Your Rights to Insurance Coverage for a Breast Pump and Lactation Services
An oldie but a goodie—KPIX Consumer Reporter Julie Watts reports on your rights to insurance coverage for your breast pump and other nursing expenses under the ACA.
This story originally aired in 2013, but the issues remain the same today.
The take away:
Call your insurer BEFORE you give birth and ask them to outline your coverage for lactation expenses. A breast pump is usually covered under your Durable Medical Equipment clause.
However, many insurers will not reimburse you if you buy a pump yourself from a retailer. They may require you to purchase it though a pre-approved Durable Medical Equipment provider. Many woman complain that those Durable Medical Equipment providers do not offer quality pumps (the most popular pumps run between $300-$400).
Many hospitals also rent hospital-grade pumps. However, in some cases the hospital rentals are billed though a separate lactation department with different billing codes than the hospital itself. As a result, many insurers will consider those lactation departments, and their pump rentals, “out of network.”
If you do your research early enough, you may want to consider simply registering for a pump and avoiding your insurer all together. However, many women don’t realize how crucial a quality breast pump is until they are struggling to feed a newborn.
We should also note that many women end up renting a hospital grade pump for the first few months until their breastfeeding relationship is established, then they switch to a consumer grade pump. Ask your insurer if they will cover both.