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Coverage Questions You Should Ask Your Insurance Company

Our latest insurance company breastpump and lactation services research indicates that your voice can be heard when it comes to getting the pump you want. So feel empowered, and don't compromise. You have a voice in your pump choice, so give your insurance company a call (their customer service number can be found on the back of your insurance card).

It's easy to get started:

  1. Take a look at the situations below.
  2. Identify the ones that apply to you.
  3. Be prepared to ask your insurance company the corresponding questions.
  4. Feel like a rock star!

You'll never know unless you ask! 

Description Questions

Congratulations!
You're pregnant, and you want to breastfeed.

  • What type of pump can I get?
  • What brand is it?
  • Can I get the pump before my baby is born, or do I have to wait until delivery?
  • What if I want a different pump from what's covered?
That's not what I wanted...
Your insurance provider doesn't cover the pump you want. Maybe they only offer a manual pump, and you need a double electric. Or maybe you want a pump with the latest technology, but it isn't offered.
  • I want a Medela 2-Phase pump. Is that covered?
  • If not, I want to upgrade to it. How much will I have to pay to do this?
What do you mean you're out of stock?
No covered pumps are available at the in-network provider where you're required to get your pump, and you can't (or don't want to) wait.
  • I need a pump now, and the one that's covered isn't available where you sent me to get it.
  • They do have the Medela Pump In Style Advanced, however, will you please cover it?
  • Or...since I need a pump now, I want you to reimburse me for the pump I buy at a retail store; is that possible?
Medical issues
Your baby is in the NICU, you're having problems initiating your breastmilk supply or there's a physical abnormality or other medical condition that separates you from your baby or otherwise interferes with breastfeeding.
  • I have a medical need for a hospital-grade pump. Will the rental be covered?
  • Do I need a prescription for proof of medical necessity?
Help!
You recently gave birth and are experiencing breastfeeding challenges. (Don't give up!)
  • I need to see a lactation consultant. What are the requirements for reimbursement? For example, does the lactation consultant need to be affiliated with a hospital or doctor's office?
  • Do my visits require pre-authorization?
  • How many visits are covered?

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