Most insurance plans now cover breast pumps and lactation consultants--here's what you need to know.
Mamas, rejoice: A provision of the Affordable Care Act requires insurance companies to provide copayment-free lactation consulting and breast pumps. But since the law is fairly new, you might lock horns with your insurance provider over what you're entitled to. Three key questions to ask your insurer:
- Is my plan grandfathered under the Affordable Care Act? Some plans, many with lactation services provisions, existed before the ACA went into effect on March 23, 2010; if no significant changes have been made since that time, the plan is "grandfathered," or exempt from many of the new ACA mandates, unfortunately.
- What's your policy for covering breast pumps as a service? Talk to your health care provider about whether you'll rent or buy a pump and which kind of pump you need—then call your insurance and find out how, given your specific situation, you can obtain the device. "The ACA does not require women to have a prescription to obtain a pump, but some insurers require it for reimbursement purposes," notes Mayra Alvarez, associate director of the Office of Minority Health at the Department of Health and Human Services.
- Do you cover the pump I want? "If not, ask what the options for recourse are," says Alvarez. You may be able to get partially reimbursed for it. The National Women's Law Center has sample letters to send to your insurance provider should you encounter problems.
Related: How to Use a Breast Pump—Properly