I came home yesterday to find my new breast pump waiting on the front step. Although I have no use for it YET, I’m still excited about its arrival. One of the best parts? It was FREE! I paid $0.00 for a pump that retails for around $225.
I’ve blogged about the Affordable Care Act before, so this post focuses strictly on breastfeeding provisions. As of August 1st, insurance companies are required to provide support to nursing mothers. This support includes covering the cost of lactation consultants and breast pumps. You don’t have to have any medical diagnosis – you just need to plan on breastfeeding your baby. Your coverage will start when your insurance policy renews – mine renewed October 1st, but some plans don’t renew until January 1st, 2013. When your plan renews, you will be entitled to this coverage.
Regardless of your political leanings and opinions on the Affordable Care Act, if you have health insurance, and are planning to breastfeed, it’s worth taking advantage of these new provisions. Here’s what I had to do to get my free pump. Obviously, every insurance company is different, but these are the basics:
1) You’re going to have to be patient and persistent about the process. It was by no means a nightmare, but because the legislation is still new, insurance companies don’t have it 100% figured out. Be prepared for different answers from different people.
2) I started by logging into my insurance company’s website (I have a Blue Cross/Blue Shield PPO product). Once I was on the website, I looked for their list of approved durable medical equipment suppliers. I think most insurers will require you to purchase your pump from this type of company. A durable medical equipment supplier sells everything from prosthetic limbs to diabetic testing supplies.
3) Once I found the list of approved suppliers (there were ten or so provided), I looked through each company’s online catalog to see which ones actually carried breast pumps. Out of all the suppliers listed, only one company carried breast pumps. The supplier I used was a company called Edgepark.
4) I looked through the offerings, and then checked everything out on Amazon so I could read reviews and compare pumps. Your insurance should cover a double electric pump – not just a cheapo manual one. Edgepark’s options were limited to those manufactured by Hygeia and Ameda. I ended up picking the Ameda Purely Yours Ultra. It retails for around $225 on Amazon, and comes with the pump, tote, extra flanges, insulated milk cooler, car adapter, pumping pad, and an adapter so I can switch to manual pumping if desired.
5) Once I selected a pump, I added it to my cart and checked out. Because Edgepark is a durable medical equipment supplier, it deals mostly with insurance companies. The check out process was lengthy – I had to provide all my insurance information, as well as contact information for my OBGYN, but it wasn’t especially difficult. You DO NOT have to provide a credit card or any other payment details. After filling in all the boxes, I submitted my order.
6) Then you wait a little while. The supplier contacts your insurance company and figures out all the billing information. After checking with my insurance company, Edgepark called me back and let me know that there was no co-pay or deductible, and I owed no money. A few days later, the pump showed up at my door.
Side note: I actually ordered my pump twice. The first time, I tried ordering it in August. Edgepark called me, and I was told my insurance company wouldn’t approve the pump purchase until I’d actually delivered a baby. They said they’d keep all the information on file, but I had to call the company the day I delivered and they’d ship it out then. I passed this information along to a girlfriend at work, and when Edgepark called her about the order, they said she could call two weeks before her EDD, and they’d approve the pump purchase then – she wouldn’t have to wait until the baby actually arrived. So, two weeks before my EDD I called back and asked them to resubmit the claim. The lady I spoke with on the phone didn’t think it would work until I’d actually had the baby, but she offered to submit it to the billing department anyway. It must have worked, because the pump showed up at my doorstep. This is what I mean about getting different answers from different people – be prepared for a little confusion.
That’s it! Although it took a little detective work to figure out how to order it, was worth it for a $200 savings.
Have you gotten a free breast pump from your insurance company? Was it a difficult process?
[Edit 11/9 - A few important additions that our great commenters have reminded me about: 1) Your coverage will not begin until your policy renews for the first time AFTER 8/1/12. If you've called your insurance company recently, and didn't like the answer they gave you about coverage, ask when your policy renewed. If it hasn't renewed since 8/1/12, your coverage may increase when it does renew. 2) As an alternative to covering the cost of a double electric pump, some companies instead choose to cover the cost of renting a hospital grade pump - this is an awesome option and worth checking into. 3) Some insurance plans were "grandfathered" - they aren't required to meet ACA provisions. If you have one of these plans, you're out of luck, at least for now. 4) Every insurance policy is different - my experience may not be your experience (but I hope it is!). ]
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6. Building up a Breastmilk Freezer Stash by mrs. wagon
7. Exclusive Pumping vs. Breastfeeding by Mrs. Bee
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