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Maybe-Baybe
My Sunshine
Member since 7/12 3415 total posts
Name:
My only Sunshine
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GHI breast pump insurance
Just called and they said it's not covered unless medically necessary like if the baby has congenital conditions or birth defects.
Has anybody been able to get breast pump coverage from them otherwise?
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Posted 5/21/13 11:43 AM  |
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KaKa2323
Got my miracle
Member since 9/11 1465 total posts
Name:
K
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GHI breast pump insurance
Sorry to crash but my SIL has GHI and I work for her doctor. We just gave her a script that said "breast pump" and it was covered no problem.
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| Posted 5/21/13 12:01 PM |
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missfabulous
#mommyneedswine
Member since 6/09 10031 total posts
Name:
Colleen
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Re: GHI breast pump insurance
Posted by KaKa2323
Sorry to crash but my SIL has GHI and I work for her doctor. We just gave her a script that said "breast pump" and it was covered no problem.
I got a script that said 'breast pump' and GHI would still not cover it.
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| Posted 5/21/13 12:22 PM |
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blu6385
Member since 5/08 8351 total posts
Name:
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Re: GHI breast pump insurance
dont have GHI but i thought by law now insruance companies have to cover breast pumps
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| Posted 5/21/13 12:32 PM |
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Maybe-Baybe
My Sunshine
Member since 7/12 3415 total posts
Name:
My only Sunshine
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Re: GHI breast pump insurance
Posted by KaKa2323
Sorry to crash but my SIL has GHI and I work for her doctor. We just gave her a script that said "breast pump" and it was covered no problem.
Thanks, I'll try that. I have an appointment in 2 weeks so I'll definitely ask my doc.
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| Posted 5/21/13 12:38 PM |
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Maybe-Baybe
My Sunshine
Member since 7/12 3415 total posts
Name:
My only Sunshine
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Re: GHI breast pump insurance
Posted by missfabulous
Posted by KaKa2323
Sorry to crash but my SIL has GHI and I work for her doctor. We just gave her a script that said "breast pump" and it was covered no problem.
I got a script that said 'breast pump' and GHI would still not cover it.
Wow, that stinks. I wonder why that some people can get it and some people can't. So messed up!
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| Posted 5/21/13 12:38 PM |
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cateyemm
Twins!
Member since 7/10 8027 total posts
Name:
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Re: GHI breast pump insurance
Posted by missfabulous
Posted by KaKa2323
Sorry to crash but my SIL has GHI and I work for her doctor. We just gave her a script that said "breast pump" and it was covered no problem.
I got a script that said 'breast pump' and GHI would still not cover it.
Yup. Are you in a large group like a union plan? The y are exempt from ACA. I was only able to get one if dc wsas in a nicu or if I had twins (which I did)
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| Posted 5/21/13 12:39 PM |
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Maybe-Baybe
My Sunshine
Member since 7/12 3415 total posts
Name:
My only Sunshine
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Re: GHI breast pump insurance
Posted by blu6385
dont have GHI but i thought by law now insruance companies have to cover breast pumps
They should be IMO.
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| Posted 5/21/13 12:39 PM |
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luvmotherhood
california dreamin'
Member since 2/13 1443 total posts
Name:
love my family!
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GHI breast pump insurance
my GHI plan said they had a grandfather clause therefore they were not required to cover it under obamacare. FLUCKERS!
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| Posted 5/21/13 4:50 PM |
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jessnbrian
Only God knows His plan for us
Member since 4/13 7238 total posts
Name:
Jessica
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GHI breast pump insurance
From a healthcare perspective, within each insurance company there are a million different plans (GHI has tons of plans, HIP has a ton, Empire BC/BS has more than anyone else, lol)... it will really depend on what your employer (or DH's employer) selected. If it's one of those things were the doctor can't get a prior authorization for it (ie the doctor calls and it's still not covered) what I would recommend is calling HR/Benefits coordinator and see what needs to be done to change this and if the company's enrollment period is before you need it you might be in luck and might be able to get it changed in time.
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| Posted 5/21/13 5:00 PM |
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stellabella
LIF Adolescent
Member since 8/10 805 total posts
Name:
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Re: GHI breast pump insurance
I have GHI thru my DH (NYC teacher) and they would not cover it. As far as the new law, they are grandfathered in somehow and don't have to cover it. I imagine if it is medically necessary there might be an exception, although they are very strict with that stuff. They wouldn't cover Alimentum for my daughter unless she was failing to thrive.
Message edited 5/21/2013 8:32:25 PM.
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| Posted 5/21/13 8:32 PM |
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missfabulous
#mommyneedswine
Member since 6/09 10031 total posts
Name:
Colleen
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Re: GHI breast pump insurance
Posted by luvmotherhood
my GHI plan said they had a grandfather clause therefore they were not required to cover it under obamacare. FLUCKERS!
This is why mine said they wouldn't cover it.
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| Posted 5/21/13 8:42 PM |
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JennB
My princess <3
Member since 5/09 2473 total posts
Name:
Jenn
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Re: GHI breast pump insurance
I'm so confused!!!! I called about a month or so ago and teh rep said it would be covered if I got a note from the doctor stating it was medically necessary. So I get the note (script) and call now this rep says well you have to buy everything first and then send us the note, and we will make a decsions then. What? Either you do or you dont!!! Anyone have a number to call for GHI beside the one on the card?
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| Posted 5/23/13 4:36 PM |
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Maybe-Baybe
My Sunshine
Member since 7/12 3415 total posts
Name:
My only Sunshine
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Re: GHI breast pump insurance
Posted by JennB
I'm so confused!!!! I called about a month or so ago and teh rep said it would be covered if I got a note from the doctor stating it was medically necessary. So I get the note (script) and call now this rep says well you have to buy everything first and then send us the note, and we will make a decsions then. What? Either you do or you dont!!! Anyone have a number to call for GHI beside the one on the card?
Me too. Sounds like they are giving you the run around. My DH had talked to some of his coworkers and they said it's not covered. I'm still going to try the Dr.'s note route anyway and see what happens.
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| Posted 5/23/13 5:57 PM |
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Kishelt
LIF Zygote
Member since 10/13 1 total post
Name:
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Re: GHI breast pump insurance
My husband is a nyc teacher. When I called ghi they told me it wasn't covered. Then I saw something about it being covered on the emblem health site (google ghi breast pump coverage). There's 3 dme providers listed. I called better living now. They told me it was covered by ghi. So I opened an account. They wanted a rx from my dr . So I submitted that and a letter of necessity (just in case)-saying pump was needed bc I would be returning to work after the birth (no dates). And I got a call today that they are covering, but I have to pay about. 95 out of pocket. Figured I'd share. Also if you go to the uft site they will reimburse for dme up to 100 per calendar year for ghi subscribers (fill out the claim form). So it's free!
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| Posted 10/2/13 10:06 PM |
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Providence718
LIF Adolescent
Member since 7/11 820 total posts
Name:
Jennifer
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GHI breast pump insurance
I am on the emblem health plan site now and the bottom reads
*Exclusions: This benefit does not apply to members enrolled in limited benefits coverage plans such as dental only and vision only, or grandfathered plans, such as all City of New York plans, certain Healthy New York plans and certain standard HMO individual direct payment plans. Manual and electric breast pumps are not part of the benefit package under the Family Health Plus plan.
Which means NYC teachers are out of luck .... I may try anyway
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| Posted 10/2/13 10:21 PM |
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