How to Get a Breastpump through your Insurance

With the passage of the Affordable Care Act (ACA), more insurance companies are offering free or low cost breastpumps as part of their preventative care coverage. No matter what your political views about the ACA, it's nice to be able to get a free breastpump. You'll want to take full advantage of this benefit. But how? 

The first thing that you'll need to do is call your insurance company. Ask them the following questions:

- Do you cover breastpumps?

- Will I have a copay for my pump? If so, how much?

- Is there a particular company that I need to order my pump from?

- When should I order my pump? Will the pump be shipped right away or do I need to reach a certain point in my pregnancy before it arrives?

- Do you need documentation from my doctor in order to get a pump?

Most companies cover pumps, but there are some companies that were grandfathered in, meaning that they are being allowed to deny women this benefit. Most will provide the pump for free, but some require a small copay. Don't let the copay trouble you too much since the cost of a copay is lower than the out-of-pocket cost of a new pump. 

Once you have all the information that you need you can start figuring out where you'd like to order your pump from. Insurance companies will not reimburse you the full amount of what it would cost to get a pump from a regular store. Why? Because insurance companies contract with durable medical equipment (DME) companies to get low prices. These DME companies purchase pumps in bulk from the manufacturer and then sell them at a low cost through insurance companies. 

Once you have identified the DME company that you plan to use, you can order your pump. With most companies you will order your pump online. They generally have user-friendly websites and are more than happy to help you with your order. Go to the website and fill in your information. After you've entered basic information and the name of your insurance company you will see a list of available pumps. Most companies will offer you the option of several different brands. Do your research and pick the pump that best suits your needs.

After ordering your pump your wait to receive the pump is based on a number of factors. Some insurance companies will only send the pump after you reach a certain point in your pregnancy. If you order the pump at 20 weeks but your insurance company only pays after 32 weeks then you will simply have to wait until you reach 32 weeks to have the DME company ship the pump to you. Also, some insurance companies require physician verification prior to getting the pump. Your OB or primary care doctor may need to write a prescription for a pump, write a letter of medical necessity, complete a form, or some combination of the above. The DME company will typically take care of contacting your doctor for you, but if your doctor is slow to respond then you may need to reach out to him or her. 

Hopefully this whole process goes smoothly (it usually does), and in no time your pump will arrive at your door. When it arrives don't be too disappointed when you discover that your pump is just a pump. Insurance issued pumps generally come without a carrying case, cooler, or any accessories. Some DME companies will offer you the option of ordering the carrying case and accessories at the same time as ordering your pump. Of course you will pay out of pocket for these items.

Ordering a pump through your insurance may be a bit of a pain, but it will save you a fair amount of money. Follow the instructions above and your ordering experience should move along smoothly.