The insurance world can be tough to navigate, and you as a new mom can get lost here. Even many moms aren’t aware that they can get a free breast pump through insurance.
Now, you might be thinking about questions like how do I get a breast pump through insurance? What does my insurance cover? Or where to get a breast pump through insurance? Stay back. This article will empower you with the insurance pump knowledge that you need to order breast pumps through insurance.
This guide will help you get the pump you want, whether it’s the willow pump, the LV pump, or any other portable breast pump. In addition, there is a help to either get you a pump partially covered by your insurance or fully covered by your insurance.
Health Care Act Around Breast Pumps/ Lactation Consultants
According to the healthcare act in 2010, all health insurance plans need to cover non-cost sharing breastfeeding support and supplies. What does non-cost sharing mean?
Well, that means you don’t have to pay co-insurance, you don’t have to pay a co-pay, and you don’t have to pay a deductible. So that means you pay $0 to get the support that you need.
In the case of health care insurance companies, there are some caveats that you need to keep in mind. For example: While a health insurer must cover breastfeeding equipment.
The law doesn’t impose the requirements such as paying or renting a breast pump through insurance. So there are some minor differences between each healthcare company.
Does Your Plan Participate?
Some rare plans land under the exclusions by which they do not need to follow the healthcare act. These acts are of two types, The Grandfathered Accounts, and The Traditional Medicare Account. So here, you won’t have a free breast pump through insurance.
Traditional Medicare Accounts
Going back to the traditional medicare accounts. At the same time, they don’t have to comply with breastfeeding support and supplies. So you won’t get breast pumps through insurance. However, many states have decided that they’ll just go ahead and extend that, so the medicare plan does include it. So definitely check with your state regulations on that.
You may be not aware but thanks to the Affordable Care Act(ACA), now breast pumps are covered under most health insurance policies for free.
How to Order a Breast Pump Through Insurance?
An obvious question raising in parents’ minds while applying for their free Breast pump is how to order it through their insurance? So, the process is somewhere the same for each site. Follow the below steps;
- Know the breast pump offered by your insurance coverage company.
- Select the best brand that fits you.
- Navigate to the brand’s official page and search for an option named ‘Qualify through insurance’.
- Now, you might see a form filling section where you have to fill in details regarding your Email, baby’s due date and submit your form.
- Once you are done with it, a specialist will contact you for further queries and will inform you of the exact thing you are qualified for.
- From there, the specialist will guide you through your personalized process depending upon your insurance plan.
What Role Does DME (Durable Medical Equipment) Company Play?
DME companies are significant, especially for first-time moms, because you know what pump works for you. Of course, you need to find the best breast pumps through insurance.
You need to have a conversation with them to know the best breast pump insurance covered by your company as you want a hassle-free experience.
Frequently Asked Questions (FAQs)
What brands of breast pumps are covered by insurance companies?
Several medical supplies companies such as Aeroflow, Elvie, Edgepark, Ameda, Ardo, and much more are offering breast pumps covered in insurance. However, it depends on your location and insurance provider to know which brand you qualify for.
Can I get a breast pump through my baby’s insurance?
No. Typically, insurance only offers coverage for only one pump each pregnancy through their Health Insurance. However, if you have purchased a breast pump before getting the knowledge that you are eligible for one free pump, you will receive one free coverage from your insurance company.
How do I get a breast pump through my insurance prescription?
If you have a prescription, you should make sure it’s VALID! Before you run for your free Breast pump, here is a checklist of a valid prescription that must be present in your prescription;
- Your name
- Date of the first meeting.
- Valid diagnosis code for your pregnancy.
- Your physician’s original signature or stamp.
- Request for breast pump prescribed by the physician.
- Your certified and registered physician’s name is on the prescription.
Out of Network Service
What if you run into an issue where your insurance is telling you they are out of network with all the lactation consultants and all the breastfeeding supplies vendors? How do you get a breast pump through insurance in this case?
Well, by law, they need to find you an out-of-network option or whatever option that will still cover the breastfeeding supplies and support at zero dollars to you.
Appeal Your Insurance Companies Decision
There are two ways to fight your insurance company. First of all, you can try an ‘Internal Review’ where you ask the insurance company, “What’s your internal process and how can I fight this? Because I believe that you are not giving me what I need according to the health care act”.
The second way there’s an external process where a third-party vendor can investigate for you. Finally, there’s another great resource for you guys that we have come across after hours of research. It’s called the national women’s law center, and they have a superb booklet explaining all the stuff to you.
With that booklet, you get a formal letter template that you can send to your insurance company to fight whatever decision they made to make sure that you’re vouching for yourself.
So these are the steps that one should proceed to get the breast pump through insurance. Breastfeeding is a vital part of a mom’s life, especially when it’s their first child, and it can have an enormous impact. So Moms, be thoughtful and careful while choosing your pump.