Insurance

How to get your breast pump covered by insurance

Aug. 23, 2013 at 10:58 AM ET

How to Get Breast Pumps Covered by Insurance
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How to Get Breast Pumps Covered by Insurance

Whether you're going back to work or have responsibilities that mean you need to be away from your baby for a few hours, a powerful and efficient breast pump can make all the difference to help you continue breastfeeding. But double electric pumps like the popular Medela Pump in Style can come with a daunting price tag of around $300.

That's one reason why a new regulation, which went into effect August, has been put in place requiring insurance companies to cover breast pump rental and lactation consultants—without co-pays or deductibles. Translation: you can now rent a breast pump gratis! Even better—some insurance companies may cover the cost to purchase one. Breastfeeding supplies and support are two of the new preventive care services now available to women thanks to the Affordable Care Act. However, even though the policy seems simplistic it's actually a tough one to navigate. Here's what you need to know about getting a breast pump covered by your insurance.

Grandfathered plans are exempt: If your health insurance plan was in place before March 23, 2010 when the Affordable Care Act was signed, it is not required to comply with the new breast pump and breastfeeding support provisions. That said, you may still have some coverage, and will only have to come up with a co-pay or deductible out of pocket. Not sure if your plan is grandfathered? Call and ask.

You might need a prescription: Sometimes your insurance will require a prescription from your health care provider, but many simply need your doctor or midwife's name and phone number.

You may be able to choose your pump: You might be able to get a double electric breast pump through your insurance company, though some plans only cover manual ones. Alternatively, your plan will cover the rental of a hospital grade breast pump.

You may need to find out where to buy it: Some insurance companies will connect you to a medical supply company that can ship your desired breast pump directly to you. Other plans may direct you to a list of medical supply companies in your area.

Bottom line: Start by calling your insurance company. Because of how the law is written, the way it'll be carried out is left up to the insurance company, explains Alex Pharr, lactation team leader at Workplace Options, a work-life services provider in Raleigh, NC. There is likely to be an enormous amount of variation, so check with your provider.

A version of this story originally appeared on iVillage.


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