If you’re in the US, you may have heard that breast pumps are covered by your health insurance. If you’re pregnant and planning to breastfeed, here’s how to easily get a free breast pump through insurance!
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How to get a free breast pump through insurance
I thought that getting a breast pump through insurance would be a giant hassle – who wants to deal with the red tape of an insurance company? I almost didn’t even bother.
But it’s actually really easy!
I would recommend skipping dealing with your insurance company altogether and go right to a medical device company that provides breast pumps. Aeroflow Breastpumps is who I recommend.
All you have to do is fill out this form, and they take it from there – they contact your insurance, get the prescription from your doctor, see what you qualify for, and help you pick out a pump.
What breast pumps are free through insurance?
It depends on your insurance policy.
Some policies cover rental of a hospital grade pump like the Medela Symphony, others cover a double electric pump like the Spectra S2, and others cover a manual pump like the Lansinoh Manual Breast Pump.
How do you find out which pumps your insurance covers?
After you contact a medical device company that your insurance works with, they will contact your insurance company and find out what breast pumps are covered by your policy.
They will then let you know what your choices are.
Anecdotally speaking, most policies seem to cover a “basic” (but effective) double electric pump. Examples of pumps that are often covered include the Medela Pump in Style with Max Flow, Spectra S2, and Motif Luna.
These breast pumps work great and get the job done, but they don’t always have all the bells and whistles of some more expensive pumps.
What if the pump you want isn’t covered?
In some cases you can upgrade and pay the difference.
For example, if you want a Spectra S1 for the rechargeable battery, but your insurance only covers an S2, you may be able to just pay for the difference in the cost of the two pumps.
Some medical device companies call this an “upgrade option” – just ask the medical device customer service if this is an option for you.
(Breast pump not covered by insurance? Here’s what to do.)
Do you need a prescription to get a breast pump through insurance?
Yes, but in most cases, the medical device company you work with will take care of contacting your health care provider to obtain the prescription for you.
How long does it take to get your breast pump through insurance? When should you get your pump?
It depends on your policy and medical device company.
Some insurance companies will not get you your pump until your baby is born. (Which isn’t ideal for people who plan on exclusively pumping from birth or who end up having a baby in the NICU!)
However, others will provide it within a few weeks of the request, before your baby’s birth.
It may make sense to go ahead and start the process now to ensure that you have the pump when you need it, and aren’t trying to pick a pump when you’re a sleep-deprived parent of a newborn.
What are the breast pump coverage requirements under the Affordable Care Act?
The Health and Human Services department issued the following guidance on what is required by the Affordable Care Act:
Your health insurance plan must cover the cost of a breast pump. It may be either a rental unit or a new one you’ll keep. Your plan may have guidelines on whether the covered pump is manual or electric, the length of the rental, and when you’ll receive it (before or after birth).
The only situation where this rule does not apply is if you have a grandfathered plan.
Grandfathered plans are plans that were in place on March 23, 2010 and have not changed substantially since then. (By now, in 2021, it’s unlikely that you have a grandfathered plan, but it’s still worth checking.) Your insurance company must notify you if you have a grandfathered plan.
The rules do not vary by state, so your insurance company needs to cover a pump regardless of where you live.
Your insurance company is not allowed to charge you a deductible or co-pay for your breast pump.
My experience getting a breast pump from my insurance
With my third baby, I was able to get my own breast pump through insurance when I was eight months pregnant.
As I noted above, it was really easy – I found out on my insurance company’s website which medical device provider they worked with, and went to the website.
After I specified my insurance company and policy number, the medical device company told me which pumps I could choose. I picked a Medela Pump in Style, and placed the order.
After that, I got an email from the company saying they would verify my coverage with my insurance company and my pregnancy with my doctor. And about three weeks after that, my pump arrived.
I didn’t have to speak with anyone on the phone or follow up or anything!
Here’s what I received:
Included was the pump, tubing, two bottles, two sets of pump parts, and some Medela breast pads.
I felt really lucky to get this pump through insurance and have the process be so easy. Because I had already bought a breast pump for my first child, I was able to leave that pump at home and leave this one at work, which made commuting much easier.
Ready to get started? Find out what you qualify for here.
Feel free to share your experience and any tips you have for how to get a breast pump through insurance below!
References- 111th Congress. “Compilation of Patient Protection and Affordable Care Act.” https://housedocs.house.gov/energycommerce/ppacacon.pdf
- Health Resources and Services Administration. “Women’s Preventative Services Guidelines.” https://www.hrsa.gov/womens-guidelines/index.html
- Healthcare.gov. “Breastfeeding Benefits.” https://www.healthcare.gov/coverage/breast-feeding-benefits/
- Healthcare.gov. “Grandfathered health insurance plans.” https://www.healthcare.gov/health-care-law-protections/grandfathered-plans/
- Medela. “Coverage Questions You Should Ask Your Insurance Company.” https://www.medelabreastfeedingus.com/tips-and-solutions/138/coverage-questions-you-should-ask-your-insurance-company
- Medela. “What Does My Insurance Company Cover?” https://www.medelabreastfeedingus.com/tips-and-solutions/166/what-does-my-insurance-company-cover#Infographic
Comments & Chitchat
My wife is going to be having a child in the next month and we are now scurrying to make sure we have everything ready for when she delivers the baby. I was unaware that breast pump rentals must be covered by insurance. I’ll have to check with my insurance company to make sure that we do not have a grandfathered plan so that we do not have to worry about paying anything for a breast pump machine.
Anyone looking for an electric single or double breast pump through insurance. Please go through website Aeroflow.com. They do all of the calling and paper work for you. You just fill out a few questions regarding your name, phone number, address, name of your insurance, and member policy number. Then pick a pump from their site. Gets delivered right to your door. No sooner than 60 days prior to your delivery date. A breast pump is covered with each pregnancy. Every 30 to 60 days through your email they send a link to summit for a resupply kit of parts and storage bottles for your pump of no charge to you. I’ve had two babies recently. One in 2015 and one 2016. I’ve received the Medea pump in style starter set double electric pump with each pregnancy and 7 kits so far. All the supplies you ever need they’ll replenish when need be. I use one pump to pump at work and one pump I keep set up at home. I tell everyone I know that’s expecting about my convenient great experience with them. So check out Aeroflow.com and skip the stress. Let someone else do the work for you.
Oh, a topic that is quite applicable to me right now! I just had the company that I rent my hospital grade pump from submit claims for each month that I have rented. I am waiting to see what my insurance company does with them. They gave me the impression that they would deny my claims, but that I could utilize their appeal process, since a customer service representative apparently misinformed me that the pump coverage is “per calendar year” not “per pregnancy,” despite having a prescription from my provider stating that it is a medical necessity. I have even found in the insurance company’s literature online that the coverage is “per calendar year.”
Some background on my situation…My baby was born in September. Aware of the Affordable Care Act, I had called months prior and was given a list of “in-network” medical supply companies that could provide a Medela double electric pump at no cost to me. I called and had everything all set up, including a prescription from my provider stating that I needed a double electric pump. But I could not order until 30 days within my due date. So September 1st rolled around and I faxed all of the necessary information to the medical supply company, assuming all went through. I got an automated message on my voicemail to call the company because they needed more information to complete my order. When I called, they said that their contract had changed with my insurance company and they were no longer “in-network.”
So, another call to my insurance company. I was given a list of local and non-local “in-network” medical supply companies to call. Most did not carry breastpumps and others did not have electric pumps, let alone the Medela double electric pump that I was hoping for. So, more calls to my insurance company and more calls to medical supply companies. FINALLY, I spoke with a customer service representative from my insurance company who STAYED ON THE LINE and had a three way call with myself and the company on the other side of the country that apparently was going to come through for me. By this time, I was getting nervous as my due date was fast approaching. Miracle of all miracles, I faxed this new company all of the necessary information. And I even had a NAME and DIRECT LINE for the representative at the company that helped me. But no pump arrived… Finally, I was in the hospital and had an emergency C-section after developing HELLP syndrome after a completely normal pregnancy. Lying sleep deprived in my hospital bed, I called the company on the other side of the country to be sure that my pump would be on my front porch when I went home. “OH, there was a problem with billing my insurance company? Thanks for letting me know… BUT, it will be there when I get home from the hospital because you will rush it to my home? Thank goodness!” Of course, no pump was waiting for me when I got home! My Mom, who flew out to help us in our crisis birth situation, went to the local grocery store to buy an overpriced single electric pump for me. I was engorged, hormonal, and my baby would not latch…AND sure enough, my pump arrived a week later. But my baby was already losing weight…and my milk supply was nearly gone from using a nipple shield WITHOUT AN ADEQUATE PUMP to maintain my supply.
After trying everything to get my baby to latch including visits with lactation consultants and specialists (the later which were quite expensive), it was clear that I would have to choose to exclusively pump or give my baby formula. I chose the first. Reading my pump instruction manual while pumping, I read the unfortunate sentence, “Do not use this pump if you plan to pump exclusively…” SO…I contacted my lactation consultant who referred me to a medical supply company in that town to rent a hospital grade pump. And thankfully, they had just gotten one returned that day! The employee would fine tune it and I could pick it up that day! Thank goodness. $60 a month seemed like a small price to pay at that point. As if we had not been through enough, after making the hour trip to get my new rental pump, I got home and read the instructions, set it up, and tried it. A few minutes into my pumping session, ERROR! I called Medela, who stated that my new pump needed to be sent back to Medela for repair. I spoke with the company that I rented the pump from and she said, “Hmmmm…I thought there might be something wrong with it” (although she failed to mention that). Several days later, the company delivered a new working pump to me. I think the employee realized I was at the end of my rope and could not physically or emotionally make the trip through the mountain pass in the middle of winter to pick it up myself.
Life has thankfully slowed down a bit. My pump works, my milk supply is plentiful, and my baby is plump and healthy. Looking back, I truly think my story would have been different if I had purchased a pump myself. As a first-time mother whose birth situation was less than ideal, I could have done without the extra stress and time required to communicate with my insurance company and medical supply companies. And now, I am still stuck with the financial burden of renting the pump that I need.
Thank you for reading my story. It is clearly something that I still harbor some feelings of bitterness about. But sharing my story helps to lift that weight from me and move on!