Yes, it may be possible to have your insurance pay for a breast pump
It’s a dilemma that many new moms run into. You’d like to get a breast pump. But you’re afraid it’s going to cost a fortune… even with health insurance.
Here’s the truth: If you have health insurance or Medicaid, you can probably get a breast pump for free or at a low cost. It just takes a phone call or two. And it’s easy to place an order.
Most health insurance plans, and Medicaid, do pay for breast pumps. How can you be sure? The Affordable Care Act (ACA) requires most insurance plans to pay for:
- breast pumps
- breastfeeding support and counseling
That means they have to cover 100% of the cost, with no copays or coinsurance.
Different Insurance Plans & How They Cover Breast Pumps
As always, with insurance plans, the details can vary. Here’s what you need to know:
- Some plans will just pay for a manual breast pump.
- Others will pay for either a manual or electric breast pump – that you get to rent (not keep).
- Others will pay for either a manual or electric breast pump that you get to keep.
It all depends on what your plan says. But you might have better coverage than you think. To find out exactly what you can get, just give your health insurer a call. Or better yet, have someone call for you – a good breast pump supplier who knows what questions to ask. That person can call you back and tell you about all of your options.
If you do buy a pump, here’s something important to remember. Many insurers just cover a certain amount of the cost, whether it’s $50, $100, $150, $200 – you get the idea. If you pick a breast pump above that cost, you’ll probably be paying the difference.
But if you pick a breast pump at that cost or below, you will probably get it for free.
Either way, you save money!
Medicaid & Free Breast Pumps
Generally, Medicaid covers the cost of breast pumps but you usually have to get a prescription. There also might be some other guidelines you have to follow. Call your Medicaid insurance provider for more details. Or have a breast pump supplier call for you.
Pre- and Post-Affordable Care Act Insurance Plans
There are a small handful of insurance plans that don’t pay for breast pumps. Generally, these are plans that existed before March 23, 2010—the day the ACA was signed into law.
Those are called “grandfathered” plans. If you’re worried you might have one of those plans, call your insurance company. Ask them, “Is my plan covered by the ACA? Or do I have a grandfathered plan?”
If you do have one of those grandfathered plans, you might want talk to a health insurance broker. They can help you find another plan that might better suit your needs.
If you have health insurance through your job, and you have questions about your plan, ask your human resources department for help.
What Are My Next Steps?
Call your health insurance company, your doctor, or a breast pump supplier. Once you order a breast pump, it could take several days to ship. If your pump is covered by insurance, the insurer usually covers the cost of shipping and handling.
Want help getting a breast pump? Call Toll-Free: (866) 633-1597, Monday through Friday, 9 a.m. to 5 p.m. CST. You can also visit nebmedical.com.
