How to Get a Medela Breast Pump Through Insurance

Why Get a Medela Breast Pump Through Insurance?

A breast pump is invaluable for breastfeeding moms who may be away from their baby but want to continue providing their breast milk. With a quality pump, women can continue maintaining their milk supply and expressing milk for their baby to meet their personal goals or the expanded recommendations of breastfeeding for 2 years and beyond from the American Academy of Pediatrics.

Obtaining a Breast Pump Through Insurance

Health insurance plans or Medicaid must cover the rental or purchase of a breast pump, with very few exceptions of grandfathered plans. Under the Affordable Care Act (ACA), health insurance plans are required to cover support, counseling, and equipment for the duration of breastfeeding. Every insurance plan has different guidelines and requirements that must be met prior to covering the cost of a breast pump rental or purchase. The types of pumps covered may also differ, so it may be beneficial to make a few calls early in your pregnancy to inform yourself and fully understand the when, what, where and how when it comes to obtaining your insurance-covered breast pump.

• It’s no secret that caring for a newborn can get costly! Applying for a breast pump through your insurance plan can provide substantial savings. Plus, the stronger your breastfeeding relationship is and the more you express your milk, the less need for expensive supplementation options.
• Insurance coverage isn’t limited to just manual or older style breast pumps! You likely have access to double-electric personal use pump options, including those in the Medela portfolio.
• Sometimes your insurance plan will allow you to upgrade to a more expensive pump. If you choose to upgrade, you may be responsible for a portion of the total cost.

How to Order a Medela Breast Pump Through Insurance

We’ve made it ultra-convenient to navigate the ins and outs of getting your insurance-covered breast pump! Whether you’re planning for your baby’s arrival soon or you’ve recently welcomed a bundle of joy, we know time and energy may be scarce. Utilize Medela’s Insurance Concierge to check the insurance-covered breast pump off that to-do list without the stress. This simple, free service will help you get a Medela breast pump through insurance in just a few easy steps.

1. Conduct some research to determine what Medela pump might best fit your needs. Consider things like where you’ll use the pump (At home? At work? While traveling?), how often you plan to pump each day and how much flexibility you need while pumping.
2. Contact your health insurance provider to inquire about breastfeeding benefits available to you and whether you first need a prescription for your breast pump through a durable medical equipment (DME) provider on their list.
3. Complete our quick Insurance Concierge questionnaire.
4. If you’re interested in upgrade options, follow the prompt during your ordering process. If you have questions, our award-winning Customer Excellence team is available via phone or chat to help.

That’s it – Simple as that! Just be sure to also be aware of the following:

• If you’re part of a non-participating health plan, no worries! We’ll connect you with one of our qualified suppliers.
• You may be able to use FSA, HSA, or HRA funds to pay for a breast pump upgrade, extra parts and breastfeeding accessories.

All Medela Breast Pumps Feature Innovative Design and Technology

• Science-Backed Innovation: Whether you opt for a manual or electric pump (or both!), all Medela breast pumps feature 2-Phase Expression^® technology that closely mimics a baby’s natural sucking rhythm.
• Closed Systems: All Medela breast pumps are also designed with a “closed” barrier system to prevent milk from overflowing into the pump mechanism.
• PersonalFit Flex™ Technology: Our unique oval shields are clinically proven to increase milk volume by 11.8%* for more milk in less time. They also feature a 105-degree opening and soft rim for a more comfortable experience.
• Intuitive Speed and Vacuum Settings: With combined speed and vacuum settings – pre-programmed based on extensive clinical research – you can take the guesswork out of pumping and find the level and suction that works best for you.

FAQs About Getting a Medela Breast Pump Through Insurance

Here’s more guidance from our team to help you through the process of getting an insurance-covered breast pump:

Does my insurance plan have to cover the cost of a breast pump?
Yes, unless your plan is classified as a grandfathered plan. These plans aren’t required to comply with certain parts of the ACA. However, if you are denied coverage due to being part of a grandfathered plan, you have the right to appeal.

When should I start the process with my insurance to get a pump?
We recommend starting as early as possible. Keep in mind that insurance providers have different guidelines about when your breast pump can be ordered. Generally speaking, a good time to start the ordering process is in your third trimester.

Do I need a prescription to get a breast pump through insurance?
Maybe. Some insurance providers require a prescription or preauthorization to get a pump. Ask early, so you’re not stuck scrambling at the last minute to get the pump you want!

Do I get to choose the pump I want?
Each healthcare plan is different, so some may offer just a few options while others may offer a wider range of choices.

Will my insurance plan cover a second breast pump?
A second pump, especially a manual back-up option or a portable double-electric pump for on the go, can be handy to keep at work or when traveling. Most likely, however, a second pump will not be covered by insurance.

Insurance is, though, required to cover a pump for each pregnancy/child.

Do I need to get my pump within a certain timeframe for it to be covered?
Yes, you must apply for a pump either while pregnant or sometime during your breastfeeding journey with each child.

*Clinical studies, PersonalFit Plus compared to PersonalFit data on file.