Breastfeeding Insurance: Are You Covered?
Did you know that your breast pump might be covered by health insurance? Neither did we! In this article, we tell you what questions to ask to find out if you’re covered and how to make the most of pumping.
Did you know that your health insurance may cover the cost of breast pumping equipment and lactation consulting?
With the average electric breast pump costing around $250, deciding to pump and bottle feed can often feel like a financially daunting exercise.
The good news is: if you have health insurance – the cost of a pump may be fully or partially covered.
HealthCare.Gov explains that under federal regulations, most marketplace health insurance plans must pay for breastfeeding counseling and breast pumps. Even though your plan may have guidelines on whether the covered pump is manual or electric, the length of the rental, and when you’ll receive it (before or after birth), this is still very exciting news.
In this article, we’ll go over:
- The benefits of breastmilk
- How to find out if a breast pump is covered by your insurance
- Our favorite breast pumps & pumping essentials
Scroll down to learn more!
The benefits of breastmilk
Breastfeeding is one of the most beneficial things you can do for yourself and your baby because human milk contains antibodies that help strengthen your child’s immune system.
It’s reported that babies who are breastfed exclusively for the first 6 months have fewer ear infections, respiratory illnesses, and bouts of diarrhea.
The act of breastfeeding also releases the hormone oxytocin, which helps your uterus return to its pre-pregnancy size and may reduce uterine bleeding after birth as well as lower your risk of breast and ovarian cancer.
Even though breastfeeding is best, we know it’s not always possible. Some babies won’t latch properly, while some mothers need or want to return to work. This is where pumping and bottle-feeding come in!
How to find out if a breast pump is covered by your insurance
Option #1: Call your health insurance or Medicaid to ask about your benefits for a breast pump and what is required.
Some plans require a prescription from your doctor and for you to order your breast pump through a durable medical equipment provider (DME) on their list.
If you’re unsure of what to ask, the National Women’s Law Center has a toolkit that teaches you how to talk to your health insurance provider about your plan.
Here are a few questions that they suggest:
- Are breastfeeding supplies and counseling covered by my health insurance?
- Will I need to pay for anything out of pocket, like a deductible or co-insurance for breastfeeding counseling or supplies?
- How do I find a lactation consultant that is on my health plan’s list (or “in-network”)?
- How many visits to a lactation consultant will my insurance cover?
- How do I order my breastfeeding equipment or supplies?
- What breast pumps and supplies are available under my benefits?
- Will I need a prescription from my doctor to order my breast pump?
- Do I have to be a certain number of weeks into my pregnancy before I order?
Option #2: If you’re looking for a Medela pump, visit www.breastfeedinginsurance.com to locate a list of Medela suppliers that may be contracted with your health plan.
Be sure to ask if the Durable Medical Equipment (DME) supplier will allow you to pay out of pocket to upgrade your breast pump. During the order process, you can ask what upgrade and accessory options are available at the time of purchase as well as if replacement parts are covered. You may be able to use pre-tax funds to pay for a pump upgrade, new parts or breastfeeding accessories. Check with your employer or account administrator to verify your benefits.
Once you receive your pump, you can visit Medela’s Tips and Solutions page. From tips on returning to work to identifying mastitis, Medela provides information and support to keep you on the path of providing breast milk for your baby. They also have a recycling program that is committed to protecting the environment. You can learn more at MedelaRecycles.com.
Option #3: If you’re looking for an Elvie pump, you can check their list of DME suppliers to see if you are eligible for partial coverage.
A note on personal insurance plans…
“Under the Affordable Care Act, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts. They also can’t charge women more than men.
The only exception to the pre-existing coverage rule is for grandfathered individual health insurance plans — the kind you buy yourself, not through an employer. They don’t have to cover pre-existing conditions.” – HealthCare.gov
Our favorite breast pumps & pumping essentials
At The Tot, we never use or recommend anything that hasn’t passed The Tot Safety Test.
This means we’ve reviewed third-party testing and asked in-depth questions about a product’s composition to make sure that it is free from chemicals we avoid.
When choosing a breast pump, we want to avoid things like BPA, BPS, Phthalates, PVC, Heavy Metals and Formaldehyde.
Scroll down to see our favorite toxin-free breast pumps and nursing essentials.
Available in more colors
Available in more colors