4 Steps for Getting a Breast Pump Through Insurance

For years, an electric breast pump was one of the most wished-for items on every new mom’s baby registry. It was an item that was essential for every mom to have, but with a price tag of more than $300, it was often something moms couldn’t afford on their own, unless their friends pitched in together to get one for the baby shower.

Luckily, thanks to the Affordable Care Act, most insurance companies are now required by law to provide a breast pump for free for all new moms. However, which pumps they cover all vary depending on your insurance provider and your particular plan.

For example, some insurance companies only provide a manual breast pump, not an electric one. Others will only cover certain brands of breast pumps, or they may cover a pump up to a certain amount, and then it’s up to you to pay for the difference.

If your insurance does cover a breast pump, it will have to be purchased through a medical equipment company. You can’t just go on Amazon and buy a breast pump and then expect your insurance to reimburse you. It’s not gonna happen.

So how do you know which breast pumps your plan covers, and how do you go about getting one? Here are some basic steps you should follow:

Step 1: Contact a Medical Equipment Company
The great thing about getting a breast pump through insurance is that you don’t actually have to go through the hassle of talking to your insurance company. Simply call us or another medical equipment company and tell them what insurance plan you have. We’ll check your benefits for you to find out if your policy covers an electric breast pump and what your insurance’s allowed amount is for the breast pump. In other words, exactly how much will they pay an in-network provider for an electric breast pump.

Once we know what your insurance covers, we’ll give you a list of which brands and models of pumps you can choose from.

For example, currently at Neb Medical, we carry four pumps that are fully covered by Medicaid:

• Ameda Mya Joy
• Ardo Calypso Essentials
• Lansinoh Signature Pro
• Medela Pump In Style
• Motif Twist
• Rumble Tuff Easy Express 2
• Zomee

If you have private health insurance, the pumps that your plan will cover may vary. We currently accept most major health insurance plans, including Aetna, Blue Cross and Blue Shield, Cigna, Humana and many, many more. (For a complete list, click here).

For example, if you have Blue Cross and Blue Shield PPO, you can currently choose from nine pumps that would be completely covered:

• Ameda Mya with Large Tote
• Ardo Calypso Essentials Breast Pump
• BabyBuddha® Breast Pump
• Elvie Double Pump
• Lansinoh® Smartpump Double Electric Breast Pump
• Medela Freestyle Flex™ Breast Pump
• Medela Pump In Style® with MaxFlow™ Deluxe
• Medela Sonata™ Smart Breast Pump
• Motif Luna with Battery Breast Pump
• Spectra 9 Plus Electric Breast Pump
• Spectra S1 Plus Electric Breast Pump
• Unimom Minuet Electric Breast Pump
• Zomee Breast Pump Bundle Pack

If a pump that you like isn’t completely covered, you may also be able to choose a few more expensive breast pumps for an additional fee.

If this seems overwhelming, don’t worry! We can walk you through everything over the phone.

Step 2: Research Breast Pumps
Once you know which breast pumps your insurance covers, you can then do a little research on each pump to decide which one fits your lifestyle best. Will you be transporting your pump to and from work? If so, you may want one that comes with a rechargeable battery. Or maybe you are looking for one that has really strong suction, to make the pumping as fast as possible. Or, maybe the number of parts you’ll have to clean is a factor for you. Check out our YouTube channel to learn more about choosing a pump, or our blog on how to choose a breast pump.

You can also compare the features of different pumps on our website by clicking on the “compare” button under each product that you’re interested in.

Step 3: Get a prescription from your doctor
At your next prenatal visit, ask your doctor, nurse or midwife to write a prescription for a breast pump. Most OBGYNs should be very familiar with this, but just in case, make sure that the prescription includes the doctor, nurse or midwife’s name and signature, your name, the date, the request for a breast pump (the terms “breast pump,” “electrical breast pump” or “bilateral breast pump” are fine) and diagnosis code. To make it super easy, you can download this prescription form and have your doctor sign it. Prescriptions can be written up to one year after you’ve given birth. Once you have it signed, either email or fax the prescription to your medical supply company. Or, if you want to make it super easy, we’re happy to get the prescription for you.

Step 4: Get your breast pump!
Yay! Now you’re ready to receive your breast pump. Once you give your insurance information and prescription to the medical equipment company, they will send out your pump right to your door. We typically send your pump about 30 days before your due date, just to make sure you have it in time. The 30 day time frame is put in place to give you the most out of your pump warranty, while making sure you have time to get familiar with your pump before your delivery. And if you need it sooner, we can get it to you in one to two business days, making it just as easy as ordering from Amazon Prime (but free!)

Have any additional questions about how to order a breast pump through insurance? Just give us a call.

(Click on infographic below to see it larger)