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What Does My Insurance Company Cover?

This is a difficult question because every plan is different. But we know that your counting on us for information, so we conducted a survey of some of the largest insurance companies and gained valuable insights into their implementation of benefits and coverage criteria for breastpumps and lactation counseling. 

 
Our findings? Great news for moms!
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1)    Your voice can be heard. Insurance companies are still shaping their breastpump coverage policies. So don’t be afraid to speak up for what you want – it just might make a difference, for you and for many other breastfeeding moms. Also, know that breastpump coverage under the ACA does not require you to make a co-payment.
 
2)    You don’t have to worry. If you or your baby has a medical issue, like the need to initiate milk supply or if your baby is in the NICU, chances are you’ll get the hospital-grade pump you need. 77% of insurance companies surveyed cover them – but most require pre-authorization, so be prepared and ask for a prescription.
 
3)    You have time to educate yourself. The majority of plans don’t allow pump pickup until your baby’s delivery or after. But you’ll benefit by being proactive! It’s never too early to ask your insurance company what pump they offer and when you can get it. So set yourself up for breastfeeding success by researching pumps beforehand. This way, you’ll already know what you want when the exciting time comes!
 
4)    You don’t have to compromise. 60% of plans surveyed allow you to upgrade from their basic option to the pump of your choice – you just pay the difference. But not all plans will proactively communicate this to their members. So if you want a Medela 2-Phase pump, like Pump In Style Advanced, ask for it! And get the pump you know is best for your breastfeeding experience.
 
5)    You don’t have to go without. Most plans require you to get your pump from an in-network provider. But, 76% of plans surveyed are also flexible if the covered pump isn’t available, letting you choose another pump or even reimbursing your purchase from a retail store. Just ask!
 
6)    You don’t have to go it alone. Breastfeeding moms, rejoice! Nearly all plans cover lactation counseling without a co-pay. Pump coverage + lactation support = successful breastfeeding more accessible to more moms.
 
Our conclusion: Feel empowered, and don’t compromise. You have a voice in your pump choice!
Learn about your options by calling your insurance provider, and set yourself up for breastfeeding success.
 
Now that you're informed, the next step is to arm yourself with questions to ask your insurance company.
Ask These Questions! 

 

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Note: some plans are "grandfathered." Learn more about grandfathered plans

 

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