Things to Know About Tricare Breast Pump Coverage 2020


A baby is a mother’s first concern. The baby’s welfare is everything that a mother is worried about. However, working mothers have it hard. They may be needed to join their offices when their babies are hardly a year old and still getting fed. In such situations, of course they babies wouldn’t be kept hungry the whole time. So, how to deal with this situation?

That’s when a breast pump comes into the picture. A breast pump is a device which helps to extract milk from the breasts of a lactating mother. Then, either of the parents can collect it in a collecting bottle. Now, even if the mother is out, this breast milk is stored for 6 hours at room temperature. This device has its benefits.

Tricare Breast Pump

Benefits of Breast Pump

A breast pump is nearly as crucial to a baby as the mother. Honestly, it doesn’t possess the emotions of a mother but it has other far-reaching benefits. Some of them are mentioned below:

  • Sometimes, it is necessary to admit the newborn child or the mother to the ICU due to health problems. Naturally, a mother cannot follow her baby to the ICU. Then, a breast pump solves the critical question surrounding the baby’s food.
  • Sometimes, a baby faces difficulty in holding on to the mother or suckling properly. Then, the breast pump plays the role of a savior.
  • The process of pumping fastens the recovery process for lactating mothers.
  • Also, the mothers who produce more milk than their babies can consume, can donate the excessive quantity to milk banks.
  • This way, the breast pumps will also be a life saver for mothers who are unable to produce the necessary amount of milk for their newborn children.

Tricare Breast Pump Through Insurance

Tricare has made a name for itself in the world of maternity coverage. Now, let’s have a clear understanding of what Tricare is. Tricare is a company that does the insurance for breast pumps, breast pump supplies, and breastfeeding counseling. The company ensures that the mothers do not have to spend a penny after insurance.

Let us follow the steps below to find out how a lactating mother may acquire a breast pump, which Tricare has insured.

breast pump through insurance

Step 1 Get a Prescription

  • The prescription has to be from a doctor or a nurse who is authorized by Tricare. This prescription doesn’t have to mention the name of any particular brand.
  • The prescription must specifically mention whether the mother needs a manually operated brand or a hospital grade one. The customer needs proper authorization and referral for a hospital quality breast pump.
  • If the customer gets a breast pump from a medical equipment supplier whom she already knows, she should ask for a diagnosis code in the prescription.

Step 2 Get the Pump

  • The customer should understand that she has to pay for the device, not the Tricare insurance. If she wants to pay upfront for the pump, she should go to a vendor who is authorized by Tricare. Even some online stores are Tricare certified. She should save a copy of the receipt which they provide. In this case, the prescription is unnecessary.
  • However, if she is not paying upfront, she has to contact her regional contractor. The local contractor will find a network supplier. However, in this case, she will have to show the prescription.

Step 3 File a Claim

  • A customer will not have to file a claim if she has a network supplier.
  • If she has bought the pump herself, she has to file a claim with the Tricare claims processor 

Breast Pump Insurance Coverage

The lactating mother may need to file an insurance claim from Tricare when she needs a reimbursement of her breast pump insurance. She should follow the steps mentioned below to file a claim:-

  • Complete the DD Form 2642
  • Attach a copy of the prescription and the receipt
  • Mail it to the Tricare claims processor.
  • After that, the regional contractor will mail a cheque back to the customer.

breast pump insurance coverage

Tricare covers one birth pump kit for each birth event. Each birth pump kit includes the following articles alongside the pump itself:-

  • One replacement of standard power adapters per birth
  • One set of tubing and tubing adaptors for each birth
  • One Supplemental Nursing System for every birth
  • Two sets of nipple shields per birth
  • Two replacement bottles and caps every month
  • Twelve valves or membranes for each of the twelve months after birth
  • Ninety storage bags for every 30 days after the birth

Tricare makes sure that the customer only gets more supplies than the ones mentioned above if the practitioner prescribes them. He has to write down what supplies the lactating mother needs explicitly in the prescription.

However, Tricare does not insure certain products unless they are a part of the breast pump kit. The products are:-

  • Breast pump cleaning products
  • Regular baby bottles, which are not necessary for the pump kit
  • The creams or ointments used to soothe minor skin infections during breastfeeding
  • Bags for carrying the pumping equipment
  • Scales for weighing the baby
  • Maternity inner wear or maternity garments

There is no specific list of approved Tricare breast pump, kit providers.

Tricare provides breast pumps with insurance and thus how pays up to a fixed amount for a breast pump and the first breast pump kit. The rates may change every year. Also Read Aeroflow Breast Pump Reviews

The good news is that Tricare does not restrict its insurance coverage to any particular model number or brand.

Last but not least, Tricare Breast Pump Insurance also covers six different outpatient breastfeeding counseling sessions after each birth.

However, it is subject to certain conditions like:-

  • The lactating mother visits a Tricare-authorized practitioner
  • The practitioner bills using preventive counseling procedure code

Under certain conditions, Tricare pays fora new breast pump if the old one breaks. The lactating mother may even get reimbursed for a hospital-grade breast pump, which she had rented. However, it should be certified to have been medically necessary. Get a breast pump covered 100% through Tricare Insurance at the time of pregnancy.

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