Breast Pump coverage

Not sure if this was posted already...but Iam estatic over the new law for breast pump coverage!! my insurance does not cover pumps so its great to know now I will get one for FREE AND the counseling /support. It baffled me how they say breast is best but then don't make the support and services available to everyone.


ETA: I have United Health Care and when I called them 2 weeks ago they told me they did NOT cover breast pumps. So it's great to see that the new law changes their policy!! This should be the same for everyone else.

The changes are going into effective for most employer plans effective at their renewal August 1st and after

Message edited 8/1/2012 8:54:47 AM.

Breast Pump coverage

What is the new law??? I was so upset when I found out my insurance didn't cover a breast pump.

Breast Pump coverage

I haven't heard about this......what is it?

Breast Pump coverage

I haven't heard about this either. My insurance doesn't cover a pump, so I'd love to know more about this.

Re: Breast Pump coverage

It was on the news this morning...here is the info from my insurance (United Healthcare) website. I'm SOOOO HAPPY!!

UnitedHealthcare's Approach to Aug. 1 Women's Preventive Care Services

New coverage guidelines under the Patient Protection and Affordable Care Act (PPACA) require health plans to cover an expanded list of women’s preventive care services with no cost-share (copayment, coinsurance or deductible) as long as services are received in the health plan’s network.

Impacted Groups
The preventive care services provision applies to both fully insured and self-funded (ASO) plans that are non-grandfathered plans under the health reform law. While grandfathered plans are not required to implement these changes, some grandfathered plans have chosen to offer preventive care services at no cost-share. In addition, UnitedHealthcare Small Business plans (generally 2-99 employees) offer preventive care services at no cost-share regardless of grandfathered status.

Breast Feeding Counseling and Supplies
Under the health reform law, lactation support and counseling as well as costs for renting breast-feeding equipment for each child’s birth are covered at no cost-share. UnitedHealthcare believes some members may prefer to purchase a breast pump rather than rent hospital-grade equipment. To offer a range of choices for our members, UnitedHealthcare will cover the purchase of a personal, double-electric breast pump at no cost to the member.

To rent or purchase breast pumps, members will be required to contact UnitedHealthcare or a network physician, hospital or durable medical equipment (DME) supplier. The physician, hospital or DME supplier will bill UnitedHealthcare directly for reimbursement. Members will not be able to purchase supplies, such as breast pumps, at retail and send the receipt for reimbursement.

If a member chooses to purchase or rent a breast pump from a non-network provider or DME supplier, then non-network preventive benefits would apply, if available. If no non-network preventive benefits are available, the breast pump would not be covered.

Breast Pump coverage

Thanks so much for posting this, I have UHC as my secondary ins! Do you know if we can go through Edgepark for this or do we have to contact UHC directly?

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Message edited 8/1/2012 9:17:54 AM.

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Message edited 8/1/2012 9:28:46 AM.

Re: Breast Pump coverage

I'll have to call mine and find out. I'm due in Nov, I'll see how that comes into play.

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This is awesome news!!

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This is great news, I'll have to check with Empire to see what their new policy is..

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I just called UHC back-for my policy; I CAN'T buy the pump before Jan 1, 2013; and then try to submit a claim. I would have to wait until my benefits go into effect Jan 1, 2013 to order the pump.

So not sure what that would mean for the Mom's due in November/December

Breast Pump coverage

Wow this is great, I have UHC and am due Dec 8th. Planning to go back to work around march so hopefully I can get a pump

Re: Breast Pump coverage

Message edited 8/1/2012 10:26:34 AM.

Re: Breast Pump coverage

Posted by Mrs213

Posted by Samira0407

Posted by lvb626

Thanks so much for posting this, I have UHC as my secondary ins! Do you know if we can go through Edgepark for this or do we have to contact UHC directly?

So I just called UHC and for my plan I have to wait until my coverage is renewed Jan 1, 2013. Hopefully that is enough time since LO is due Jan 12, 2013!

You have to log onto MYUHC and search for facility-durable medical equipment

Edgepark did not come up in that list; but the agent said that might be because it's searching my nearest facility (within 100 miles of my zip) and if Edgepark is not in NY it might not come up.

I found the address for Edgepark and changed the zip to their Ohio address and it came up!! So YES Edgepark is a UHC In-Network vendor.

But if the insurance is covering the pump 100% it doesn't even matter if you go through Edgepark...any facility In-Network in NY (or where ever you live) will supply you with a brand new pump.

How do I get to that? When I clicked on that link it just told me what the coverage was

Re: Breast Pump coverage

I hadn't heard about this new law. Do you know if it applies to all insurance companies? I have GHI and I called them a couple of months ago and they told me they don't cover breast pumps. I'm hoping that maybe now they will but I can't find any information online about the new law.

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Breast Pump coverage

Luckily my baby isn't due until Jan 12, 2013; so I plan on calling and ordering a pump first this Jan 1! LOL! Hopefully if she/he comes in time I'll have the pump home by the time I need to start using it.

Re: Breast Pump coverage

I just called my insurance company and they said they will only cover it after the in-network deductible has been reached.

So I guess it's worth it for me to buy it and then use it towards my deductible and then whatever is left will be paid to the hospital. I get so confused by these things!

Re: Breast Pump coverage

Here is info on the plan.

New law

Re: Breast Pump coverage

Posted by Samira0407

I just called UHC back-for my policy; I CAN'T buy the pump before Jan 1, 2013; and then try to submit a claim. I would have to wait until my benefits go into effect Jan 1, 2013 to order the pump.

So not sure what that would mean for the Mom's due in November/December

Re: Breast Pump coverage

So wait, if the idea is that you don't even have to pay a co-pay is my insurance company allowed to say I am eligible only AFTER reaching my annual deductible???

Re: Breast Pump coverage

Posted by Samira0407

Posted by Mrs213

Posted by Samira0407

Posted by lvb626

Thanks so much for posting this, I have UHC as my secondary ins! Do you know if we can go through Edgepark for this or do we have to contact UHC directly?

So I just called UHC and for my plan I have to wait until my coverage is renewed Jan 1, 2013. Hopefully that is enough time since LO is due Jan 12, 2013!

You have to log onto MYUHC and search for facility-durable medical equipment

Edgepark did not come up in that list; but the agent said that might be because it's searching my nearest facility (within 100 miles of my zip) and if Edgepark is not in NY it might not come up.

I found the address for Edgepark and changed the zip to their Ohio address and it came up!! So YES Edgepark is a UHC In-Network vendor.

But if the insurance is covering the pump 100% it doesn't even matter if you go through Edgepark...any facility In-Network in NY (or where ever you live) will supply you with a brand new pump.

How do I get to that? When I clicked on that link it just told me what the coverage was

On the main page click "Find a Doctor" then a page opens with some options...on the left hand corner it should say find a doctor or facility. You just have to put "durable medical equipment " in the search field and all the facilities in your area that are In-Network pop up.