Are you a pregnant mom planning to breastfeed? Then chances are, you are going to need a breast pump. But many women aren’t aware that they can get a free breast pump through their insurance provider.
We know how every dollar counts when you’re a new mom, but we also know it can be hard to find the time to work out insurance coverage details.
We’ve put in many hours researching this process so you can learn how to get a free breast pump. We’ve outlined all the necessary steps in this simple and useful guide.
- Pregnant mothers planning to breastfeed can get a free breast pump through their insurance provider.
- The Patient Protection and Affordable Care Act (ACA) includes the provision of breastfeeding support and equipment to mothers “for the duration of breastfeeding” and requires 100% insurance coverage of these supplies.
- Grandfathered plans created or purchased on or before March 23 2010, are not subject to this requirement.
- The legislation does not specify what constitutes “breastfeeding supplies,” so some insurance providers may only cover certain items.
- Mothers should communicate closely with their insurance company to learn about their requirements and identify which medical supply companies they are contracted with.
Do I Really Need a Breast Pump?
If you’re nursing or planning on breastfeeding, having a breast pump on hand is wise. While pumps are often associated with working moms who express their milk when away from their babies, breast pumps are useful for any nursing mom.
The benefits of having a breast pump include:
- Building a freezer stash of breast milk for emergencies.
- Increasing milk supply.
- Resolving mastitis or clogged milk ducts.
- Being able to go on date nights.
- Emptying your breasts when they are engorged but your baby is asleep.
- Allowing your partner to handle overnight feeding.
Breast Pumps for Free? How Is This Possible?
The Patient Protection and Affordable Care Act (commonly referred to as “Obamacare” or ACA) includes the provision of breastfeeding support and equipment to mothers “for the duration of breastfeeding” (1). Obamacare requires 100 percent insurance coverage of these supplies.
So, regardless of your typical deductions, co-pays, co-insurance amounts, or other out-of-pocket costs, your insurance company must cover the full cost of these expenses — at no cost to you.
Are There Any Exceptions or Limitations?
While most health insurance plans are subject to this legislation and its mandate to fully cover breastfeeding supplies and support, there are a few exceptions.
Additionally, the legislation does not specify what constitutes “breastfeeding supplies,” so some insurance providers may decide to cover manual pumps while others will fully cover a double-electric pump complete with a cooler and carrying case. Still, others may only cover the rental of a hospital-grade pump for a pre-determined period.
This means you need to check with your insurer about the specifics of what they will cover.
Can’t I Just Buy One?
Unfortunately, the process of getting a breast pump covered by your insurance complicates your buying process. While you could just buy a pump and submit the receipt to your insurance company for reimbursement, most insurance companies require you to go through a medical supply company.
However, not all medical supply companies carry breast pumps.
What Should I Ask My Insurer?
When you call your insurance provider, these are the questions you need to ask to get a fully covered breast pump:
- Does my policy cover the purchase of a breast pump for a nursing mother?
- At what point in my pregnancy can I qualify for this benefit, or do I need to wait until my baby is born?
- Do I need a prescription from my doctor, or is documentation of prior maternity care in my insurance record sufficient proof of my need?
- Can I purchase a pump from a regular store and submit the receipt for reimbursement? If so, where can I find the reimbursement request insurance form, and where do I mail it?
- What contracted medical supply companies can provide me with a breast pump?
- Are there limitations about which types of pumps you cover — manual vs. electric?
- Are there certain breast pump brands I can choose from?
- What is the value limitation — i.e., what is the maximum cost you will cover?
- Do you cover other related supplies such as additional milk bottles, flanges, breast milk storage bags, or replacement tubing?
- Is there anything else I should know about properly purchasing a breast pump through insurance?
The Best Breast Pump Suppliers
While many medical supply companies provide breast pumps, there are four common online breast pump options. Here is an overview of some of the features they offer.
|1. Aeroflow Breastpumps
|2. Edgepark Medical Supplies
|4. Byram Healthcare
Before finalizing an order from any company, verify with your insurance that they are a contracted company. Most companies will verify your insurance as part of their process, but it’s ultimately your responsibility to confirm your coverage.
You can find more in-depth details, such as the brands offered, FAQs, and order form links for each of the four companies listed below.
1. Aeroflow Breastpumps
|Medela, Ameda, Spectra, Motif, Tomy, Lansinoh, Elvie, Willow, Evenflo, Zomee.
|Fill out the online form. Aeroflow coordinates with your insurance then ships your pump to your door.
|Length of Time:
|2 days to verify insurance information plus shipping time.
|No out-of-pocket costs unless you choose to upgrade from what your insurance approves. Free shipping.
2. Edgepark Medical Supplies
|Medela, Spectra, Ameda, Freemie, Ardo, Lansinoh.
|You fill out the online form, Edgepark coordinates with your insurance provider then ships your pump.
|Length of Time:
|No out-of-pocket costs as long as your chosen pump is within the limits of insurance guidelines. Shipping is free, but you may pay to upgrade if you’d prefer 2-day or overnight shipping.
|Brands available: Motif, Rumble Tuff, Melodi, Medela, Spectra, Ameda, Freemie, Lansinoh, Hygeia.
|Fill out their online insurance order form. They’ll contact your insurance provider and send your breast pump upon approval.
|Length of Time:
|The pump will be shipped upon verification with the insurance company. If you are pregnant, your pump will ship 30 days before your due date.
|Your pump is free as long as your insurance is verified. Shipping costs are not listed.
4. Byram Healthcare
|Brands available: Medela, Ardo, Unimom, Ameda, Spectra, Freemie, Evenflo, Lansinoh.
|Fill out the online form. Upon insurance approval, they will ship your breast pump.
|Length of Time:
|7–10 business days.
|Your breast pump is free upon insurance approval. No option is available to upgrade your pump. Shipping costs are not listed.
Getting A Free Breast Pump
While most medical supply companies say they verify your insurance coverage when purchasing a pump, it’s always better to understand your benefits so you can make the process as smooth and painless as possible. Here’s how to do things properly.
1. Do Your Pump Research
First, fully research all the breast pumps on the market, then choose the one that best matches your lifestyle. Ask breastfeeding friends and family for recommendations, or ask your lactation consultant.
2. Call Your Insurance Company
When you call, have your insurance card on hand to give your group number or member ID so they can properly verify your benefits. At the beginning of the conversation, ask for the customer service representative’s name and whether they have an ID number.
Write these things down, and take notes throughout your conversation to reference them later if you have any issues.
3. Ask Lots of Questions
Ask the questions we’ve listed above, and try to think of any others that may be important to your specific situation.
4. Ask The Representative For a Store
If you’d prefer to walk into a medical supply company instead of ordering online, sometimes it can be challenging to find one with breast pumps.
To ensure you know exactly where you can go (and save yourself some legwork), ask the representative to put you on hold and call their approved medical supply companies to locate one that provides breast pumps.
5. Order Your Pump
After you have all the information you need from your insurance provider, order your pump. You can either:
- Order it online from a medical supply company.
- Purchase it from a brick-and-mortar medical supply store.
- Buy it yourself and submit the receipt for reimbursement to your insurance company.
If the company you’re working with doesn’t carry your preferred brand, contact additional medical supply companies to see if they carry it or research the company’s available brands and choose a new one to fit your needs.
Some hospitals will order your pump for after your baby’s birth but before you are discharged. You may want to check with the facility where you plan to deliver to see if this service is offered.
Editor's Note:Michelle Roth, BA, IBCLC