Get a Breast Pump Through Your Health Insurance

Breast Pump Insurance

If you plan to breastfeed, you might think that you do not need a breast pump in the early days. But any number of breastfeeding complications—such as clogged ducts, mastitis, and milk supply issues can happen, and it is a great idea to be prepared with a breast pump on hand. Thanks to the Affordable Care Act, most insurance companies are required to provide breast pumps to policyholders within a year of birth. (Read here). See the following for the steps to getting your pump:

  1. Consult your summary of benefits. Despite the requirement that insurance companies provide a free pump to pregnant people within a year of baby’s birth, some insurance plans have been grandfathered in and do not sponsor the cost of pumps. You can likely download your summary of benefits from your employer or insurance company’s website and search to see if breast pumps are mentioned. If breast pumps are not mentioned, your insurance may still cover them, so it is a good idea to go ahead and contact your insurance provider to check.
  2. Call your insurance company and speak to a representative about what the coverage for breast pumps is. When you call, ask the person you talk to whether pumps are covered, how and when they recommend that you order yours, and whether they can tell you which pumps are available to you. Some insurers that cover breast pumps allow you to order the pump at the end of your pregnancy, so that you have it when your baby arrives, but others require that you wait until baby is born. And many companies require that you get your pump from an online or brick and mortar supplier with whom the insurance provider has an agreement, and the representative you speak to should be able to point you in the right direction. Ask for and make a note of the name of the insurance representative you speak with, as well as the time and date of your call, in case you need to clarify anything with your insurance company later.
  3. Contact the supplier recommended by your insurance company. Most insurance providers work with a designated medical supply company for breast pumps. The preferred supplier could be an online retailer or could be a brick and mortar location in your area, and sometimes insurance companies have agreements with multiple medical suppliers, which means you can choose the route that works best for you. Many people find ordering online to be easy, while the immediacy of receiving your pump from a physical location close by is a great option, especially if your baby arrives early. Once you are in touch with the vendor, they should be able to tell you or you should be able to see on their website what your breast pump options are.
  4. Choose your breast pump. Some insurance companies only offer one brand and type of pump to policyholders, while others have several options available. You likely will be choosing an electronic pump, as opposed to a manual pump. (Read more about the differences between the two in this blog post). If you discover in your research that you have several choices, go online to read reviews or talk to people you know who have recently breastfed babies to ask what pumps they used. The Pregistry Facebook page is another place that you can connect with other new parents and parents-to-be and discuss breast pump options.
  5. Order your breast pump. If you are ordering online, through a medical supply company’s website, it should walk you through the steps to ordering. Support via phone and chat will also likely be available if you run into trouble. The clerks at an in-person medical supply company can also help you order the pump you want. Be prepared with the information of your care provider (doctor or midwife), whom the insurance company may contact to confirm your pregnancy or birth, and relevant insurance information such as group number and subscriber identification, which is likely found on your insurance card. You may be able to receive your pump for free, or in rare cases, have to pay upfront and receive reimbursement later. The insurance company representative you spoke to should be able to tell you what to expect in this regard.

Final thoughts about feeding and pumping

It is up to you whether you want to breastfeed your baby. Sometimes breastfeeding can be difficult and sometimes it comes easily, but you have plenty of options that are healthy for you and baby. If you do end up pumping, this post offers great ideas about maintaining your pump in good working order. And if you struggle with breastfeeding or need strategies for pumping for any reason—such as a return to work—you can get help.

Abby Olena
Dr. Abby Olena has a PhD in Biological Sciences from Vanderbilt University. She lives with her husband and children in North Carolina, where she writes about science and parenting, produces a conversational podcast, and teaches prenatal yoga.

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