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Breast Pumps Covered Under Affordable Care Act


March 1, 2013

Breastfeeding support, supplies, and counseling now provided for each birth

By: Dana Hardek
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A little-known provision of the Affordable Care Act (ACA) of 2010 requires health insurance companies to pay for breast pumps for women after they’ve had a baby, and no co-pay or co-insurance is necessary on the mom's part. That's great news, but it doesn't mean that you can purchase a pump and then expect your insurance company to pay for it. Keep these tips in mind and be sure to plan ahead. 

Know your insurance coverage and benefits
You may have already researched breast pumps and decided on the particular model you want. Unfortunately, the ACA does not specify any brands or types of pumps that must be covered, or where the pump should be purchased or rented. In other words, some insurance carriers may only cover hospital-grade rental pumps, which are often larger and more cumbersome, and would be difficult to transport back and forth from work or onto an airplane. Some carriers may only approve a certain brand of personal pump, or may cover only manual pumps rather than electric ones.

Some insurance companies may require you to contact an in-network medical supply company for your pump, which could take weeks to deliver. They may also impose a dollar limit, so know in advance exactly how much your insurance carrier will cover.

The key? Contact your insurance company well ahead of time—months before your baby is due, if possible—so that you know what will be supplied and how long it will take. Ask what kind of pumps will be covered and find out if coverage is brand-specific. Finally, see if it is possible to arrange to have the pump delivered before the baby is born.

Lactation consultant coverage
This ACA provision also covers lactation support and consultation. Many women who have started breastfeeding find that a lactation consultant helps provide the best possible start for both mom and baby. Again, call your insurance carrier and ask for some details: Find out how to contact a consultant that is approved under your coverage, how many visits per week or month are allowed, and if you must travel to a consultant or if they’ll come to your home.

Have your say

Comments

1) Kylynn said:
Thanks for the info! I'm due May 1st so I need to get on this, I had no idea that insurance companies even helped with this:)
1 year, 6 months ago
2) Kelley said:
I am confused- I have a five month old and when I needed lactation support after I brought baby home I sought out a LC. When I called Tricare to check for coverage ( I have Tricare Standard) I was told that a LC was only covered while I was in the hospital. That is great for when I'm in the hospital- but most new moms need help after they get home and most end up quitting because of the lack of help/support. I did continue to nurse desptie the difficulties we experienced and am glad I was able to do so but I so wish I had more support/help when the times were really rough. Just wanted to mention my experience. Make sure you find out your options before baby and be prepared to be on your own. I bought a great book that helped me tremendously- The Womanly Art of Breastfeeding. Thank goodness I had that book to help when a real person couldn't!
1 year, 6 months ago

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