Expecting parents sometimes ask us how they can get a breast pump from their health insurance company.
Whether you’re planning to return to work or not, a breast pump is handy to have available for those times when you can’t nurse your baby at your breast. Thanks to the Affordable Care Act, these should be covered at no charge by your insurance in most scenarios.
Many insurance companies send you a packet of information when you first report as pregnant. Inside this packet are all of the benefits they offer you, including your breast pump. Check there! Also, don’t be too shy to call your member services number and ask a customer service representative.
To save you time, we’ve researched the top health insurance providers in Florida and share how to get a covered breast pump – and other breastfeeding services. Of course, you should check in with your specific provider and plan.
You can also try using a third-party supplier like Aeroflow, where they do all the work for you of working with your insurer to get your pump covered and delivered.
Florida Blue – from their website.
Breastfeeding Support, Supplies and Counseling:
- In-network services are covered at a $0 cost share amount.
- One electrical or manual breast pump per member per delivery is covered. Members who qualify for a breast pump can contact CareCentrix at (877) 561-9936.
- Hospital grade electric breast pumps are excluded except when medically necessary during an inpatient hospital stay.
- If an eligible member received a manual breast pump in the last nine months and is now requesting an electric breast pump, they will be eligible to receive one upon request.
- Lactation support and counseling, as part of prenatal and postpartum services, are included.
How Members Obtain a Breast Pump
- Members may purchase breast pumps without cost-share by contacting a network doctor or approved breast pump supplier up to 30 days before their delivery date or 365 days after their delivery date.
- For a list of breast pump suppliers, members call the number on their health plan ID card.
- If contacting the breast pump supplier directly, members may be asked for their doctor’s contact information, the baby’s due date or the date the baby was delivered. The breast pump supplier may verify this and other information with the member’s doctor before the breast pump is issued.
- National breast pump suppliers issue the breast pump directly to the mother.
- The doctor or breast pump supplier will bill UnitedHealthcare directly for reimbursement.
- Members do not need to obtain a prescription when contacting an approved breast pump supplier.
- Members will not be reimbursed for breast pumps purchased at retail stores.
Tricare – from their website – lots more details and coverage at the link!
TRICARE covers breast pumps and breast pump supplies at no cost for new mothers, including mothers who adopt an infant and plan to breastfeed. >>Read Questions and Answers
You must have a prescription from a TRICARE-authorized physician, physician assistant, nurse practitioner, or nurse midwife. The prescription will state which type of breast pump you need:
- Hospital-grade breast pump
- Manual breast pump
- Standard electric breast pump
This coverage is retroactive to December 19, 2014. If you paid out-of-pocket, you can send a claim for reimbursement.
Include the following with your claim:
- Your prescription
- Itemized receipt
Manual and Standard Electric Breast Pumps
TRICARE covers one manual or standard electric breast pump per birth event (birth or adoption).
Hospital-Grade Breast Pumps
TRICARE covers electric hospital-grade breast pumps and supplies when needed for mothers and infants:
- Who are separated due to illness
- Who are unable to feed directly from the breast because of medical reasons
When a hospital-grade breast pump is no longer needed, you may be covered for a manual or standard electric breast pump. A new prescription is required.
Aetna – from their website
PS – Aetna says most plans cover up to six visits from a lactation professional!
Check your plan to see which of these providers is in network. You may be able to buy a breast pump and supplies from one of our suppliers at no charge or at a discounted rate. Covered items may include:
- A standard electric pump (non-hospital-grade) while you are pregnant or for the duration of breastfeeding, once every three years, or
- A manual breast pump while pregnant or for the duration of breastfeeding, if you have not received an electric or a manual breast pump in the last three years, and
- Another set of breast pump supplies if you get pregnant again before you are eligible for a new pump
Byram Healthcare (1-877-902-9726)
Edwards Health Care Services (1-888-344-3434)
Edgepark Medical Supplies (1-800-321-0591)
Genadyne Biotechnologies (Lucina Care) (1-888-809-9750)
Yummy Mummy (1-855-879-8669)
Sterling Medical (1-888-220-5010)
Pumping Essentials (1-866-688-4203)
Cigna – from their document, Preventative Health Care. Breastfeeding supplies and counseling are covered for women, during pregnancy and after birth.
“Subject to the terms of your plan’s medical coverage, breast-feeding equipment rental and supplies may be covered at the preventive level. Your doctor is required to provide a prescription, and the equipment and supplies must be ordered through CareCentrix, Cigna’s national durable medical equipment vendor. Precertification is required for some types of breast pump equipment. To obtain the breast pump and initial supplies, contact CareCentrix at 877.466.0164 (option 3). To obtain replacement supplies, contact Edgepark Medical Supplies at 800.321.0591.”
Simply – Florida Medicaid
According to their resource guide “Pregnancy and Beyond,” this provider says if your plan qualifies you for a breast pump, you are to work through the provider breastpumpsmedsline.com to select and obtain the pump. The document doesn’t list any resources for getting help with skilled lactation counseling, so be sure to call Member Support to find out what is covered.
We hope this helps you on your way to getting a breast pump covered through your health care insurance!
You might also be interested in this post: When Should I Start Pumping Breast Milk?