Are breast pumps covered by insurance? It is a question I have been seeing more and more lately! I was speaking with a local store who heard the news and went through hoops to become a medical supply store so they are able to offer breast pumps, they are a Medela retailer to their customers. YAY! But after trying to do research and learn more about the Affordable Care Act and who can get a breast pump and what breast pump you can get, and where can you get it, its enough to drive anyone up the wall!
According to the HealthCare.gov article on the Affordable Care Act (which is not crazy to read) it states that breast pumps and lactation consultants should be available to women without a co-pay. The catch is that your policy has to re-new after August 2012 for this to happen, there are also catches about being ‘grandfathered’ in before President Obama signed the Affordable Care Act, and I am sure many more about what breast pumps and supplies are actually covered.
Based on the information that I can find on the internet, it seems like there are several insurance agencies that are telling women that breast pumps are not covered, so it is important to call your insurance provider to speak with them about specifics, make sure to tell them that according to the Affordable Care Act that as of August 2012 (and after your plan as of August 2012 renews) that insurance agencies are required to cover women’s well visits, breastfeeding supplies and support, contraception, support and counseling for domestic abuse and more, to find out what they cover as far as brands and specific supplies.
You also need to find a local medical supply store to purchase the pump from, if you have local stores, they should already be started in the process to make their store a medical supply store. From Here to Maternity is a local Medela Breast Pump provider that will be able to sell Medela as a medical supply store. If you do not have one locally, contact them for shipping options!
After speaking with a local OBGYN, who was only aware of breast pumps provided by insurance for some medical needs (i.e. pre-term birth, recessed nipples, cracked nipples, low milk production, etc). I also talked to a local insurance firm, Workplace Benefits, who says that it seems to be covered on a policy by policy basis. So overall if you are pregnant, or thinking about getting pregnant you need to call your insurance company to verify if breast feeding supplies and counseling is available and to what level! Remember you can always get breastfeeding help at no cost from the La Leche League and at the hospital where you delivered.