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Cheeks24
Living a dream
Member since 1/08 8589 total posts
Name:
Cheeks
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Re: Breast Pump coverage
Posted by readyornot2
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???
I would think so since you have to fulfill your annual deductible first.
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Posted 8/1/12 3:53 PM  |
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Long Island Weddings
Long Island's Largest Bridal Resource |
MaZz
* Lovin my baby girl!!! *
Member since 2/09 6243 total posts
Name:
Gina
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Re: Breast Pump coverage
Unbelievable... Where was this change 2 freakin months ago  $250 that they should have covered a long time ago
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| Posted 8/1/12 6:45 PM |
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mrsyoungmommy
can't wait to meet Sophia!
Member since 6/10 1441 total posts
Name:
Danielle
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Breast Pump coverage
This is huge! I just called Oxford today and my policy renews Sept 1st, which means my pump will be covered when baby girl gets here! I'm so relieved!
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| Posted 8/2/12 6:06 PM |
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Samira0407
Love being a Mom
Member since 6/08 4030 total posts
Name:
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Re: Breast Pump coverage
Posted by mrsyoungmommy
This is huge! I just called Oxford today and my policy renews Sept 1st, which means my pump will be covered when baby girl gets here! I'm so relieved!
that's great!!!
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| Posted 8/2/12 7:38 PM |
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jennarose023
Jack's gonna be a big brother!
Member since 11/08 7769 total posts
Name:
Jenna
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Breast Pump coverage
For anyone who needs one before they become eligible Jan 1st I have one from DS (only used it literally 4-5 times) and I'm selling it really cheap. Just putting it out there in case someone didn't want to rent. 
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| Posted 8/2/12 8:15 PM |
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Desyre
LIF Zygote
Member since 5/05 16 total posts
Name:
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Re: Breast Pump coverage
I just spoke with GHI ( I am a NYC teacher) and yes they do allow breast pump coverage under the new law. They are unsure how it works. I am calling around as GHI is trying to find out how to get it covered.
Now, she said that it excludes all of the city of New York plans, which I am trying to find.
I spoke with NYCAPS in reagrds to this issue and they said they are still trying to figure out how and if they have to adhere to the new policy. 
Message edited 8/3/2012 11:42:26 AM.
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| Posted 8/3/12 10:04 AM |
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LiveItUp
Love my babies!
Member since 8/11 4096 total posts
Name:
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Breast Pump coverage
I just called GHI and was told basically what I was told a couple of months ago when I called, which is that it's only covered if the baby is premature and has a medical necessity for a pump as determined by the doctor. I asked the rep. about the new law and he said he's "unfamiliar with it." And he said that even if GHI were to cover it IF my baby had a medical need for it, we would still have to pay a $100 deductible plus 20% of the rest of the cost of the machine. So basically, I might as well just the by Ameda one I want off of Amazon bc it will still be cheaper. Maybe the change is just too new and GHI hasn't gotten with the program yet? I'll probably try calling them back in a few weeks or so to see if anything has changed.
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| Posted 8/3/12 11:55 AM |
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Samira0407
Love being a Mom
Member since 6/08 4030 total posts
Name:
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Re: Breast Pump coverage
Posted by LiveItUp
I just called GHI and was told basically what I was told a couple of months ago when I called, which is that it's only covered if the baby is premature and has a medical necessity for a pump as determined by the doctor. I asked the rep. about the new law and he said he's "unfamiliar with it." And he said that even if GHI were to cover it IF my baby had a medical need for it, we would still have to pay a $100 deductible plus 20% of the rest of the cost of the machine. So basically, I might as well just the by Ameda one I want off of Amazon bc it will still be cheaper. Maybe the change is just too new and GHI hasn't gotten with the program yet? I'll probably try calling them back in a few weeks or so to see if anything has changed.
that doesn't sound right-perhaps like you siad the law was too new. I would call again and if that rep doesn't know ask to speak with a supervisor.
ETA: I just did a little searching on the GHI/Emblem Health website and I saw this link
http://www.hrsa.gov/womensguidelines/
They should be covering the breast pump supplies for you.
Message edited 8/3/2012 12:07:30 PM.
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| Posted 8/3/12 12:04 PM |
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butterfly20
Party of 5 - 2015
Member since 4/06 7390 total posts
Name:
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Re: Breast Pump coverage
bummer, my company doesn't renew the insurance plan til January 1st.
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| Posted 8/3/12 5:35 PM |
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Novemberbaby
LIF Infant
Member since 8/12 133 total posts
Name:
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Re: Breast Pump coverage
Just called GHI today and apparently NYC employees are not eligible for the new federal law, Due to some grandfather clause.
So Bloomberg is mandating that all woman breast fed and NYC employees can't even participate in the new Federal law.
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| Posted 8/6/12 11:25 AM |
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Gracie821
LIF Infant
Member since 9/09 63 total posts
Name:
Grace
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Re: Breast Pump coverage
I'm calling my insurance now fingers crossed!!!!
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| Posted 8/6/12 11:40 AM |
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Gracie821
LIF Infant
Member since 9/09 63 total posts
Name:
Grace
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Re: Breast Pump coverage
Yay Empire bluecross blue shield covers it! I am responsible for 20% which isn't that bad! So glad i saw this post!
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| Posted 8/6/12 11:57 AM |
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Beachgirl59
LIF Infant
Member since 5/12 296 total posts
Name:
K
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Re: Breast Pump coverage
Posted by Novemberbaby
Just called GHI today and apparently NYC employees are not eligible for the new federal law, Due to some grandfather clause.
So Bloomberg is mandating that all woman breast fed and NYC employees can't even participate in the new Federal law.
Ugh that sucks. I have GHI also
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| Posted 8/6/12 3:22 PM |
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Novemberbaby
LIF Infant
Member since 8/12 133 total posts
Name:
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Re: Breast Pump coverage
Posted by Beachgirl59
Posted by Novemberbaby
Just called GHI today and apparently NYC employees are not eligible for the new federal law, Due to some grandfather clause.
So Bloomberg is mandating that all woman breast fed and NYC employees can't even participate in the new Federal law.
Ugh that sucks. I have GHI also
It only matters if you are a NYC employee if you aren't GHI will cover it
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| Posted 8/6/12 3:50 PM |
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NewMrsG
Love my GiGi
Member since 12/11 1442 total posts
Name:
Mrs. G
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Re: Breast Pump coverage
Posted by Novemberbaby
Posted by Beachgirl59
Posted by Novemberbaby
Just called GHI today and apparently NYC employees are not eligible for the new federal law, Due to some grandfather clause.
So Bloomberg is mandating that all woman breast fed and NYC employees can't even participate in the new Federal law.
Ugh that sucks. I have GHI also
It only matters if you are a NYC employee if you aren't GHI will cover it
This sucks I am a teacher in nyc too in a charter school.
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| Posted 8/29/12 9:12 PM |
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maryb
LIF Adult
Member since 6/08 914 total posts
Name:
Mary
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Re: Breast Pump coverage
I also have United Health Care.
I had my twins last wed (at 32 weeks) and they are in the NICU for some time.
I will say - the insurance co didnt really help us with where to go to rent one - only have certain pharmacies they work with. We had to find out about prescription. They do cover $500 worth - its $75 a month to rent a hospital pump. It was an annoyance to deal with while trying to be in NICU and with the babies.
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| Posted 8/30/12 7:49 AM |
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cjb88
Little Brother
Member since 5/05 3540 total posts
Name:
C
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Re: Breast Pump coverage
I know this is an older post, but I just recently heard about this, and with new pregos coming on, I thought it was helpful info since the new year is here... I just called my insurance company (Empire NYSHIP) and with my other pregnancies I was not covered, but now I am as of tomorrow!! I'm so excited! 
eta: just have to contact one of these companies and they will set me up:
Double-Electric Breast Pump Suppliers:
Edgepark: 1-800-321-0591 or www.edgepark.com
Genadyne: 1-800-208-2025 or www.genadyne.com
Message edited 12/31/2012 1:23:26 PM.
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| Posted 12/31/12 1:22 PM |
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want2bemom
LIF Toddler
Member since 9/12 476 total posts
Name:
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Re: Breast Pump coverage
Is this still not covered under GHI? I am a NYC teacher
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| Posted 1/1/13 10:55 AM |
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NewMrsG
Love my GiGi
Member since 12/11 1442 total posts
Name:
Mrs. G
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Re: Breast Pump coverage
Posted by want2bemom
Is this still not covered under GHI? I am a NYC teacher
I just got a second follow up call saying that its not covered unless medically necessary. Meaning if the baby is in the nicu or has something else going on.
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| Posted 1/1/13 10:57 AM |
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want2bemom
LIF Toddler
Member since 9/12 476 total posts
Name:
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Re: Breast Pump coverage
Posted by NewMrsG
Posted by want2bemom
Is this still not covered under GHI? I am a NYC teacher
I just got a second follow up call saying that its not covered unless medically necessary. Meaning if the baby is in the nicu or has something else going on.
Oh nooooo ur kidding Wow, that really does suck. How much do breast pumps cost?
Also, is there a website with the codes on it?
Message edited 1/1/2013 11:11:08 AM.
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| Posted 1/1/13 11:01 AM |
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NewMrsG
Love my GiGi
Member since 12/11 1442 total posts
Name:
Mrs. G
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Re: Breast Pump coverage
Posted by want2bemom
Posted by NewMrsG
Posted by want2bemom
Is this still not covered under GHI? I am a NYC teacher
I just got a second follow up call saying that its not covered unless medically necessary. Meaning if the baby is in the nicu or has something else going on.
Oh nooooo ur kidding Wow, that really does suck. How much do breast pumps cost?
Also, is there a website with the codes on it?
[/QUOTE
You can check babies r us or buy buy baby for different pumps and pricing on them. It depends on if it is manual or electric or if it is single or a double pump. I don't know if there is a website with codes....I just know I called one of the places GHI used and this was the info they gave me.
Message edited 1/1/2013 12:20:31 PM.
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| Posted 1/1/13 12:20 PM |
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Re: Breast Pump coverage
I called my insurance co yesterday to get more info about this. I have cigna and was clear that I'm early and not due until summer. They told me that I cant apply for a pump until the babies are born and my dr will need to send a prescription for it as well as a medically necessity code. If so, it would be covered. They use edge park and said once it was in process I could contact them to see about getting a specific one if I wanted it, as long as it was one of the approved ones. Hope this info helps someone!
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| Posted 1/1/13 3:02 PM |
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