I’m so happy to offer this guest post today about how to get your best breast pump covered by insurance. Sarah Wells is a mom, an entrepreneur and a women’s health advocate. She is also the CEO and founder of Sarah Wells Breast Pump Bags and she shares her best tips with us. Affiliate links and excellent advice included.
By now, you may have heard that the health reform law (or Affordable Care Act, ACA, Obamacare, whichever name you prefer to use) will cover a breast pump for expecting and new moms who have health insurance coverage. Many moms have already reaped the benefit of a free pump; while some may still not know exactly how to get started. Here’s a quick rundown, for most* moms, on how to get your breast pump on insurance:
- Find a supplier. Call your insurance (or look at their website) and ask for an approved list of “durable medical equipment” (DME) suppliers that stock breast pumps, or Google “breast pump and DME” and you’ll find several with easy-to-use websites from suppliers and pump manufacturers. (In most cases, you cannot go out and get a pump from a retail store and be reimbursed – you need to work with a supplier.)
- Let the DME do the heavy-lifting. Contact the DME and ask them to deal with your insurance on your behalf (they will probably have you fill out a form and/or get a prescription from your doctor for a pump). Trust me, this will save you a lot of hassle of back-and-forth with your insurance. They will figure out WHEN you can get the pump (while pregnant or after baby is born?) and WHAT pumps you can get (based on insurance reimbursement levels and the suppliers inventory).
- Make an informed decision about your pump. Talk with the DME you have chosen to work with about which pump brands and models are an option for you, but also which pump is RIGHT for you and your circumstances (e.g., the full-time working mom who plans to pump a lot may want a double-electric pump to own).
- Ask for help. After you receive your pump from the supplier, speak up and call the DME if there are any problems with the equipment, it doesn’t fit well, or if you need extra parts. Many DMEs have certified lactation consultants on staff who can help you with pumping challenges, such as low supply (and if they do not, seek out support from a CLC practice in your area).
A breast pump can be a really helpful (and often necessary) tool for a mom to achieve her breastfeeding goals; under the new law, you are entitled to a pump from your insurance. Buying a pump off-the-shelf can run upwards of $300+, so this benefit is a huge one to many new moms.
More about Sarah and her cool pump bags: She spent 15 years running national nonprofit organizations committed to achieving quality healthcare for Americans; she has been quoted in Time Magazine, The New York Times, The Wall Street Journal and spoken before international audiences on health policies for girls and women. After the birth of her daughter, she had her entrepreneurial “light bulb moment” and launched Sarah Wells Breast Pump Bags, based on a stylish and functional designer handbag that replaces the frustrating tradition of carrying a cheap vinyl breast pump bag. Since that time, her business has grown by leaps and bounds, while she speaks with women from across the country about the blessing and challenges of motherhood.
Related affiliate links:
Sarah Wells Annie Breast Pump Bag in Dazzling Blue (also comes in black)
Sarah Wells’ Lizzy and Annie bags fit portable pumps including: Medela Pump in Style (with or without a case) and Freestyle, Hygeia, Freemie, Spectra, Ardo and Ameda while the Maddy fits smaller models of portable pumps such as the Medela PIS (without a case) plus pump accessories and all of your purse items. Click your favorite to read extended specs and reviews.
* PS. There are some exceptions to the health reform coverage mandate of breast pumps. Tricare, the military’s health care program, is exempt from the health reform law mandate for breast pump coverage; Tricare only covers hospital-grade pumps in some cases of premature birth. Legislation to require Tricare to cover breast pumps is working its way through Congress now. Also, insurance plans in place prior to the new law are “grandfathered” in. This means they can follow the old rules. They do not have to provide you a pump free-of-charge. But, do not give up. They may still offer you a pump with a co-pay.
[All photos by Sarah Wells, rights reserved]