How to Get A Breast Pump Through Your Health Insurance
Hi, Mama! Did you know that under the Affordable Care Act (ACA), health insurance companies are required to provide a breast pump and related supplies to expecting and breastfeeding moms? However, because exact coverage for type and cost of pump is not dictated by the ACA, coverage varies greatly plan by plan. This is why it's important for you to do your due diligence in checking your personal health insurance coverage for a pump, so that you can maximize your benefits and get the best breast pump for you.
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In this guide, I will be covering -
Brief overview on the different types of breast pumps
The exact questions to ask you health insurer regarding your coverage for a breast pump
How to actually order your breast pump
If you should add a breast pump to your baby registry.
Getting a breast pump is just one small part of preparing for a baby. You also need to learn how to use your pump, and learn how to properly store and prepare breast milk for your baby, in addition to all of the house preparation and baby to-do’s. Check out my Baby Prep Toolkit, a comprehensive baby planning roadmap, checklists, and guides to get you prepared and organized for welcoming a new baby.
Types of Breast Pumps
If you are planning to pump you’ll need to understand the various types of breast pumps so that you can choose the right pump for you. The two main categories of breast pumps are manual pumps and electric pumps, and hands-free wearable electric breast pumps are also an increasingly popular type of pump. I personally have a manual breast pump, a double electric breast pump, and a hands-free wearable electric breast pump and use all three in various situations for different reasons. However, it’s definitely not necessary to have more than one breast pump. Check out heck on my blog post, All About Breast Pumps, to learn more about each type of pump and how each is used.
To help you choose a type of breast pump, consider your lifestyle and how you plan to feed your baby.
Are you planning to exclusively breastfeed and want a pump as a backup option?
Will you be pumping on the go?
Are you planning to return to work and need to pump several times daily?
Do you have a demanding job where it will be difficult to find time or space to pump?
I recommend a double electric breast pump as a primary pump, which health insurers will cover part or all of the cost for.
Your Health Insurance Coverage
You can check your coverage online through your health insurance portal but I encourage you to call and speak to a representative so that you can get all of your questions answered and have clear direction about the type of breast pump you can order and how to move forward with the ordering process.
Questions to ask your health insurer:
“What types of breast pumps are covered under my plan?” - The representative will let you know which breast pumps are covered for you. If you’ve done some research and there is a certain breast pump you want to get, make sure to ask about coverage for that pump specifically.
“Do I have the option to upgrade?” - Typically health insurers will have a baseline coverage amount but will let you upgrade breast pumps by paying part of the cost out of pocket. For example, I knew I wanted the Spectra S1 but my health insurer did not cover the full amount of that pump. I paid a small amount out of pocket to get that pump.
“Is there a certain vendor I need to purchase my breast pump through?” - These vendors are in-network providers and you will usually have a few options. Sometimes these are durable medical equipment suppliers such as Aeroflow Breastpumps, which will do the backend work for you so that you can purchase directly through their online site. Again, check with your insurer and use one of their recommended providers if they have one.
“Do I need to be a certain number of weeks along to purchase a breast pump?” - Sometimes insurance will require you to be a certain number of weeks along before they will allow you to order a breast pump. For example, the health insurer I was under with my first baby I had to be at least 28 weeks along. The health insurance I had with my second baby, I needed to be 36 weeks (I’m a planner and personally thought this was extremely late to be ordering a breast pump considering you need to learn how to use it and could go into labor early).
Be sure to save this post on Pinterest so you can reference these questions when you call your health insurer!
Ordering Your Pump
Once you have direction from your insurance company on what type of breast pump you can get, where and when to order, the process is fairly straightforward. Utilize the provider your insurance company recommends and follow the provider’s process for ordering.
It can sometimes take several weeks to get your breast pump so don’t wait until the last minute to order. You will want some time before the baby arrives to read your breast pump’s instruction manual and become familiar with it. If you’re a new mom you will want to learn how to use your pump and plan for storing and organizing your pumped breast milk. I teach all of this in my Pumping Course.
I highly recommend packing your pump in your hospital bag and taking it with you to the hospital or birthing center for delivery too. The Lactation Consultant there can properly fit you for the right size flanges and show you how to best use your pump for your body and your baby.
Should You Add a Breast Pump to Your Baby Registry?
I often get asked if a breast pump should be added to a baby registry. The answer is, it depends. First, check your insurance coverage to see what your benefits are and utilize your insurance coverage to the fullest. I understand there are cases when you may want to upgrade your breast pump or purchase a type of breast pump that isn’t covered by insurance. For example, a hands-free wearable breast pump like the Elvie or Willow is typically not covered by health insurance for most women. You could add one of these to your baby registry as an option for someone to gift you.
I also recommend getting a manual pump to throw in your diaper bag or keep in your car in case there are times when you need to pump and you don’t have your primary pump. Manual pumps are pretty inexpensive and are a great option for your baby registry. You will also want to add all of your breast pumping supplies and accessories to your baby registry, like those mentioned in the blog post linked.
By taking this step of understanding your health insurance coverage for a breast pump, you’re on your way to being prepped and ready for a new baby! I’d love to help take you the rest of the way through planning with the Baby Prep Toolkit. You can also get more new mom tips and need to know information about caring for a newborn by joining my email list.
