As an expectant parent, there are many things that you may need to take care of your new baby. It’s one of the reasons that family and friends throw baby showers: You’ll need to be showered with gifts.
Quick Answer: How Do You Get a Breast Pump Through Insurance?
Most health insurance plans cover a breast pump during pregnancy or after birth, but the exact process depends on your plan. In most cases, you’ll need to confirm your coverage, choose an approved pump, provide your insurance information, and submit a prescription if your plan requires one.
- Contact your insurance provider or use BabyBuddha’s insurance form to check your benefits.
- Ask which breast pump types and brands are covered by your plan.
- Find out whether you need a prescription from your OB-GYN, midwife, or primary care provider.
- Submit the required insurance, prescription, and shipping details.
- Wait for approval and delivery instructions.
To check whether a BabyBuddha pump may be covered by your plan, complete the BabyBuddha insurance form.
Much of the stuff your baby will need is relatively inexpensive, like onesies and diapers, but they add up quickly since your baby will go through them like that. There are plenty of big-ticket items, like a crib or stroller, but those tend to be one-time purchases. One thing to add to your registry is a breast pump since if you plan on pumping exclusively, a breast pump is a given.
Breast pumps are typically expensive, but in 2012 the Affordable Care Act (ACA) mandated that health insurance companies provide free breast pumps to their pregnant members or members who recently had a baby. It can be a multi-step process, and you’ll want to fill out the insurance forms for your pump of choice to get started.
A pump can also help moms who plan to do a mixture of breastfeeding and pumping. Pumping allows breastfeeding mothers to have milk on hand so that if someone else needs to feed your little one, a supply is at the ready. It also helps stimulate milk production, especially while mothers are away at work.
How can you get this great benefit? Let’s find out.
How To Get a Breast Pump Through Insurance
If you’re looking to get a breast pump through your insurance provider, start by following these steps.
1. Check Your Breast Pump Benefits
The first thing you’ll want to do is talk to your insurance provider. It may be helpful to have a list of questions ready and take note of the answers you get. That way, you know what breast pump brands are in-network, what type of pump you can get, and whether they cover rentals or personal-use pumps.
You may want to discuss the process that your provider will want to follow: what the timeline looks like, whether or not you need a prescription, and things like that. You’ll also learn whether you have a grandfathered plan or not.
2. Ask Whether You Need a Prescription
Once you’ve figured out what kinds of insurance coverage you have, you should talk to your primary care provider, OB-GYN, or midwife. If you need a prescription, you should be able to get one from them. Then you can give the prescription to your health insurance provider or submit it as part of your pump request.
Depending on your healthcare provider’s recommendation, you may be able to get either a personal-use pump or a hospital-grade pump. The recommendation can depend on your and your baby’s health needs.
3. Submit the Required Insurance Information
Once you’ve learned and gotten what you need, submit your request to your insurance company. Every company can have a different process, but by using the answers to the questions you asked at the beginning of the process, you should be able to submit everything you need to.
4. Use BabyBuddha’s Insurance Form
If you want a breast pump that is small, discreet, and performs well, you might be considering a BabyBuddha breast pump. To start the process, fill out our breast pump insurance form. With this form, we can talk to your insurance about sending you a covered breast pump.
In order to process this claim, we’ll need some information, including a prescription from your doctor if your plan requires one.
What Types of Breast Pumps Are There?
When looking for a breast pump, you’ll want to find the one that’s best for you. There are many brands of breast pumps, but there are also different types. The two primary kinds of breast pumps are electrical and manual.
An electrical pump is either battery-powered or can be plugged in, and it has a motor that can mimic the sucking motion of a baby. Usually, electrical pumps have multiple settings for speed, strength, and rhythm that you can adjust depending on your comfort needs.
Battery-powered pumps are generally portable, and some are even rechargeable, like ours. They make pumping on the go much easier.
Among electrical pumps, you can usually find both single-breast pumps and double-electric breast pumps. Additionally, there are hospital-grade pumps, like the BabyBuddha Breast Pump, wearable breast pumps, and standard breast pumps.
Manual pumps typically require less apparatus, but if you’re pumping a lot, they aren’t as practical. However, if you only need to pump occasionally, like on a short road trip or to help soothe breast engorgement, a manual pump might be the right fit.
Which Types of Breast Pumps Are Covered by Insurance?
Coverage rules vary by insurance plan. Some plans cover personal-use double electric pumps, while others may have specific rules about brands, suppliers, prescriptions, or upgrade options. BabyBuddha may be covered by many plans, but it’s important to confirm your exact benefits before ordering.
Does My Insurance Cover Breast Pumps?
The ACA requires health insurance providers to cover the cost of breast pumps and other breastfeeding supplies. However, the rule doesn’t universally apply because some insurance plans were grandfathered in, which means they aren’t required to fulfill this obligation.
It’s best to check with your provider before trying to order one since companies are able to decide what they will cover.
What Information Do You Need To Get a Breast Pump Through Insurance?
The exact requirements depend on your insurance plan, but many parents are asked to provide a few basic details before a breast pump can be approved.
- Your insurance card: This helps verify your plan, member ID, and benefits.
- Your due date or baby’s birth date: Some plans only allow pump orders during a certain window.
- Your shipping information: This is used once the pump is approved.
- A prescription, if required: Some plans ask for a prescription from an OB-GYN, midwife, or primary care provider.
- Your preferred pump: Your plan may limit which pump types or brands are covered.
Because coverage can vary, it’s best to confirm your plan’s rules before choosing a pump.
What About Medicaid, WIC, or Medi-Cal?
Medicaid can cover breast pumps as well, although you still should check with the specific health plan that you are under.
Although there aren’t typically any restrictions on brands, most Medicaid plans will only cover double electric pumps that are for personal use. Hospital rentals and single pumps usually aren’t covered. Medicaid is usually a last resort, so if you have a private healthcare plan, you should check with them before your Medicaid plan.
Medi-Cal typically only provides a breast pump when the mother cannot feed her baby through breastfeeding. Medi-Cal and other insurance companies may ask for a doctor's referral to accompany requests for pumps.
Women Infants and Children (WIC) can provide a breast pump if you are eligible. If there is a waiting period with the individual’s insurance, WIC might step in. Additionally, if mothers have no insurance, WIC will likely provide a pump in that case. If you can’t get one through private health insurance, you can check with your local office to see if you are eligible for aid through this resource.
When Should I Apply for a Breast Pump?
Usually, you’ll want to start applying for a breast pump before the due date, but it can depend on your insurance plan. Some companies may require that you wait until after the baby is born. You may need a prescription from your doctor, which may also need to wait until the baby has arrived.
Sometimes life has different plans, so even if your goal is to start the process before your baby’s birth, that may not be possible. You can still start the process after your little one has been born.
To get started, fill out the BabyBuddha online insurance form so our team can help review your coverage options.
Getting What You Need for Your Baby’s Arrival
New moms need a lot of different things, especially support. That support comes in the form of family, friends, your healthcare provider, and the supplies you need.
Whether it’s for health reasons or work reasons, it can be helpful to have a breast pump on hand. With the steps above, you should be able to better understand what your plan may require and how to move toward getting the breastfeeding equipment you need.
Important Coverage Note
Insurance coverage can vary by provider, plan, state, and timing. This article is for general education and should not replace guidance from your insurance provider, healthcare provider, or BabyBuddha’s insurance support team.
Sources:
Breastfeeding and Insurance | Baby Your Baby
Breastfeeding Benefits | HealthCare.gov
Helpful Hints on Obtaining a Free Breast Pump Through your Insurance | Knox County Tennessee
Working with Your Health Insurance to Get a Breast Pump | Intermountain Healthcare
How To Get a Breast Pump | Louisiana Department of Health
