Will My Health Insurance Cover a Breast Pump?

Since the passage and implementation of the Affordable Care Act (ACA), or Obamacare, many women have enjoyed increased healthcare benefits. Women in general have seen insurance rates more in line with their male counterparts now that insurance companies are no longer allowed to charge more for women who are pregnant or may become pregnant. Simply being a woman or being pregnant is no longer seen as a pre-existing condition.

In addition, mandatory essential coverage requirements include coverage for a variety of female reproductive health needs, such as annual well woman visits, mammograms and colonoscopies, STD testing and counseling services, FDA approved contraception, and more. Women now have more access than ever to affordable preventive care services.

In a bid to lessen the burden on underserved groups, including pregnant women and children, Obamacare also stipulates additional coverage for pregnancy. In some cases, pregnant women are eligible to take advantage of Medicaid coverage. However, certain services related to pregnancy, childbirth, and postnatal care are included in essential coverage for all health insurance policies.

For example, screening for gestational diabetes is provided for during the first prenatal visit and/or between 24 and 28 weeks of pregnancy. Additional essential coverage is extended to new mothers and may include services related to breastfeeding. Are breast pumps included in this coverage? Here’s what new mothers should know.

Breastfeeding Support
Many new mothers face a steep learning curve when it comes to caring for an infant. One of the most difficult challenges can be learning to properly breastfeed a baby.

In addition, many mothers are interested in ways to supplement breastfeeding. When the baby wakes every couple of hours to feed, it can be handy to have milk available so that dads or other family members can take over feeding duties while moms get a few hours of much-needed rest.

Many new mothers will also have to return to work eventually, some following a relatively short period of maternity leave. These women are interested in alternatives to breastfeeding, such as using a breast pump to express milk for later use. The good news is that Obamacare includes coverage for breastfeeding support, supplies, and counseling services.

What is Included?
According to the Obamacare Facts website, this coverage includes “Comprehensive lactation support and counseling by a trained provider during pregnancy and/or in the postpartum period, and costs for renting breastfeeding equipment.” This is available after every birth.

Are breast pumps included under “breastfeeding equipment”? The answer is, ostensibly, yes, although there may be certain restrictions.

While insurance coverage is required to pay for breast pumps as part of breastfeeding equipment, they have some latitude to decide whether they will cover purchase or only rental of such equipment. In addition, they may elect to restrict the purchase of new breast pumps to certain brands or models.

If you’re interested in obtaining a breast pump following childbirth, you’ll simply have to contact your insurance provider to find out exactly what is covered under your particular policy. You always have the option to forego the covered products and pay out-of-pocket for your preferred device.