The United States Department of Health and Human Services (HHS) has adopted guidelines for several women-specific health services to be covered by health plans. These services include "breastfeeding support, supplies, and counseling." According to the HHS web site Healthcare.gov, "Pregnant and postpartum women will have access to comprehensive lactation support and counseling from trained providers, as well as breastfeeding equipment." The web site adds: "Breastfeeding is one of the most effective preventative measures mothers can take to protect their health and that of their children. One of the barriers for breastfeeding is the cost of purchasing or renting breast pumps and nursing related supplies."
What does this legislation mean to you?
This means that commercial health providers are now required by law to allow breast pumps as a covered expense for lactating women. There is some variation around co-pays, depending on your insurance carrier and plan.
How can you get a breast pump covered by insurance?
Firstly and most importantly, you are going to have to do your own research regarding what your insurance provider covers. All insurance providers are different and most providers have chosen only to offer a specific few types of breast pump models. So, you'll need to figure out which ones are covered under your plan before you go out and purchase one. Also, it is important to know that many insurance companies won't cover breast pumps until the baby is born. So, it is best to do your homework and be prepared while you are still pregnant. Then, plan to take action soon after your baby is born. The entire process may take a few weeks and you'll want to get a head start on pumping and filling your freezer well before you head back to work from maternity leave.
When you call your insurance provider, be prepared to answer some important questions. For example, you'll need to know basic information regarding your policy number, your doctor's name, the hospital name and contact information. In addition, many insurance providers have partnered with third party medical supply providers to handle the breast pump purchase, but oftentimes you can choose to purchase your breast pump from whichever company you want.