breast pump health insurance breastpump medela

Your Health Insurance Must Cover Your Breast Pump

Your insurance company must provide you support, counseling, and equipment for the duration of breastfeeding.  This applies to marketplace plans as well as all other health insurance plans.  The only exception is if you have a “grandfathered plan”.  (Click here for information on grandfathered plans)

Coverage for Nursing Pumps 

Your health insurance may have restrictions on whether you buy or rent, what type of breast pump they cover, and when you will get it (before or after the baby is born),but one thing does not differ: they are required to provide you with breastfeeding equipment.  Ultimately, you and your doctor are in control of what is best for you in your breastfeeding plan.

Your Doctor’s Role

Insurance companies are at the mercy of doctor’s recommendations.  This means that it is important that you and your doctor discuss and document your plan to breastfeed well before your baby is born.  To make the process as efficient as possible, find out what is required of you and your doctor from your insurance company and come to your doctor’s office prepared.  Since insurance companies are generally big fans of paperwork, have any required forms with you when you see your doctor.  Insurance companies may also require a pre-authorization from your doctor.  Know the process so that you can get the necessary paperwork to your doctor.

 If Insurance Uses Open Enrollment Rules to Deny Your Nursing Pump

Sometimes the insurance company will attempt to avoid paying for your breast pump by claiming that Open Enrollment is not in effect and that your pump is not for you, but for a “new dependent”.  If this happens, know that having a baby qualifies you for a “Special Enrollment Period” (SEP).  This means that they are not allowed to deny the coverage due to Open Enrollment timelines.

Comparing Good Breast Pumps

The breast pumps below are high-quality, reliable breast pumps to start your baby off right.

To stay in the know about breast pump supplies and breastfeeding articles:

One thought on “Your Health Insurance Must Cover Your Breast Pump

What are your thoughts?