Under the Affordable Care Act, most insurance companies will cover one pump per pregnancy as a preventive benefit (ACA). The Affordable Care Act (ACA) mandates that health insurance plans cover breastfeeding support, counseling, and equipment.
Simply fill out our “Qualify Through Insurance” form to get started, and we’ll take care of the rest! The form will provide us with the insurance information we’ll need to confirm your coverage and determine which breast pumps are available to you.
We may be able to validate this information almost rapidly in some situations, allowing you to select your breast pump the same day you complete the qualification form. In some circumstances, we’ll need to get more information from you or your health insurance provider before we can narrow down your breast pump alternatives.
You will be notified by phone or email when it is time to choose a breast pump once we have all of the relevant information.
We’ll contact your doctor for a prescription and notify you when your breast pump is ready to ship once you’ve placed your order. Unlike a typical online purchase, the pump you order cannot be dispatched until we have a prescription on file and have completed the scheduling requirements set forth by your insurance plan.
Many health insurance companies, for example, mandate that breast pumps be sent 30 days before your due date. Others may want proof of birth before shipping. Don’t worry; we’ll let you know when your breast pump is due to arrive, and we’ll provide you updates through email or text along the way.
Once you’ve satisfied these requirements, your breast pump will be delivered to your door for free. Every year, we are delighted to assist hundreds of thousands of mothers in finding the best breast pump for their lifestyle and needs. We understand how complicated and perplexing health insurance coverage may be. Our objective is to make receiving the pumping equipment you need to fulfill your unique breastfeeding goals as stress-free as possible!
Does insurance replace broken breast pump?
will most likely be determined by your specific insurance policy. Medela, Ameda, Spectra, and Lansinoh are some of the most widely covered breast pump brands, and each of these companies offers a variety of breast pump alternatives. Most insurance plans cover the cost of a double electric breast pump, and in some situations, even if you haven’t met your deductible, insurance may cover the entire cost of a breast pump.
Are breastfeeding supplies covered by insurance?
Breastfeeding health insurance benefits were expanded under Obamacare (Affordable Care Act). They’ll most likely continue to do so under the new legislation. Here’s what your plan usually covers and what it doesn’t.
Although breast milk is free, quality pumps are not. Breastfeeding is more expensive than many realize, because to the cost of bottles and milk storage bags, as well as the logistical hurdles of pumping at work. There’s a lot regarding your breastfeeding health insurance advantages that you probably don’t know (if you even knew you had them).
Breastfeeding: What’s Covered? What Must Be Paid for Out-Of-Pocket?
When it comes to breastfeeding services and equipment, it’s critical for women to understand what their health insurance plans are legally required to cover. Health insurance companies are obligated under the Affordable Care Act (ACA), or Obamacare, to cover breastfeeding support and supplies without imposing cost-sharing measures such as deductibles, copayments, or coinsurance, with the exception of a small number of “grandfathered-in” insurance plans.1
More specific coverage specifics vary by plan; new parents and expectant parents should call their health insurance provider for clarification the National Women’s Law Center (NWLC) has a handy guide outlining questions to ask.
2 Some health insurance policies, for example, will only compensate women for the cost of a manual pump not an electric pump (which is more efficient and less labor-intensive than the manual pump). While most insurance companies cover breast pumps in full, the Affordable Care Act does not specify which kind of pumps must be covered. 3 In addition, many insurance policies do not cover the cost of other pumping accessories like nursing bras, bottles, or milk storage bags.
New Benefits for Nursing Moms: Facts and Tools to Understand Your Coverage Under the Health Care Law, a toolkit prepared by the NWLC, provides an in-depth, complete reference to understanding your insurance coverage as it relates to breastfeeding. Refer to the chart below for a more general overview of which breastfeeding supplies and services are covered by your insurance plan:
Obamacare or Affordable Care Act Helped Working Moms Breastfeed
According to data from the Centers for Disease Control and Prevention (CDC) and recent research published in the American Journal of Public Health, there is a link between increased access to breast pumps and higher breastfeeding prevalence and duration rates among new parents in the United States. 4 While those higher rates aren’t necessarily linked to the availability of breast pumps, the data suggests that Americans profited greatly from the Affordable Care Act’s mandated workplace safeguards and health insurance coverage of breastfeeding equipment and support services.
By forcing private health insurance plans to pay the cost of pumping equipment and support services such as lactation counseling, the Inexpensive Care Act (ACA) made breastfeeding much more accessible and affordable for women in the United States.
5 Employers must also provide nursing staff with “appropriate break time” and private facilities to pump milk during the workplace, according to the rule.
Returning to Work While Nursing
According to a 2018 survey, more than 75% of expectant mothers expected to breastfeed at work. 6 New gadgets have made pumping easier than ever before, and more working mothers intend to nurse their children in the future.
Similarly, the study indicated that a large majority of expectant women thought their employer’s maternity plan would fulfill their needs, that they felt comfortable using a breast pump at work, and that they had never had an unpleasant contact with a coworker as a result of nursing.
Only half of the pregnant women polled had addressed their breastfeeding plans with a supervisor or human resources before giving birth. You might wish to ask your HR person to create a fully stocked and private pump room.
Breastfeeding Health Insurance Benefits Expected to Stay in Future Legislation
In the past, policy debates over the future of the Affordable Care Act (ACA) and Medicaid reorganization have focused on maternity care and support for nursing moms. Many people wondered if health insurance benefits for breastfeeding would be cut as part of the GOP’s repeal-and-replace plans. Legal experts, on the other hand, feel that the ACA’s provisions requiring health insurers to provide breastfeeding support and equipment are safe for the time being (this cannot be said for contraception coverage or other women’s health measures).
What if Insurance Companies Violate the Law?
While Obamacare’s (Affordable Care Act) coverage of breastfeeding equipment, support, and counseling was a game-changer, the ACA’s essential benefits clause for breastfeeding has not been routinely implemented. Two NWLC analyses discovered a slew of instances in which insurance policies failed to meet the ACA’s breastfeeding coverage standards or restricted coverage in ways that went against the law’s objective. 8
In other cases, “government guidance describing coverage standards falls short of what women need to breastfeed successfully,” according to the research.
9 So, what can you do if your health insurance plan fails to provide legally mandated breastfeeding coverage? Let’s take a deeper look at the warning signs.
Some insurance plans have put limits on coverage in violation of ACA provisions. Noncompliance took the following forms:
- When in-network services were unavailable, women were not allowed to seek breastfeeding services out-of-network without incurring out-of-pocket charges.
While not unlawful, the investigation also discovered insurance firms obstructing new parents’ ability to breastfeed in legally permitted, if ethically dubious, ways:
- Having a small network of lactation specialists in order to be geographically inconvenient.
Solutions, Insurance Scorecards
In addition, the consumer division of your state’s Department of Insurance should be able to assist you if you have a problem with an insurer who isn’t following the ACA’s rules.
How can I get free breast pump parts?
When experts compare the advantages of breastfeeding vs. formula feeding, they frequently point out that breastfeeding is significantly less expensive. While breastfeeding is less expensive than formula, it isn’t exactly free if you plan on pumping.
Not only will you need to buy a pump, but you’ll also need to buy a variety of other breast pumping supplies on a regular basis. Many breast pump components, including as valves, tubing, and backflow protectors, must be replaced every few months to ensure that the pump continues to function effectively. That’s not even taking into account the bottles, breastmilk storage bags, cleaning supplies, and other necessities.
However, don’t let the cost of breast pumping dissuade you! It turns out that there are numerous methods to save money on both the cost of a breast pump and the cost of breast pumping accessories.
One thing to remember is that using an old pump to save money is never a good idea. Manufacturers only design breast pumps to last for the duration of their warranty (about one to two years). When they approach that time limit, the motor and other parts may begin to fail, resulting in suction loss. That means the pump may not empty your breasts as effectively as it should, and you could lose milk supply or have clogged milk ducts or mastitis as a result. Don’t try to save money by buying an old pump!
Instead, use these money-saving techniques to save on breast pumps and pumping accessories:
There’s no reason to spend money on a breast pump if you have medical insurance (or even if you only have Medicaid). Breast pumps are mandated by law to be covered by insurance providers, so all you have to do is ask your doctor for a prescription and then deliver the prescription to a medical equipment firm to acquire a free pump. They’ll tell you which pumps are covered by your plan and send you one. For no cost!
This is an absolute lifesaver. If you or your spouse has a benefit-eligible job, you may be able to open a Flexible Spending Account or a Health Savings Account, often known as an FSA or an HSA, which are special, tax-free accounts into which you can deposit money to pay for medical expenses. (People with low-deductible health plans can use FSAs, while those with high-deductible policies can use HSAs.) FSA accounts can cover anything from breast pumps to all of the equipment you’ll need, including bottles, flanges, replacement tubing, nursing pads, breast milk storage bags, breast milk coolers, pregnancy belts, pumping bras, nipple shields, breast pump car adaptors, and more. You can start an FSA during open enrollment (typically in November or December) or after a significant life event, such as the birth of a child.
Breast pumping equipment is available at Target, Buy Buy Baby, and Amazon. Medela, Spectra, Lansinoh, Elvie, Evenflo, and Willow all have replacement flanges, tubes, valves, and other parts available at Target. Medela and Spectra replacement parts are available at Buy Buy Baby, and Medela, Spectra, Lansinoh, Motif, Ameda, Zomee, and other brands are available on Amazon. In addition, all three stores carry a variety of other essentials like breast milk storage bags, bottles, pumping bags, nursing bras, power adaptors, and more. Not only may your friends and family buy some of these products for you if you put them on your register, but you can also save 15% on items from your list that you buy yourself. (If you’re an Amazon Prime member, you can save 15% on remaining goods in your registry.)
Additionally, when you build a baby registry with any of the three businesses, you will receive a welcome package with free samples and coupons. It’s impossible to go wrong with it!
Signing up for Medela Family’s emails is another option to get free gifts. You’ll not only get breastfeeding ideas and advice, but you’ll also get a free box of breastfeeding product samples.
Look for Facebook garage sale groups, Facebook Marketplace, or Facebook groups for breastfeeding parents to save money on pumping supplies. Moms frequently sell spare bottles, flanges, baby coolers, pump bags, and other items, many of which have never been used. Remember not to buy secondhand pumps or things that could be contaminated by milk, such as valves or tubing, but if the packaging is still intact, this can be a gold mine.
Breastmilk storage bags are useful if you are exclusively pumping or if you wish to store a large amount of breastmilk because they save freezer space. If you plan to feed your infant within four days of pumping the milk, however, you can save money by keeping the milk immediately in bottles in the fridge. (You won’t have to move the milk from the storage bags to the bottles for feeding, which saves time.)
Although this does not apply to breast pumps or breast pumping equipment, Target has a semi-annual promotion in which you may bring in an old car seat and receive a 20% discount on any new baby gear. It will take place in 2021 from now until September 25. If you’re expecting a second child or have a friend who can donate an old car seat, this is a terrific option.
Is Spectra or Medela better?
I strongly suggest the Spectra over the Medela. After using both (and a variety of other pumps), I recommend the Spectra if you have the option. Overall, it is more efficient and offers superior features.
The Medela is a reliable pump that does its job well. But, in my opinion, it isn’t as good as some of the others.
Remember, both of these pumps are functional at the end of the day! With either pump, you will be able to express milk effectively, which is the primary purpose.
However, I’ve found that the Spectra gives me less of a headache and makes pumping a little more bearable. That’s why I believe we’re all here.
What breast pumps are covered by BadgerCare?
What kind of breast pump and brand can I obtain via my insurance? Members of BadgerCare Plus may get one electric or manual breast pump from Medicaid once in their lifetime. The Spectra S2 Plus double electric breast pump model is available to Dean Health Plan participants thanks to a partnership with SSM Health at Home.
How often should I change my Medela pump parts?
Every 2 to 8 weeks, Medela pump parts such as valves and membranes should be updated. This is determined by the number of pumping sessions performed each day.
Breast shields, connectors, and bottles, among other Medela pump parts, should be replaced every 6 months or if they appear unclean.
If the Medela pump tubing has mold or appears to be dirty, it should be replaced very once.
I looked around and discovered that the cheapest pricing for Medela replacement components was on Amazon. Because it includes tubing, breast shields, valves, and membranes, this is my favorite Medela replacement set.
Does OHP cover breast pumps?
No, it isn’t. Non-WIC participants do not qualify for any form of breast pump (or loan) from the Oregon WIC Program, and Oregon WIC does not rent breast pumps.