Is a Breast Pump Covered by Insurance? FAQs Answered

Is your breast pump covered by insurance? The Affordable Care Act (ACA) requires insurance plans to cover these types of devices. But this doesn't mean you automatically get a pump if you have insurance. If you're a first-time parent, take a look at the top free breast pump questions expectant mothers have answered.

Why Does Insurance Cover Breast Pumps?

According to the American Academy of Pediatrics (AAP), breastfeeding provides benefits to the child and mother. In children, these include some level of protection against common childhood illnesses (such as respiratory tract infections and otitis media), type 1 and 2 diabetes, leukemia, lymphoma, and obesity. Maternal health benefits may include decreased postpartum bleeding, earlier post-pregnancy weight loss, and a lower risk of ovarian or breast cancer.

The health benefits of breastfeeding make it necessary to support nursing mothers. The ACA and Patient Protection Act help women to breastfeed by making it possible to afford educational tools, counseling, and equipment (such as breast pumps).

Will the Insurance Cover a New Pump?

It's possible your insurance company will cover a new pump that you can keep. But it's also possible the plan will cover a rental. Even though your insurance plan needs to cover a pump, the ACA doesn't specify the type of equipment. This accounts for the differences in new and rental options. Contact your insurer with questions about which type of pump your policy covers.

What Type of Breast Pump Will Insurance Cover?

New and rental aren't the only two categories of breast pumps. The basic categories of pumps include manual, battery-powered, and electric. A manual pump is typically the least expensive option. Like the name says, these pumps require manual (or hand) power. A battery pump is the next step up in strength and convenience. These are easy to transport — but not as powerful as an electric/plug-in model.

Some plans cover hospital-grade equipment. These are typically rental electric double pumps that have a higher degree of suction than new (single-user) options. Hospital-grade pumps aren't always covered, or fully covered, by health insurance plans. Your doctor may need to provide a prescription or contact the insurance company for coverage. This may require documentation of medical necessity and specific diagnosis codes.

Where Can You Get a Breast Pump?

Talk to your insurer or a retailer before you buy or rent a breast pump. The company or your policy may only cover specific brands, manufacturers, or retailers. To get a breast pump covered by insurance contact a medical supplier near you.