do have ... [snip!] ... next appointment and see if they know anything about it...like maybe if they write me a prescription I can get it for cheaper. "


yah thats what i was talking about....:D
sorry they dont cover it this year.