12 Common Questions About Getting a Breast Pump Through Insurance

While many expecting mothers are overwhelmed with the growing to-do list that comes with having a baby, understanding insurance is a whole different ballgame. Coverage options, deductibles, co-pays, limits on providers, and all of the technical jargon that’s involved in migrating the landscape of insurance can cause a great deal of stress—especially when you’re already in the midst of becoming a parent. Even though it seems overwhelming, it’s worth the effort to understand. Insurance providers cover a lot more than you’d expect during your pregnancy, delivery, and even after you’ve welcomed your new baby into the world. One thing that will help you survive in those first few months is a breast pump and because of the Affordable Care Act, insurance providers are required to cover the cost. So, to help you get started, here are 12 common questions about getting a breast pump through insurance.

  1. How Can I Get a Breast Pump Through Insurance?

    The Affordable Care Act (ACA) requires that health insurance companies provide coverage in their plans for equipment necessary for breastfeeding along with different options for support and counseling if needed. This means that all insurance providers and plans must cover at least one breast pump for expecting mothers. The process for obtaining an insurance covered breast pump varies based on your provider and plan, but the general guidelines are fairly consistent.

    Start by finding a reputable medical equipment supplier like Byram Healthcare. Byram is a nationwide leader in medical supplies delivered directly to your home. We carry a wide range of breast pumps and supporting equipment to help assist new mothers in their breastfeeding journey.

    Order Your Insurance Covered Breast Pump

    Next, fill out the qualifying forms through the online prompts. This will relay your insurance information to better understand your coverage options. Sometimes the verification process is immediate; other times you may need to wait while additional information is acquired. Whether it’s immediate or momentarily delayed, as soon as the company receives your insurance information, you’ll receive a confirmation and instructions on how to choose your breast pump.

    Take your time when choosing your breast pump. Do the research you need and make sure that you understand the differences between each model under your eligibility. Once you place your order, Byram will work with your doctor to determine whether or not you’ll need a prescription and, if you do, how to get it. In many states, a prescription is required—we’ll discuss this in more detail below.

    Depending on your due date, you may have shipping restrictions and delays. Some providers only ship your breast pump within 30 days of your due date. Others may hold off on shipping until you’ve actually delivered. Whatever the decision your provider makes, you’ll be informed about the process and when the time comes, your breast pump will be shipped free of cost to your home.

  2. Can I Choose a Model? What Breast Pumps Will Insurance Cover?

    The type and model of breast pump that you’ll receive without any out-of-pocket costs depends on your insurance provider and current plan. Every provider has different options and each of those plans has a unique set of guidelines. To better understand what your qualifications are, you can either call your insurance provider directly or simply start the process of ordering online with Byram Healthcare. This will give you more information regarding which breast pumps will be covered.

    If you’d prefer a model that’s not currently covered by your insurance, you may be eligible to get it partially covered. Work with your insurance provider or Byram representative to gain a better understanding of your situation.

  3. Will I Need a Prescription? How do I Get a Prescription for a Breast Pump?

    Depending on your plan, provider, and state of residency, you may need a prescription in order to get a breast pump through your insurance. While it seems like extra effort, getting a prescription is a lot easier than you’d think. All you need to do is talk to your OBGYN. Prescriptions are also accepted from a primary care doctor, nurse practitioner, or pediatrician if you’re getting a breast pump postpartum.

    While getting your prescription before ordering will save time, most companies can help you coordinate this with your doctor.

  4. When is the Best Time to Order a Breast Pump?

    We recommend that you order your breast pump when you’re around week 30 of your pregnancy. While you can place an order at any time, you may not be eligible to actually receive it until the later stages of your pregnancy anyway. Take your time and research all of your options. However, it is beneficial to get your breast pump prior to your delivery date so that you can gain a better understanding of how it works before you have your hands full. If that’s not possible, you can still order an insurance covered breast pump up to one year postpartum.

  5. When Will I Get my Breast Pump?

    Every insurance provider is different. Your breast pump may ship before you’ve delivered, or you may not receive it until postpartum. Regardless, you will get your breast pump at the earliest time that you’re eligible through your insurance plan. If you’re concerned about timing, or have more questions, talk to your provider or one of the representatives at Byram Healthcare for more information.

  6. Can I Still Get a Breast Pump After Giving Birth?

    Yes, you can still receive an insurance covered breast pump up to one year postpartum. The Affordable Care Act extends the period of eligibility to give new and expecting mothers more time to understand their needs. The process will be the same and you should be able to receive it quickly after you’ve placed your order.

  7. How Often Does Insurance Cover a Breast Pump?

    Standard insurance plans cover one breast pump for mothers for every pregnancy. This means that you’ll be able to get a new breast pump with each additional child. While you can use your old one, we recommend opting for a new, cost-free breast pump for updated features and optimal safety.

  8. How Many Breast Pumps Can I Get Through Insurance?

    You’ll received one breast pump per pregnancy covered by insurance. If you’ve already made a purchase, you can still receive a free one through your insurance, but you won’t be reimbursed for your previous purchase. Due to the sensitivity of a breast pump, it is also unlikely that you’ll be able to return the product. If this happens, try getting a completely different model through insurance to give yourself more pumping options.

  9. Will Insurance Cover Additional Supplies?

    Many insurance plans also cover breast pump supplies that are necessary for operation. These supplies include things like flanges and milk storage bottles along with extra tubing, but they do not include unnecessary options like breast pump bags.

  10. What Happens if I Need a Lactation Consultant?

    Many insurance plans also cover lactation consultants for those who need them. If you’re having trouble breastfeeding or struggling with developing a good latch, ask your doctor for recommendations on a local lactation consultant. If you’re unable to cover these costs out-of-pocket, make sure that you double check with your provider for details. Understand what will be covered and if there’s a co-pay, how you will be reimbursed, and if there are any limitations regarding appointments.

  11. Is it Important to Register for a Breast Pump?

    There are options to register for a breast pump on a baby registry, but if you have insurance this is a waste. Keep your registry for other items that aren’t covered by your insurance provider. The only time you may want to include a breast pump on your registry is if your insurance plan does not cover your preferred option.

  12. How Do I Get Started Getting a Breast Pump Through Insurance?

The first step you need to take is to find a medical supply company that you trust. Byram Healthcare is a top-rated company with a wide variety of electric breast pumps available to expecting mothers. Our process is simple and starts with an easy online form. If you need any help along the way, one of our representatives will happily help you through the process.

Order Your Insurance Covered Breast Pump

Byram Healthcare is here to assist you on your journey of acquiring a breast pump through insurance at no cost to you. To get started, fill in the insurance to use for your selected breast pump and walk through the steps when prompted. If you have any questions, or would like to speak to a Byram representative, reach out using the live chat option on our website. Since coverage varies based on where you live and what insurance policy you have, always call your local representative if you have any insurance-related questions or concerns. While the professionals at Byram do their best to help clarify any confusion, understanding your unique coverage is more effectively achieved directly with your insurance provider.

Byram Healthcare Featured Breast Pumps:

Ameda® Mya

Medela Pump in Style®

Lansinoh® Smartpump

Spectra S2 Plus