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How to Get Your Insurance to Pay for Breast Pumps

For breastfeeding new moms, going back to work after maternity leave - or even making it so you and your partner can split nighttime feeding duties - often requires the use of a breast pump. Not only can these pumps help working parents, but they can also allow you to save up a stash of breast milk for emergencies, and help you increase your milk supply by pumping even when the baby isn’t hungry. Even having enough milk saved for date night can be a relief. These handy machines that allow you to pump extra milk and store it for later are lifesavers for busy parents, but are also costly: Some electric double pumps cost around $300! Anything to bring that cost down is helpful, and what many parents don’t know is that their insurance will cover the cost of a pump.

Breast Pump Laws

There’s a little-known provision in the Affordable Care Act, also called the ACA, that required insurance companies to cover the cost of breast pumps, pay for lactation support, and get assistance in acquiring other breastfeeding equipment and supplies. There are only a few “grandfathered” insurance plans that get around this law, which were purchased or created before March 2010. Any plans after March 23, 2010, are subject to the ACA’s breast pump laws. To receive this assistance, parents need only go through their healthcare provider and ask for recommendations. The healthcare provider can recommend many breastfeeding assistance devices, including double electric pumps and breast milk storage supplies. Doctors can prescribe this equipment to you, which will enable most insurers to cover it. You will also need to reach out to your insurer about the individual limitations of their plans, beyond what the doctor can recommend or prescribe.

Can You Get Breastfeeding Help For Free?

Indeed, you can get your breast pump for free! The great thing about the ACA requirement is that it requires the insurer to cover 100 percent of the cost of the pump, for the duration of breastfeeding. You will not have to pay deductions, co-pays, co-insurance, or other out of pocket costs for your pump, as long as you pay attention to the limitations of your individual insurance plan.

Are There Any Exceptions Or Limitations?

What counts as covered breastfeeding assistance devices varies between insurance providers. Some providers will only cover certain models or brands, with others even requiring the pumps and other parts to be bought from “durable medical equipment suppliers” instead of off the shelf from your preferred store.

There is also variance in the way that the equipment can be purchased: many plans will require a prescription from your doctor. Some policies will also only cover manual breast pumps, which are more labor-intensive than the electric pumps. Plans will sometimes also include rentals of breast pumps, instead of actual breast pump purchases. These rentals will usually be of hospital-grade pumps, and last for a predetermined period of time. Others will have you simply submit a receipt for a purchased breast pump, then reimburse you for your purchase.

Sadly, there are a few plans that are also not subject to this requirement. Plans that were created or purchased on or before March 23, 2010, are considered “Grandfathered” plans and are not subject to the ACA law requiring the coverage of breast pumps and other lactation support equipment. Be sure to check that your insurance plan is dated after this date. Otherwise, your breast pump may not be covered.

What Should I Ask My Insurer?

Calling your insurer to get the details of your plan and its limitations is important. Make sure to ask your insurer their specific guidelines for purchase, if you need a prescription from your doctor, and if you can purchase your equipment off the shelf from a retailer, or if you need to get it directly from a durable medical equipment supplier. You should also ask if their definition of “breastfeeding supplies” only covers manual pumps, or if it will only cover the rental of hospital-grade pumps.

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