When Should I Order My Breast Pump Through Insurance?

as quickly as possible! Ordering a breast pump through insurance can take some time because it requires teamwork between moms, doctors, and insurance representatives. As a result, as soon as a mother learns she is expecting and wishes to breastfeed, she can start the process of buying a breast pump.

When should I purchase my breast pump?

Around week 30, we discovered that the majority of moms order a breast pump. During your pregnancy, you can order a breast pump at any moment. We recommend starting the process before your third trimester to give us enough time to finalize the details before your baby arrives.

If you’ve already given birth and only recently discovered that a breast pump is a covered benefit through your insurance, you’re still eligible for a breast pump up to one year after giving birth.

Keep in mind that each insurance company has its own set of rules for when your breast pump can be delivered. As a result, it’s possible that your pump won’t arrive until 30 days before your due date, or even after you’ve given birth in some cases.

How long does it take for insurance to approve breast pump?

A: No problem; Edgepark offers a helpful guide to picking the best breast pump for you right here (with a handy breast pump comparison chart). It lists the pumps that are most likely to be covered by your insurance, so you don’t fall in love with something you’ll have to pay for out of pocket. For even more information, you can always refer to our own guide here.

A: No, you can order your pump at any time throughout your pregnancy (or up to a year afterward), and Edgepark will hold it for you until your insurance plan allows it. You should receive your pump within 1-2 days after it arrives.

A: I don’t know. While some firms require you to fill out a form and wait to be contacted about your breast pump alternatives, Edgepark allows you to get your breast pump immediately online. They’ll take care of the rest once you’ve completed your order form.

A: Your insurance coverage will determine this. If you qualify for Edgepark, you’ll receive a brand-new breast pump from one of the well-known brands, such as Medela, Spectra, Freemie, Lansinoh, and others. There are no product limits or additional expenses based on your insurance, so you can pick the one you want. You can acquire any product offered by your insurance provider if Edgepark partners with them.

How do I get a breast pump through my insurance?

Under the Affordable Care Act, insurance companies are required to cover a breast pump and supplies at no cost to pregnant or breastfeeding members. The problem is that the Affordable Care Act does not specify which kind of breast pumps must be covered by insurance, nor does it specify the price range. As a result, breast pump coverage varies significantly depending on your insurance.

Contact Your Insurance Company

Because there are no standard criteria, the best approach to learn more about your coverage is to call your insurance carrier.

Lisa Paladino, a certified nurse midwife and worldwide board-certified lactation consultant in private practice in Staten Island, New York, advises her patients to contact their insurance carrier by the third trimester.

Most insurance companies, according to Paladino’s experience, have a specialized maternal child specialist who can explain the process and the coverage you’re entitled to. However, call the Member Services phone number on the back of your insurance card to get started.

Ask the Right Questions

Gather your questions before making the call. Here’s a rundown of what you should expect from the representative to get you started:

  • What are the different varieties of breast pumps that you cover? Some insurers provide up to nine options, including double-electric, single-electric, battery-operated, and manual types. Some insurance firms, on the other hand, only provide one or two possibilities.
  • I’m looking for a place to buy a pump. Most insurance companies require you to get your pump from a provider who is part of their network. In most cases, there are multiple possibilities, so ask for a list. In-network providers are frequently online-only durable medical equipment (DME) companies like Yummy Mummy or Aeroflow Breast Pumps. “These vendors have a lot of experience working with insurance companies,” Paladino says. “They know what pumps your insurance covers, and they have all the documents and documentation you’ll need.” You also don’t have to pay anything up ahead. It could be a simple procedure.” Retailers like Walmart and Target may be included in your insurance company’s in-network providers. These shops also offer an online ordering option for your pump. Choose one and browse to their website after you know which providers are in-network. On the homepages of most of these firms (including Walmart and Target), you can choose your insurance company and state. It will display you all the pumps that your insurance covers once you’ve input your information.
  • Is it possible for me to upgrade my breast pump? If you’re ready to pay a fraction of the expense, several insurance companies and DME suppliers will allow you upgrade to a more expensive pump. The website will indicate the pumps that are considered upgrades if this is an option. The pumps will say $0.00 if they are completely covered. If you desire that pump, the improvements will include a price value that represents your half of the cost. The availability of this option varies by insurance company.
  • Is a prescription required? To acquire your pump, you may need a prescription and/or pre-authorization. Inquire about this policy so you’re not running at the last minute to seek it from your midwife or obstetrician. Even if you don’t require a prescription, the DME (or another provider) may need to double-check some details with your doctor before shipping your pump. Again, each insurance company’s procedure is different.
  • Do you provide coverage for hospital-grade pumps? A hospital-grade pump is a higher-powered electric pump than a personal double-electric pump. “Most insurance companies don’t pay these pumps unless it’s a medical necessity,” adds Paladino, such as if the baby was born tongue-tied or with a low birth weight, or if the mother has a low milk production. Your doctor or midwife will need to write a prescription and submit a diagnosis code in these circumstances.
  • Will I be required to pay for a hospital-grade breast pump? These pumps are quite expensive, costing up to $2,000 each. If you qualify, the insurance will cover a rented property rather than one you own. It’s possible that you’ll have to buy your own collection kit, which contains the tubes, valves, breast shields, and bottles you’ll need to use the pump. Before your coverage kicks in, you may have to pay a deductible and a co-payment. The DME coverage in your plan determines your expenditures. While you’re on the phone with them, the insurance representative should be able to check up this information.

Consider Various Breast Pumps

If your insurance provider offers a variety of pumps, you’ll have to pick which one is ideal for you. Here’s a quick rundown.

  • Pumps with two electric motors: “According to Nicole Drury, a certified La Leche League leader in Northampton, Massachusetts, “electric pumps are designed to simulate the way a baby feeds, initially with quick, short pushes to establish a let down and then with a longer pull.” “Because it allows you to pump both breasts at once, the double-electric pump is the most efficient. “However, some ladies don’t enjoy this setup and feel as if they’re attached to a machine,” she explains.
  • Single-electric breast pumps: With this kind, you can only pump one breast at a time, which takes longer. However, some mothers prefer the option of pumping one breast while allowing the infant to suckle on the other.
  • Breast pumps that run on batteries: These pumps are great for when you’re on the go. “If you’re traveling and don’t have certain access to an electrical outlet,” Drury says, “you might pump in the car.” “If portability is more essential to you than speed, this pump might be appropriate for you.”
  • Pump by hand: “This low-tech method appeals to certain ladies,” adds Drury. “They’re quite portable, and I know a lot of parents who swear they can get a lot of milk pumping done manually, with good suction and a long draw.”

How to Get Your Pump

The time it takes to obtain your pump varies. When it comes to when your breast pump can be shipped, each insurance provider has its own set of rules. You can get it after you give birth if you don’t get it while you’re pregnant. However, if at all possible, Paladino recommends getting it during your third trimester. She explains, “It’s one less thing to worry about.”

Should I buy a breast pump before or after baby is born?

With the arrival of a new baby comes both delight and worry about raising them. When it is possible, most individuals have heard that nursing is encouraged. Many women begin to question if they will also require breast pumps as a result of this. We’ll examine into whether or not breast pumps are necessary in this article.

A good breast pump will be quite beneficial to many women. However, as you may expect, not all ladies will require one. There are a variety of reasons why women use a breast pump, and regardless of why you need one, you should have one.

Breastfeeding is a natural instinct for most babies. However, just as no two people are alike, not all babies will respond to breastfeeding in the same way. It’s possible that they’ll never get used to it. If your baby does not nurse for an extended period of time, you can use a breast pump to maintain the amount of milk your body produces.

If you plan to return to work, either because you have to or because you want to, a pump will assist you in providing the required milk for your baby. It’s not strictly required, but you’ll almost certainly find it handy.

It is possible that you will be separated from your kid for a few hours at a time. Another instance where having a breast pump comes in handy is when you’re pregnant. These are just a few of the reasons why a woman could find a breast pump useful, but there are likely to be more. Let’s have a look.

Some mothers want to know if they should get a breast pump before their baby is born. This is a decision that will only be made by the mother. It’s not required to purchase a pump before the baby is born, but there’s no reason why the mother shouldn’t if she feels more comfortable doing so. The highest-quality pumps can be hired from the hospital, although they are usually not rented until the mother requires them.

However, there are numerous varieties of high-quality pumps available in supermarkets and pharmacies. Finding one should not be difficult, and there is always the option of going online. Breast pumps will be available in a variety of styles, pricing, and overall quality.

The answer to this question is very dependent on the circumstances. Some newborns may go through a period where they aren’t breastfeeding, and the mother may desire or need to use a breast pump until the baby resumes breastfeeding. Even if she intends to stay with her infant at all times, there are additional reasons why a woman may want to use a breast pump. It is just not accurate to advise a mother that she must have a breast pump. However, there are a variety of conditions in which a mother would benefit from having one.

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.

Will insurance cover two breast pumps?

For each pregnancy, most insurance plans will cover a new double electric breast pump, allowing you to nurse with the most up-to-date technology. Insurers, on the other hand, are unlikely to fund a second breast pump if they have previously paid for one.

Does insurance cover breast pump replacement parts?

Is Breast Pump Replacement Parts Covered by Insurance? Yes, most marketplace plans are required to include breastfeeding supplies.

How many breast pumps Does TRICARE cover?

TRICARE-eligible female beneficiaries who have had a child. A pregnant beneficiary or a female beneficiary who lawfully adopts an infant and plans to breastfeed it herself is considered a birth event. These things can be obtained either before or after delivery.

It makes no difference whether TRICARE plan you use (TRICARE Prime, TRICARE Select, the US Family Health Plan, TRICARE Reserve Select, and so on) or if your sponsor is active duty, retired, or in the Guard/Reserve.

Should you get a new breast pump with each pregnancy?

With each pregnancy, we recommend purchasing a new breast pump. The majority of insurance companies will cover one breast pump for each new pregnancy.

You could reuse your old breast pump if you maintained it clean and sterilized, stored it carefully, and purchased new breast pump parts. Because most breast pump motors are only good for a few hundred hours, you may notice a reduction in suction power.

How do I get my breast pump through insurance anthem?

Simply fill out our qualification form to acquire a breast pump through your Anthem BCBS insurance policy. Within 1 to 2 business days of receiving your information, we will verify your coverage and tell you of your eligibility through email.

We’ll tell you which breast pumps you can choose from in the email, as well as the other Anthem BCBS goods you’re eligible for (upgrade options may have an out of pocket expense because they contain additional items that are not covered by your insurance policy).

Our team will work with your physician’s office to secure a prescription so that we may bill Anthem BCBS after you’ve chosen your breast pump. Your breast pump will be shipped once we receive your prescription (we cannot ship your breast pump until a prescription is received from your physician). The majority of moms will have their breast pump within 7 days of completing our intake form!