Obamacare and Your Breast Pump

| Well Being

So, you’ve decided to breastfeed your sweet little one. Providing your baby with mother’s milk is a healthy option, but what about when you return to work or leave your child with someone else for the day? It’s difficult to get around buying a breast pump. Expenses for your newborn's needs add up quickly, and even if you aren’t a savvy with couponing, saving a little cash goes a long way for parents. Before you spend a dime on your breast pump, read how you can get your insurance to cover the cost.

woman breastfeeding copy

The Affordable Care Act, also known as Obamacare, was signed into law by President Obama and went into effect August 2012, meant to reform the health care industry. A major facet of this plan requires insurance plans to provide quality women’s preventative health care services. This means that Health Insurance Marketplace plans and all private health plans (unless it is a grandfathered plan) must cover the cost of a breast pump and provide breastfeeding support, counseling and equipment while a mother breastfeeds her child.

Learn about your plan. The first step to getting your breast pump covered is to contact your insurance. Some providers have guidelines on the type of pump covered (manual or electric), how long they cover a rental pump if applicable, or when they provide the pump to you (before or after birth). Make sure you learn about your insurance coverage before buying a pump to ensure it will be provided or reimbursed without worry.

If you have private insurance that claims it cannot cover your breast pump costs, you may file an appeal under the Affordable Care Act.

If your insurance company partners with specific in-network providers, get a list of them along with any necessary paperwork. And if your insurance requires a prescription, consult with your doctor to determine the pump that’s right for you and collect his written recommendation.

breast pump

Understand the transaction process. Some in-network providers do a direct transaction with your insurance company, allowing you to walk away without paying for your pump up front. Others may ask you to buy your pump and apply for reimbursement. This is another question for your provider as they conduct this transaction in different ways.

Get your pump and learn to use it. Once you get your new or rental pump, be sure you provide the necessary paperwork to your insurance to ensure you are reimbursed (if applicable). Then use the other women’s health perks covered by your insurance. Your plan must cover counseling and support services to help you learn about your pump and give tips on using it. Utilize these resources, especially if you are a first-time breastfeeding mom, to ensure you are safely and effectively pumping your milk. Many moms experience difficulty pumping, especially when returning to work.

breastfeeding

Obamacare has made it simpler and more comfortable for many women to pump after returning to work. The Fair Labor Standards Act requires many companies to provide nursing moms with reasonable break times throughout the day to pump for up to one year after birth. They may be unpaid, but this time is ensured for nursing moms. Employers are also required to give breastfeeding moms a private space to pump or nurse, which cannot be a bathroom, ensuring that you are given a comfortable space to pump.

>> New to breastfeeding? Breastfeeding 101 is a must-read.

TO-DO:

Call your provider

  • Ask what type of breast pump is covered (manual or electric)
  • Ask if they cover the cost of a new pump or a rental
  • Ask for a list of in-network providers
  • Confirm their process to see if you’ll be provided a breast pump or need to purchase one for reimbursement
  • Get details on what other counseling or support services are offered

Consult your doctor

  • Ask for recommendations
  • Obtain a written authorization if you require a specific type of pump

Get your pump and use your resources

  • Get your pump sent or make the purchase
  • Utilize the counseling your plan provides to learn to get milk flowing, clean your pump and store milk safely
  • Ask your employers what services they provide for nursing or pumping mothers.