This coverage is under preventative care so you should not need a prescription from your doctor. There may be some stipulations mandated by your particular insurance company so you will want to get that information from them. For example, some insurance companies are stipulating that only one breast pump will be covered every three years. In that case, you will want to purchase a pump like the Hygeia EnJoye Breast Pump that has a three year warranty over a Medela Pump In Style that only has a one year warranty.
Use these steps to get started:
1. Call your insurance company and ask the following questions:
A. Is a breast pump covered under my policy? What type? Is there a three year limit?
B. Do I have to buy from an "in network provider"? If so, where do I get the list?
C. If not, can I buy from a DME and then submit my receipt for reimbursement? If so, how soon will I see reimbursement?
2. If you must go through a network provider, call the ones on the list and ask for the breast pump of your choice. If they do not have the breast pump in stock or the time frame to receive one is too long, call the insurance company back and ask them about GAP coverage. GAP coverage allows you to buy out of network and then file for reimbursement if the providers do not have what you need.
3. If the insurance company allows you to buy out of network, give us a call at 800-216-8151. We will provide you with our DME information and the breast pump insurance codes needed. Giving this info to your insurance company before they receive your receipt for reimbursement speeds up the reimbursement process. Once the insurance company has this information, you can buy your pump directly from us on the phone or online at http://www.lactationconnection.com. Your package will arrive within 3-10 days. Once you receive your package, you will use the enclosed receipt to file for reimbursement. The receipt will contain the insurance codes needed for reimbursement of a breast pump and breastfeeding supplies such as additional parts, storage bottles and bags, etc.
For more information of the Affordable Care Act and Breast Pump Insurance Coverage, follow this link: http://www.lactationconnection.com/Breast_Pump_Insurance_Coverage_s/1916.htm
If you need advice on which breast pump is right for you, please give us a call at 800-216-8151.
Tanya Roberts, Owner