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wantsababy
LIF Adolescent
Member since 10/09 560 total posts
Name:
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empire blue cross/sheild
any one of here have empire blue cross/bluesheild for insurance and get a breast pump covered with insurance??
if yes were you able to pick the pump of your choice?
i know the insurance covers pumps just wondering if i can get the medela freestyle one..
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Posted 1/27/10 10:30 AM  |
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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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Re: empire blue cross/sheild
i have Empire BC/BS and they cover it at 100%. I wasn't given any guidelines on what to pick and i'm just waiting to see if my doc will sign off on it!
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| Posted 1/27/10 10:33 AM |
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wantsababy
LIF Adolescent
Member since 10/09 560 total posts
Name:
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Re: empire blue cross/sheild
yeah what is that about i called one place today and they have to call me back but did say i needed a presciption..
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| Posted 1/27/10 10:36 AM |
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maymama
my little loves
Member since 8/08 18453 total posts
Name:
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Re: empire blue cross/sheild
Posted by jennarose023
i have Empire BC/BS and they cover it at 100%. I wasn't given any guidelines on what to pick and i'm just waiting to see if my doc will sign off on it!
really? i have empire bc/bs too and didnt even think of calling to find out. i am still debating BF but this is good to know. How do you arrange it? is there a number to call? 
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| Posted 1/27/10 10:42 AM |
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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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Re: empire blue cross/sheild
Posted by mrskparetta
Posted by jennarose023
i have Empire BC/BS and they cover it at 100%. I wasn't given any guidelines on what to pick and i'm just waiting to see if my doc will sign off on it!
really? i have empire bc/bs too and didnt even think of calling to find out. i am still debating BF but this is good to know. How do you arrange it? is there a number to call?
empire gave me edgepark 800-321-0591 since they are an in-network supplier...called them they took my info and are doing all the leg work. all i had to do was give them my doc & ins info and tell them which pump i wanted (medela pump in style - shoulder bag)
really easy 
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| Posted 1/27/10 10:44 AM |
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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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Re: empire blue cross/sheild
Posted by wantsababy
yeah what is that about i called one place today and they have to call me back but did say i needed a presciption..
if you have empire call edgepark (see my previous post) 
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| Posted 1/27/10 10:44 AM |
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wantsababy
LIF Adolescent
Member since 10/09 560 total posts
Name:
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Re: empire blue cross/sheild
i was gonna do the shoulder bag one but i figured if im not paying for it why not get the best one, the freestyle is same as pump in style but its hands free so it would make it easier
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| Posted 1/27/10 10:45 AM |
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Sunday
In love with a boy named Luca
Member since 6/09 1799 total posts
Name:
`
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Re: empire blue cross/sheild
I went through this all last week-
It all depends on ur plan within Empire- some people r covered 100%, some not at all, some in between.
I was covered 50% and my out of pocket for the Freestyle would have been $116 (the starting price is different for a med supplier than it is for us in a baby store) BUT my Dr. would not sign off on it unless it was medically necessary- i.e. baby in the NICU, etc.
The Edpe Park rep told me some Drs will just sign without a question and some just won't- which is the truth b/c some girls on here just got it and others did not- but "medical necessity" is supposed to be present (although I don't know how much room Drs have to interpret that).
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| Posted 1/27/10 12:10 PM |
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SecretTTCer
LIF Adult
Member since 6/08 2284 total posts
Name:
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Re: empire blue cross/sheild
I have Empire BCBS and that pump cost be only $24. But you need to check with your individual plan.
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| Posted 1/27/10 12:14 PM |
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Re: empire blue cross/sheild
Does your OBGYN have to sign off or can a pedatrician sign off?
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| Posted 1/27/10 1:32 PM |
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MaMaTeenie
Party of 5
Member since 4/08 6489 total posts
Name:
Mommy
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Re: empire blue cross/sheild
I have empire bc/bs, they covered 100 percent, no medical reason required. I was able to pick any pump carried by a durable medical supply co. I dealth with edge park medical supply over the phone (they are in Ohio, I'm in NY). I just received my free freestyke yesterday.
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| Posted 1/27/10 1:39 PM |
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maymama
my little loves
Member since 8/08 18453 total posts
Name:
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Re: empire blue cross/sheild
wow, thanks for all the info girls!
too funny, maybe its a sign but I actually had a dream last night about shopping for a pump for BF ... and I am still undecided. maybe someone is telling me I should try it 
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| Posted 1/27/10 1:42 PM |
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wantsababy
LIF Adolescent
Member since 10/09 560 total posts
Name:
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Re: empire blue cross/sheild
i just called edgepark and they said no prescription needed they just call my insurance and dr and get back to me within 48hrs to let me know if all is ok then i can pick a pump. im hoping to get the medela freestlye as well :)
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| Posted 1/27/10 1:55 PM |
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Sunday
In love with a boy named Luca
Member since 6/09 1799 total posts
Name:
`
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Re: empire blue cross/sheild
Posted by wantsababy
i just called edgepark and they said no prescription needed they just call my insurance and dr and get back to me within 48hrs to let me know if all is ok then i can pick a pump. im hoping to get the medela freestlye as well :)
That "phone call" to the Dr. is the part where he needs to sign off on it. They phrased it like this to me as well- "not an Rx"- just "a call". I THOUGHT (wrongly) that the call was just to verify I am a patient/pregs/etc.
For the PP that got it no prob- I think that for insurance to cover ANYTHING it needs to be "medically necessary"- it's just in how that is interpreted and whether or not ur Dr. is willing- and urs (LUCKILY :) was.
Message edited 1/27/2010 2:04:24 PM.
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| Posted 1/27/10 2:02 PM |
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MaMaTeenie
Party of 5
Member since 4/08 6489 total posts
Name:
Mommy
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Re: empire blue cross/sheild
Posted by BrinaEsq
For the PP that got it no prob- I think that for insurance to cover ANYTHING it needs to be "medically necessary"- it's just in how that is interpreted and whether or not ur Dr. is willing- and urs (LUCKILY :) was.
That very well may be, but I did ask the member services person at Empire when I called. Does there have to be a medical reason? NO Is there a co-pay? NO. Deductible? NO so I am going off what Empire told me not edge park. Edgepark told me they needed my Dr's info to confirm that I am infact pregnant. Every policy is written differently .... I'm not sure what the Dr would be able to sign off on at this point. I mean the Dr couldn't say now that the baby will be in NICU. KWIM?
Anyway, regardless of any of that its worth trying
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| Posted 1/27/10 2:17 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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Re: empire blue cross/sheild
Posted by BrinaEsq
Posted by wantsababy
i just called edgepark and they said no prescription needed they just call my insurance and dr and get back to me within 48hrs to let me know if all is ok then i can pick a pump. im hoping to get the medela freestlye as well :)
That "phone call" to the Dr. is the part where he needs to sign off on it. They phrased it like this to me as well- "not an Rx"- just "a call". I THOUGHT (wrongly) that the call was just to verify I am a patient/pregs/etc.
For the PP that got it no prob- I think that for insurance to cover ANYTHING it needs to be "medically necessary"- it's just in how that is interpreted and whether or not ur Dr. is willing- and urs (LUCKILY :) was.
yup even if Empire tells you it's covered at 100% breast pumps are paid for only if deemed "medically neccesary" and then that depends on your doc...i placed my order last thursday and still no response from my doc...i have an appt next wk so i'll talk to her about it then. It really all lies in the hands of our docs
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| Posted 1/27/10 2:18 PM |
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