“The best things in life are free.”
Who can argue with the wisdom of Coco Chanel? And even though the fashion and cultural icon had no children running through and cuddling into her own life, she too would undoubtedly agree that the little midnight coos, morning hugs, the budding smiles of happy content—some of the precious first moments shared between mother and baby—are free and the very, very best.
But few of us are familiar with the conclusion to Coco’s cheery sentiment, which says, “The second best things are very, very expensive.” One can only imagine the couture-clad figure waltzing into a Buy Buy Baby off of Fifth Avenue, taking a look at the price tag of this year’s hottest strollers and—yes, breast pumps—and nodding a confirming head. Because along with all the wonderful, life-changing, heart-swelling (and free) things that will become a part of your new mama life, the equipment that you will need to support this new life, is never free. It is all very, very expensive.
It’s no wonder then, that with any casual mention of “free,” the mamas will come a-running. And it’s no mistake for you to up and run towards the Affordable Care Act incented vendors peddling, “Breast pumps for free! Breast pumps for free!” But that’s not the exact truth and it’s important for you to understand the difference between “free” and “covered” before you acquire your new breast pump.
Here’s the (very) good news: Under the Affordable Care Act a breast pump is fully covered under most health insurance plans. The new legislation makes special allowances for the unique costs of female healthcare, with maternity care receiving much emphasis and breastfeeding needs finding address with the CDC’s pronouncement of breastfeeding among the top preventative efforts a mother can do for herself and her child. (1)
Here’s the word of caution: “most.” The Affordable Care Act doesn’t say that all breast pumps are now free for everyone. Rather, the legislation has pushed insurance companies to cover breast pumps under their offered polies so now “a breast pump is fully covered under most health insurance plans.” With your policy number in hand, call your insurance company and have them walk you through the exact coverage terms of your policy and the specific procedure you follow to acquire your “covered” breast pump. Usually, this procedure simply involves you ordering your breast pump through the carrier’s approved distributor: https://www.byramhealthcare.com.
And here’s more (very) good news: If your policy is one of the few that doesn’t fully cover your breast pump, there may be another way. The Affordable Care Act emphasizes that it’s up to you and your doctor to decide what's right for you and your breastfeeding needs. As such, some insurance plans may require pre-authorization from your doctor to ensure the proper services and equipment is provided. (2)
To support the women taking secondary steps to access their entitled equipment and services, the National Women’s Law Center created a toolkit that includes letter templates and reimbursement forms. You can access those resources through their site.
The National Breastfeeding Center published a Breastfeeding Policy Scorecard in 2014 to keep insurance carriers accountable for their services transparent. If you’re interested in checking your policy’s rating you can access the scorecard here.
For further reading on the Affordable Care Act please see our previous blog post The Affordable Care Act’s Impact on Maternity Care and Breastfeeding.
[2] https://www.healthcare.gov/coverage/breast-feeding-benefits/
Our resident “Moms Who Know” informed this post and our writers composed it. No one contributing to this post is a trained medical professional. For further reading and information on familiarizing yourself with your breast pump, please visit the websites for any of the five brands Byram Healthcare proudly distributes:
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