Is Breast Pump Insurance coverage possible with the changes to the Affordable Care Act?

Breast Pump Insurance coverage

The Affordable Care Act will now allow new or expecting mamas coverage through their insurance for some or all of the cost of a new breast pump. At the first of the year, when many insurance policies renewed, this change became active for breast pump insurance coverage.

There have been a lot of questions about how the insurance industry will handle the new regulations :

1) What does The Affordable Care Act say about Breast Pump Insurance coverage, Lactation Support and Supplies?

“In conjunction with each birth, a mother may receive comprehensive lactation
support and counseling by a trained provider during pregnancy and/or in the
postpartum period as well as costs for renting breastfeeding equipment.”
Health Resources and Services Administration

2) Where can I get my Breast Pump and Lactation Support?

Most insurance companies require you go through a Durable Medical Equipment (DME) provider to have your breast pump covered by insurance under your preventive care benefits. Santé Mama is a DME provider and specializes in breast pumps, breastfeeding supplies and lactation services. We are conveniently located on the Southeast Corner of 92nd and Mill Plain in Vancouver, WA. You can also Contact us here, or give us a call at (360) 253-BABY(2229) and we will be happy to help you through the process of getting your breast pump covered by insurance!

3) Should I call my insurance company?

Baby On PhoneWhile you may certainly call your insurance to check your coverage, it can be a great benefit to have Santè Mama make the call for you. We have helped a lot of mothers go through the process of acquiring their new breast pump covered by insurance and the services stipulated by the Affordable Care Act. Therefore, we know that asking the right questions is paramount. Some insurance companies are still quoting breast pumps as excluded, only providing if medically necessary, or are providing only hand pumps – as these changes are just coming into effect with some companies and the representatives are not aware of them yet.

4) When am I eligible?

Depending on your insurance coverage, you may be eligible before the baby is born under preventative care and up to 12 months after delivery. This means that you can prepare ahead of time and not have to worry about it after the baby is born. Also, since there has been such a rush on breast pumps now that insurance is covering the cost, it makes it much less likely that the pump you want would be out of stock when the time comes that you’d need it. The sooner, the better!

5) What are the advantages of ordering my breast pump from Santé Mama ?

  1. Since Santé Mama is a DME company we are contracted with the insurance companies and you will not be charge the full retail amount, only the insurance allowable amount. If you purchase a breast pump at a retail store you will pay the retail price and insurance will only reimbursed the allowable amount, which is less than the retail price.
  2. Santé Mama provides support with checking your insurance coverage for you. We do this every day and know what questions to ask to get a clear picture on how your insurance company is managing the changes with The Affordable Care Act.
  3. Once we find out what your coverage is, we can help you find which breast pump would be the best for you. We have breast pumps in stock and our staff is trained to help answer any questions you may have in regards to breast pumps and other feeding concerns. See our Lactation services and Boutique for other products and services.
  4. We will complete the paperwork needed to submit the claim to your insurance company and will bill your insurance company for you.
  5. You receive a breast pump covered by insurance and the support around it when you purchase it from Santé Mama as we are more than a DME company, we specialize in pregnancy and postpartum.
  6. Santé Mama is in network with Blue Cross Blue Shield and many other insurance companies. This means with us you will be able to access the full allowable benefits when buying or renting your breast pump.
  7. With the provisions that became law at the beginning of the year, federal regulations are mandating that breast pumps are covered by insurance. While we are able to help mothers get their breast pumps covered by insurance right now, we don’t know how long the insurance companies will continue to interpret the new laws in the same way. Give us a call today before things change.

6) This all sounds great, how do I get in touch with you to get started?
Our goal is to serve expecting and new mamas with everything they could need throughout pregnancy, birth, and postpartum. For more information about answering the question, “Is a new breast pump covered by my insurance?” or any other question you may have, you can check out our contact page, call us at (360) 253-BABY (2229), or email us at hello@santemama.com

By: Rhonda Davis


4 Comments

  1. Anne Russell

    I was just told by my ins company that a breast pump is not covered. Can you help me with this? Thanks.
    Anne

  2. Jamie C.

    This is very informative, thanks for the great post. I am an expectant mom that is just getting ready to have my first baby and am in need of a breast pump, but they are so expensive! Thanks again.

  3. You actually created some remarkable stuff inside ur article, “Breast Pump Insurance Coverage |
    Sante Mama Baby Boutique”. I am going to be coming back again to ur blog soon.

    Many thanks ,Daniele

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