How do you get a breast pump through your health insurance?

Originally posted on 17/06/2023 @ 01:21

Pumping is an essential way to establish and maintain your daily breast milk supply. Some moms go the extra length and store large amounts of it in breast milk storage bags in the fridge and to do this, you need an electric breast pump device. Many insurance providers will offer coverage for this equipment, which can be expensive to pay on your own. You’ll also find that the Affordable Care Act covers breast pumps as preventative care, because they are considered a medical necessity.

You may want to call your health insurance provider about covering your breast pump before purchasing one online or from a store. Consider using a flexible spending account (FSA), if you’re unsure how much of your pump cost will be covered. An FSA allows employees to use pre-tax dollars to pay for certain medical and childcare expenses, and many plans cover breast pumps under these accounts. 

You can also investigate Group Health Insurance Plans. Group health plans are usually offered as an employment benefit and use people to provide coverage for group members. Many groups who provide this plan include it as part of employee benefits that employees may select, such as vision care or dental care, in addition to medical coverage. It is also possible for you to have been Grandfathered in with the type of plans, which provides not the best benefits.

If you think you might be able to get a breast pump through your health insurance, call the customer service number on your insurance card and ask if they provide coverage for breast pumps. If so, request an order form so you can have one sent to you. Many times an insurance representative can send you online forms right away.

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Ask The Right Questions:

• Do they reimburse the cost of purchasing or renting a breast pump?
• Are there any costs to you?
•  Are the costs covered without requiring you to pay anything out of pocket?
• Do you need a prescription from a doctor and, if so, where and how should it be sent?

Here is also a very helpful video about how to get a FREE Breast Pump through ANY insurance:

Do I need a prescription to get a breast pump through insurance?

Yes, in most cases, moms do need a prescription to get a breast pump through insurance. Whether you order directly through your insurance or buy one yourself, a prescription is required because breast pumps are considered medical devices. Some insurance providers may offer a flat rate to cover the pump, but you’ll need to contact them for this information. The Affordable Care Act requires that insurance companies provide access to “breast pumps and supplies that are reasonable and necessary” without any cost-sharing or co-pays.

Where can I get the breast pump?

You can get a breast pump from many stores that offer medical equipment, such as a medical supply company or any medical equipment provider. You can also go to a certified lactation consultant for advice and guidance on choosing the right pump.

You will likely need a prescription from your doctor to purchase the pump through insurance coverage. The insurance company may send you a form containing all of the details about how they cover equipment, so bring all of this paperwork with you when you go to pick up your new pump.

If you have a Group Health Insurance plan, talk to your HR representative at work. These plans generally cover breast pumps for breastfeeding mothers without requiring an additional payment from the mother herself.

In general, it’s best to check; you may or may not be able to order one online, depending on your insurance provider.

Consider Various Breast Pumps Options Before Buying

If your insurance plan offers various choices, you’ll have to choose the type of pump that’s best for you. Here’s a quick rundown of the types of breast pumps options available.

• Double-electric pump: These pumps have a motor inside them that works for both the suction and release of the device. These are usually rechargeable, which means you can take them with you on the go.
• Single-electric pumps: This is a more basic pump without many extras, but it will still get the job done. You operate it manually, so operation time varies from person to person.
• Battery-operated breast pumps: This is a good choice for people who want to take their pump with them when they’re out and about, but the battery life may not be adequate.
• Hybrid breast pumps: If you see this option, know that it’s a combination of electric and manual devices. The operation time varies from person to person, but it will require some work on your end to operate the suction part of the device manually.
• Manual breast pumps: This manual pump option is inexpensive and can be carried in your purse or bag. However, it requires more time and effort on behalf of the breastfeeding mom, so keep this in mind if you’ll need to set aside extra minutes each day for pumping.
• Hospital grade breast pump: This is one of the most expensive options, but it’s also made to be more powerful. If you’re looking for a strong suction pump that can handle frequent use, this might be your best option.

Spectra breast pump through insurance

Unfortunately, your insurance may not cover the cost of purchasing a high end or Hospital-Grade Pump. However, you may find that it covers the rental or lease of an expensive breast pump brand at little to no cost to you. If this is an option, look into renting through your local store that offers medical equipment for purchase and use.

If you have health insurance with Group Health Insurance, check with your HR representative to see if they cover the cost of these high-end devices like Spectra without requiring an additional payment from you.

Consider lowering the deductible on your plan so that it’s easier to reach each month. Doing so will lower your monthly payments but require higher out-of-pocket expenses if something significant happens, such as being hospitalized overnight or taking multiple trips to urgent care.

Will insurance cover a second breast pump?

It is most likely that insurance will cover a second breast pump as well, but you will need to read your policy closely to make sure you are receiving the benefits you think you are entitled to. Even if they do, you’ll almost certainly end up spending some money out of pocket—you may have co-pays or coinsurances depending on the plan and provider network coverage accepted by your medical provider’s office. Keep in mind, too, that many employers offer supplemental benefits for which you’ll want to inquire as well.

In general, it’s best to check with both your insurance provider and the pump manufacturer or retailer to see what type of coverage is available for a second breast pump. 

How much do breast pumps cost with insurance?

Depending on your health insurance plan, some breast pumps will be 100%. There could be some rules on what type of breast pump your insurance lets you get, such as manual vs. electric, or only certain brands.

Most health insurance companies may allow you to purchase your own breast pump, then they reimburse you up to a certain amount.

One way to reduce your costs is by renting or leasing the device through your medical supply store. However, if you plan to purchase a pump instead of renting one, be sure to check with your insurance provider for more information before taking the plunge!

How much does a breast pump cost without insurance?

The average cost of a good-quality electric breast pump is between $50 – 500$ or so. However, this price range varies by brand and type, so make sure to do some research ahead of time to find the best option for you!

It’s also worth noting that insurance companies usually do not cover accessories unless they are required for use with your specific condition. For example, a supplement may be necessary for someone who plans to pump, because it may provide better milk flow than other types exclusively.

Double pumps can cost anywhere from $60 to $3500, like the Medela Symphony Hospital Grade Breast Pump. Manual devices are cheaper, but they require more time and effort on your part.

When to order a breast pump from insurance?

It is best to ask your insurance about their breast pump policy during your pregnancy to eliminate any surprises later. You may not need one at all, but you will need it fast if you do, so try to figure it out early.

This will also give you time to consider whether or not the pump is right for you, what features are important to you, and which brands are best in each category.

It’s always good practice to be prepared for the worst-case scenario, so make sure that your plan fits your needs before anything happens!

What if your health insurance doesn’t cover a free breast pump??

If your health insurance provider doesn’t cover the cost of a breast pump, you need to start looking for other options right away. Even if you can’t get one free through your insurance company, there are different ways that you can get one without paying the total price.

For example, many manufacturers offer programs where consumers can use their devices without actually owning them. This means that they may help you find a way to get one at no cost to you — or at least lower prices — and it’s worth checking into!

You may also purchase used breast pumps from sellers on Amazon and eBay to save money. After all, once they’ve been used for several months, even years, they’re still perfect for their intended purpose, and they’re more cost-effective than buying a brand new device every time.

Finally, don’t forget to ask your doctor if they can provide you with one or help you get in contact will someone who can.

Conclusion

If you’re having a baby, the chances are that your health insurance provider will cover the costs of one or more breast pumps. However, it’s essential to find out exactly what they plan on covering ahead of time so that there aren’t any surprises later on. There are several types and brands available, so be sure to consider your needs before purchasing!

Remember that it’s not just about which model works best for you but also how well your insurance company will help you get what you need. The last thing you want is to waste money on something that doesn’t quite meet all of your needs simply because it was the only option available.