Free Spectra Breast Pump Through Insurance

How to Get a Free Breast Pump Through Insurance In 5 Simple Steps

Last Updated July 22, 2017

Are you a pregnant mom who plans to breastfeed your little one? Or a mother who is already nursing?

Then chances are, you need a breast pump.

Even if you don’t plan to work outside of the home or use it on a regular basis, it’s a good idea to have one.

The great news is that today, the vast majority of women can get one FREE through their insurance provider.

But before you head out to that retail store and pick one up, there are some things you need to be aware of in order to get it properly covered. Read on to find out more.

Do I Really Need A Breast Pump?

If you’re nursing (or planning to), having a breast pump on hand is a wise idea. While pumps are often associated with working moms who need to express their milk while they are away from their baby, breast pumps can actually come in handy for any mom who’s nursing.

Read: What Are The Best Breast Pumps?

There are many benefits to having a breast pump, including:

  • Building a freezer stash for emergencies

  • Increasing milk supply

  • Resolving clogged milk ducts

  • Being able to go on date nights

  • Emptying your breasts if you are engorged but your baby is still sleeping

  • Allowing your partner to handle an overnight feeding

What Makes It Free?

When the Affordable Care Act (commonly referred to as “Obamacare”) was passed, it included provisions that breastfeeding support and equipment would be supplied to mothers “for the duration of breastfeeding” (source). But beyond simply saying that insurance needed to cover it, they required that it be covered at 100%.

That means that, 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?

Simply put, yes. While the vast majority of health insurance plans are subject to this legislation and its mandate to fully cover breastfeeding supplies and support, there are a few exceptions.

Note About Grandfathered Plans

Any health insurance plan that was “grandfathered” under the Affordable Care Act is not subject to this requirement. Grandfathered plans are those which were created or purchased on or prior to March 23, 2010 (source).

Additionally, the legislation was not specific about what constitutes “breastfeeding supplies,” leaving exact coverage up to each individual insurance company. Some may only elect to cover manual pumps while others will fully cover a double-electric pump complete with a cooler and carrying case. Still others may cover the rental of a hospital-grade pump for a pre-determined period of time.

You will need to check with your insurer about the specifics of what they will cover.

Can I Just Go To the Baby Retail Store and Buy Whatever I Need?

Unfortunately the process of getting a breast pump covered by your insurance makes things a little more complicated than simply running to the closest baby-specific retail store and picking up a pump.

While it may be possible to buy a pump and submit the receipt to your insurance company for reimbursement, most insurance companies will require that you go through a medical supply company.

However, it gets even more complicated: Not all medical supply companies carry breast pumps.

Remember

You will need to communicate closely with your insurance company to learn about their requirements, identify which medical supply companies they are contracted with, and make sure you stay within their purchasing parameters to take advantage of your opportunity for a free breast pump.

What Questions Do I Need to Ask My Insurer?

When you call your insurance, these are the questions that you will need to ask in order to get a breast pump that is fully covered:

  • 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 after 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 form and where do I mail it?

  • What medical supply companies are you contracted with that can provide me with a breast pump?

  • Are there limitations on what types of pumps you cover - manual vs. electric?

  • What is the value limitation - i.e., what is the maximum cost you will cover so I make sure I choose a pump within those dollar limits?

  • Do you cover other related supplies - additional milk bottles, flanges, breast milk storage bags, replacement tubing, etc.?

  • Is there anything else I need to know about properly purchasing a pump through my insurance?

What Are The Best Breast Pump Suppliers?

While there are many medical supply companies that will provide breast pumps, there are four online options that are quite common. Here is an overview of some of the features they offer.

Supplier

Brands Offered

Processing Time

Upgrades?

1. Aeroflow Breastpumps

8

2 Days

Yes (Paid)

2. Edgepark Medical Supplies

8

7-10 Days

Yes (Paid)

3 . Lucina

8

Unlisted

Unlisted

4 . Byram Healthcare

6

7-10 Days

No

Prior to finalizing an order from any company, you should 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, FAQ and order forms links for each of the 4 companies listed below.​

Click to expand...

1. Aeroflow Breastpumps

2. Edgepark Medical Supplies

3 . Lucina

4 . Byram Healthcare


How Do I Get a Free Breast Pump Through My Insurance?

While most medical supply companies say they will verify your insurance coverage for you when purchasing a pump, it’s always a good idea to understand your benefits so you can make the process as smooth and painless as possible. Here’s how to make sure you do things properly.

1. Do Your Pump Research

First, fully research all the breast pumps available on the market and choose the one that you feel will best meet your needs.

2. Call Your Insurance Company’s Customer Service Phone Number

When you call, make sure you have your insurance card on hand so you can give them your group number or member ID, so your benefits can be properly verified. At the beginning of your conversation, ask the customer service representative’s name, and whether they have an ID number.

Write these things down, and take notes throughout your conversation so you can 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 you, or your specific situation.

4. Ask The Representative to Contact the Medical Supply Company

If you’d prefer to walk into a medical supply company (as opposed to ordering online), sometimes it can be challenging to find one that actually supplies breast pumps. To ensure that you know exactly where you can go (and to save yourself some legwork), ask the representative to put you on hold and call around to 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.
  • Purchase 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, you will need to either contact additional medical supply companies to see if they carry it, or research the brands available through that company and choose a new one to fit your needs.


The Bottom Line

When getting a breast pump through insurance, it’s important to make sure you’re doing things correctly to make sure you don’t end up with a bill later.

To summarize, these are the 5 steps you should take to get a free breast pump through insurance:​

  1. Choose your pump.

  2. Call your insurance.

  3. Ask detailed questions about coverage.

  4. Ask the representative to contact the medical supply company directly.

  5. Contact the company yourself and order your pump.

Most women who plan to breastfeed can benefit from owning a breast pump. From helping boost milk supply to allowing for the occasional date night, a breast pump provides both practical and medical benefits to a new mother.

The Affordable Care Act made breast pumps fully covered under most insurance policies, but navigating the complex and confusing world of insurance can be confusing. To get a breast pump for free through your insurance, it’s important to do things properly.

Share this with a new or expectant mama to help her get her own free breast pump.

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Jenny Silverstone
 

Jenny is just another Mom trying to do her Best. She loves organizing things into lists and helping others find what they are looking for. When she's not using her powers to find her kids missing socks, you can find her giving actionable parenting advice & buyers guides at MomLovesBest.com

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