Insurance FAQs

FAQs – Benefits and Product Coverage

1. What breastfeeding products and lactation services are covered by health insurance?

Each health insurance plan is different. Check with your health plan or Medicaid to find out about your coverage. Under federal regulations, many health insurance plans must pay for breastfeeding counseling and breast pumps. Learn More

2. What questions should I ask my health insurance plan?

The National Women’s Law Center has a toolkit to talk to their health insurance provider about their plans.  Here are a few questions that we suggest:

a.       Are breastfeeding supplies and counseling covered by my health insurance?

b.       Will I need to pay for anything out of pocket, like a deductible or co-insurance for breastfeeding counseling or supplies?

c.       How do I find a lactation consultant that is on my health plan’s list (or “in-network”)?

d.       How many visits to a lactation consultant will my insurance cover?

e.       How do I order my breastfeeding equipment or supplies?

f.        What breast pumps and supplies are available under my benefits?

g.       Will I need a prescription from my doctor to order my breast pump?  Is there anything else I will need to order my breast pump or supplies?

h.       Do I have to be a certain number of weeks into my pregnancy before I order?

3. Will I need to pay anything out of pocket for the breast pump and/or lactation counseling?

Some health insurance plans ask for a deductible and/or co-insurance. Please contact your health insurance plan to ask about your benefits.

4. Where can I find more information on breastfeeding benefits and support?

For more information on breastfeeding benefits please visit the National Women’s Law Center or The Department of Health and Human Services Health Resources and Services Guidelines (HRSA).

FAQs - Ordering My Breast Pump

1. How can I order an insurance-covered breast pump?

The first step is to call your health insurance plan to ask about your benefits for a breast pump and what is required. Some health insurance plans ask that you have a prescription from your doctor and order your breast pump through a durable medical equipment provider (DME) on their list. After you learn about your benefits, visit our website at www.breastfeedinginsurance.com to locate a list of Medela suppliers that may be contracted with your health plan.

2. Will I need a prescription to order my breast pump through insurance?

Each health insurance plan is different.  Call your health insurance plan to find out what is required.  If a prescription is required, contact your healthcare provider to write you a prescription prior to placing your order.

3. Do I have the option to upgrade my breast pump set and add accessories? 

All health insurance plans are different. First, check with your health insurance plan.  Next, check to see if the durable medical equipment provider (DME) will allow you to pay out of pocket to upgrade your breast pump. During the order process, you can ask what upgrade and accessory options are available at the time of purchase.

4. Can I use my pre-tax funds (like Flexible Spending Account (FSA), Health Savings Account (HSA) or Health Reimbursement Account (HRA)) to pay for upgrades and accessories?

You may be able to use pre-tax funds to pay for a pump upgrade, new parts or breastfeeding accessories. Check with your employer or account administrator to verify your benefits.

5. If my healthcare provider sends a prescription for me to the durable medical equipment Provider (DME), what do I need to do to process my order?

Please contact the breast pump supplier where your healthcare provider sent the prescription to place your order.

FAQs – Additional Questions

1. Am I able to order replacement parts for my Medela breast pump?

Yes. Replacement parts are available at www.medelabreastfeedingus.com. Some health insurance plans include coverage for some replacement items.  Please check with your health insurance plan to learn about your benefits. You may also be able to use your FSA or HSA card to buy replacement parts.  Call your FSA or HSA administrator for more information.

2. What do I do with my Medela breast pump once I am done using it?

Recycle! Medela Recycles is a breast pump recycling program that supports Medela's commitment to the environment.

Learn more at MedelaRecycles.com.

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