How Is My Breast Pump Covered Under Insurance?

When shopping for your breast pump, it’s important to know the difference between “free” and “covered” and to educate yourself on the actual coverage of your insurance policy under the Affordable Care Act (ACA).

Under the ACA 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. 

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 policies 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.

That’s great news.

Here’s more 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.  

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 http://www.nwlc.org/resource/new-benefits-breastfeeding-moms-facts-and-tools-understand-your-coverage-under-health-care- .

Once you’re ready to start shopping for your covered breast pump, visit the Byram Healthcare site, select your insurance provider, and select from the variety of popular models we offer.