How To Get Your Insurance To Cover Your Breast Pump

No matter what your opinion is about President Obama, I think we can all agree that the affordable care act (ACA) has some great advantages for women. There are eight additional women’s preventative services that are now covered in all new insurance policies and most established policies. These include well woman visits, Gestational Diabetes Screening, HPV screening, STD counseling, HIV screening and counseling, Contraception and contraceptive counseling, Domestic violence screening and counseling, Breastfeeding support, supplies and counseling. Thanks to the ACA, both pregnant and postpartum women must have access to lactation support and counseling from trained providers through their insurance companies, as well as have the cost of a new breast pump covered. So now we know we can get it,  but how do we actually get the darn thing? It is important to start talking to your insurance company even before that first tingle of labor.

• Ask your insurance company what kind of pump is provided. It could be a brand new personal use pump or a hospital grade rental. It is also important to know that personal use breast pumps are designed to be used by only one person. There is no way to properly sterilize every nook and cranny and this can lead to your baby getting very sick.

• Find out if you need a prescription. Most insurance companies will require it. You can request that your OB fax a prescription immediately after the birth or you can wait a couple of days for baby’s first well checkup with the pediatrician. I put in a call to my family doctor who wrote the prescription for me.

• Ask if there is a special diagnostic code you need written on your prescription. Having the correct code will save you a bunch of time and hastle.

• Where is your pump coming from? If it is a hospital rental you can usually take it home with you after delivery. Sometimes it will be mailed directly to your home. It could even be delivered from a medical supply company.

If at first you don’t succeed…. When I called my insurance company to get a breast pump the representative had no idea that it was covered. I had to speak with three different people before they could find the new requirements. After they confirmed that I did indeed qualify for a pump, they gave me the number of the medical supply company to fax a prescription to. I called my family doctor who sent the prescription right away. Unfortunately it had the wrong diagnostic code so I had to call the insurance company back and ask for the codes they would accept in order for it to be covered. They gave me a list of twelve codes that my doctor tried until finally it was accepted by the medical supply company. It took me about three hours and eight phone calls, but I had a brand new personal use breast pump delivered to my doorstep by 5:00pm that evening. I should note that I requested my pump 6 months after the Affordable Care Act took effect; since then, the process has since been streamlined and the insurance representatives are much more knowledgeable of the requirements.

Good luck and happy pumping!

For more information on the benefits of breastfeeding check out The Babble Out.