Breast Pump and Insurance
Feeding moms and the babies can now enjoy the luxury of knowing that insurance companies support both their feeding efforts and counseling. The ACA better known as the Affordable Care Act or simply the Obamacare requires the insuring companies to cover for health services with breastfeeding support being among the most looked on. For instance if a coverage commenced on August 1, 2012 or later and the company the breastfeeding mother is insured to is any “non-grandfathered” plan then the feeding support and equipment’s must be covered 100% with no cost sharing or forced payments.
How to get the company you’re insured under to pay for the breastfeeding pump. For starters make sure your plan is governed by the Obamacare/ACA. If it was in existence before March 23, 2010 (the day the Act was signed) and it is relevant with some standards then it might be a “grandfathered” plan, seek to find out from their customer care the specifics. As much as most grandfathered plans don’t give benefits on breastfeeding as required by the ACA some do offer so hope is still alive. If not step two is convenient for consideration.
The second step is finding out the benefits most preferably in writing, so the mom should ask for specifics from the customer care agent of the insurer if it is possible let them email the details. Relevant question to ask during the call;
• What are the breastfeeding benefits most likely to be received?
• What pumps they cover?
• Is it possible to get a specific brand of pump?
• Should I buy or rent a breastfeeding pump from certain suppliers (i.e. a specific medical supplier, pharmacy or retailer)?
• Is it’s a must to get a prescription from the doctor?
• Is it possible to buy the breast pump prior to the arrival of the baby?
It is important to note that in some coverage’s you will have to get the breastfeeding pumps from specific suppliers (at times known as “durable medical equipment” or DME supplier) designated by the insurance company. It is important to call the suppliers of the pump and inquire if they have a pump of your choice and how fast it can get to you, since it is necessary to have it before the child’s arrival as to get familiar with its operations. If they don’t shelf a pump of your choice or they won’t have it anytime soon you can get it from a different supplierbut don’t forget to pick part of the cost. It is important to talk to your insurer first.
As a buyer it is important to know that most insurers only cover for manual breast pumps which areconvenient frequently but not always. While other insurers pay for you to buy or rent an electric double breast pumpwhich is most convenient if you’re working away from the baby. As much as the insurer may not pay for an electric pump, they will most likely pay for it if your pumping for medical reasons, like if the baby was born premature or if the baby has other medical conditions like palsy or down syndrome that cause for feeding with the breastfeeding pump or if their exists issues with supply. If any of the above is the reason for feeding with a breastfeeding pump on talking to the insurer they might consider the electric pump but they will need to consult a doctor or might need an approval note from the doctor that states the same.
A proper pump will definitely cover the mom’s breastfeeding goals which equate to proper health of both the infant and the mother and that is the main reason why pumps are considered a preventive service. The mother should hence consider this important money saving tips. You just need to call your insurance company and know the top rated breast pumps covered by the insurance policy.