Breast pumps and insurance coverage

[pinotgrig]

Has anyone done this yet? Mine was delivered today and I'm ridiculously excited to go home and see it.

I have bcbs insurance and they let me pick which model I wanted. I went with the medela pump in style advanced with the shoulder tote. I had to pay a $165 cost differential since it's a "premium" pump, but considering it's a $300-something pump I felt ok with that. And I was able to that with my fsa card.

All I did was call my insurance who put me in touch with the actual supplier and send them the RX from my ob. We handled everything via email after the initial phone call. Total process has taken about 1.5 weeks. I've been really pleasantly surprised at how smoothly the process has gone.

[smock]

That's awesome! I think my insurance specifies that you must be within 30 days of your due date to get a breast pump, so I'm planning to go through that process in like ten days (holy shit!!!). I'm also planning to get the PISA.

[SJ]

Yes, that's exactly what I did!

[Deleted]

Good to know. I still have many months to go, but it's helpful knowing I should reach out to the ins company before I'm even due.

[picksthemusic]

I can't have mine until I deliver. Boo. But I'm going to call my insurance to see if the provisions of the plan have changed since our plans changed this year.

[narockshard]

I got mine last week and it was completely free! Our insurance covers "one standard grade breast pump 100%" so I was able to get the Medela Pump in Style Advanced as well, although it looks slightly different than the one sold in stores (at least from the picture on the outside of the package, I haven't opened it up yet). It was a super easy process and I'm so thankful that it was completely covered.

[aqualuv]

Thanks for posting. I was apprehensive about going through my insurance since I wanted the Medela Freestyle Hands Free pump. On the list that Aetna gave me only Sunmed was able to offer me the breast pump where I pay the $150 difference from what my insurance covers (my insurance covers $250).

[laurack]

I got the Hygeia one free as well

I used a company called Acelleron. They deal with the insurance company for you. Just go to the website print form had midwife sign it and sent it back. A few days later my pump arrived in the mail. So easy!

I have blue cross blue shield. My other free options were Ameda purely yours and some basic Medela model. I still have my Medela PISA from my daughter so wanted to try something new.

[D2M]

Apr 22, 2014 15:41:39 GMT -5 narockshard said:

I got mine last week and it was completely free! Our insurance covers "one standard grade breast pump 100%" so I was able to get the Medela Pump in Style Advanced as well, although it looks slightly different than the one sold in stores (at least from the picture on the outside of the package, I haven't opened it up yet). It was a super easy process and I'm so thankful that it was completely covered.

That's what I ordered, too.  The company I went through won't ship it until 30 days before my due date (like smock, coming up in two weeks!) but I wanted to get the ball rolling, so my order's in.  I read that the insurance PISA is different from the regular retail PISA, but I haven't been able to figure out what exactly.  narockshard, does your insurance PISA come with a carrying case thingie?

[narockshard]

Apr 22, 2014 16:21:02 GMT -5 D2M said:

Apr 22, 2014 15:41:39 GMT -5 narockshard said:

I got mine last week and it was completely free! Our insurance covers "one standard grade breast pump 100%" so I was able to get the Medela Pump in Style Advanced as well, although it looks slightly different than the one sold in stores (at least from the picture on the outside of the package, I haven't opened it up yet). It was a super easy process and I'm so thankful that it was completely covered.

That's what I ordered, too.  The company I went through won't ship it until 30 days before my due date (like smock, coming up in two weeks!) but I wanted to get the ball rolling, so my order's in.  I read that the insurance PISA is different from the regular retail PISA, but I haven't been able to figure out what exactly.  narockshard, does your insurance PISA come with a carrying case thingie?

Yes, mine has a carrying case although it's different than the retail one. The lady from the place I got it said that after they run out of these the new standard model won't have a case or it'll have a smaller one or something like that. It doesn't look like mine has the little ice pack deal though. It's also listed on the box as the Medela "advanced personal double breastpump" so I'm hoping it's basically the same thing!

[bowies]

I put my order in a while ago with a third party supplier (called Yummy Mummy). I needed to cross something off my to-do list. I didn't even need a prescription - they deal directly with my insurance who cleared it already. The only unfortunate thing is that i sit in a queue based on my EDD, so if don't have it yet. I think I ordered the Medela Freestyle. I don't get a travel bag with it though.

[katinthehat]

I have United Healthcare (a PPO) and they won't ship until the baby has been born but do cover the cost of renting one while in the hospital.

I (like most people) dreaded calling them, but they were super helpful and very friendly on the phone. I have three suppliers that all offer slightly different options so I just need to figure out what I want and then I deal with the supplier and they file it with insurance.

[boscobee]

My insurance made the process pretty easy, I can purchase whatever pump I want from any retailer and submit the receipt to the ins co. They cover 100% up to $250, and will cover a hospital grade pump if I have a RX for one. I'm planning to also purchase the Medela PISA, probably from Amazon or Target as they both have them for $240ish plus taxes.

[robinsbff]

DH ordered mine which i found kinda funny. he just called insurance asked for one and it arrived in two days, so simple. no rx, no paperwork at all.

[mrspost08]

I have been told my insurance/hospital will give me one after I give birth. If the standard model doesn't work for me I need to see a lactation nurse (is that what they are called drawing a blank all of a sudden) and they can get me a hospital grade pump.

[IndiaInk]

Apr 22, 2014 15:26:45 GMT -5 tulips said:

That's great! I got a Hygeia Enjoye 100% covered from insurance for my son. The rule was that my doc could write the prescription for the pump at any time in 3rd tri, but the supplier house wouldn't "fill" it until the hospital confirmed the baby was born. My H picked it up a few days after he was born.

Do you like the Hygeia? That's the brand I am thinking of getting but it haven't seen much first hand knowledge from anyone on these boards.

I need to order mine! I've been so busy I keep forgetting!

[mannah]

Apr 22, 2014 17:15:12 GMT -5 bowies said:

I put my order in a while ago with a third party supplier (called Yummy Mummy). I needed to cross something off my to-do list. I didn't even need a prescription - they deal directly with my insurance who cleared it already. The only unfortunate thing is that i sit in a queue based on my EDD, so if don't have it yet. I think I ordered the Medela Freestyle. I don't get a travel bag with it though.

This is me EXACTLY. I was just starting to wonder when it would come... Maybe they wait till 30 days before the due date to ship?

[pitterwoo]

Mine will only cover a manual pump.

[bowies]

Apr 23, 2014 0:21:06 GMT -5 mannah said:

Apr 22, 2014 17:15:12 GMT -5 bowies said:

I put my order in a while ago with a third party supplier (called Yummy Mummy). I needed to cross something off my to-do list. I didn't even need a prescription - they deal directly with my insurance who cleared it already. The only unfortunate thing is that i sit in a queue based on my EDD, so if don't have it yet. I think I ordered the Medela Freestyle. I don't get a travel bag with it though.

This is me EXACTLY. I was just starting to wonder when it would come... Maybe they wait till 30 days before the due date to ship?

Do you have Aetna too?  When I called to talk to them a couple of months ago, they told me they ship based on inventory/EDDs.  I think I might call at the beginning of next month just to get a status update.

[mannah]

Apr 23, 2014 6:40:11 GMT -5 bowies said:

Apr 23, 2014 0:21:06 GMT -5 mannah said:

This is me EXACTLY. I was just starting to wonder when it would come... Maybe they wait till 30 days before the due date to ship?

Do you have Aetna too?  When I called to talk to them a couple of months ago, they told me they ship based on inventory/EDDs.  I think I might call at the beginning of next month just to get a status update.

Yep Aetna. I actually have to call soon anyway because I keep getting bills for things I was told are covered at 100%, I'll ask about the breast pump timelines too!

[D2M]

mannah and bowies, I also have Aetna and also ordered through Yummy Mummy. I placed my order a few weeks ago just to cross something off my giant to-do list, but I was under the impression that I would get the pump no earlier than 30 days prior to my due date. When I log into my account at Yummy Mummy, my order is still pending. I have a reminder on my calendar to log in again at 36 weeks to check the status again.

ETA: I think I'm repeating exactly what both of you just wrote.  Ha.

[aqualuv]

I called Sunmed Medical back this morning to complete my order of my breast pump. They mail out the breast pump immediately. I should have it by this weekend and I'm not due until August 21st. I have Aetna insurance.

[bowies]

Apr 23, 2014 7:58:29 GMT -5 D2M said:

mannah and bowies, I also have Aetna and also ordered through Yummy Mummy. I placed my order a few weeks ago just to cross something off my giant to-do list, but I was under the impression that I would get the pump no earlier than 30 days prior to my due date. When I log into my account at Yummy Mummy, my order is still pending. I have a reminder on my calendar to log in again at 36 weeks to check the status again.

ETA: I think I'm repeating exactly what both of you just wrote.  Ha.

Well, at least we know they're consistent!  Now I'm kicking myself for not using Sunmed.

[kermit]

I just called and they said I can't order it until 30 days before my due date. So I guess I'll just get my prescription from the doctor at my next appointment and have that ready to go.

FYI for anyone else with BCBS - They had given me the numbers of different supply companies to call. Edgepark apparently has a Medela similar to the PISA but doesn't have the battery pack. It looks like Advanced Medical Solutions does have the PISA with battery pack (according to their website) so I'm going to call them first when the time comes.

[gretchenindisguise]

This is all good to know. Thanks ladies!

I have a PISA from my last pregnancy that I got from my bff. Then I passed it along to my other bff. So I'm thinking after 3 people using it (me for a year, them for less) the motor is probably not what it used to be.

[D2M]

bowies and mannah, I just got an email from Yummy Mummy saying my order was now being processed. This means they've verified the info with my insurance company and the pump will be shipped in 5 business days. Hopefully you'll get similar notifications soon!

[zarapipe]

I called my ins today and they do cover one. I don't really want to go through edgepark so I found a local supplier in my state that will let me upgrade to the Freestyle. I can't get it till I give birth though, but I will rent a hospital one at first just like I did with DD.

[bowies]

Apr 25, 2014 10:22:12 GMT -5 D2M said:

bowies and mannah, I just got an email from Yummy Mummy saying my order was now being processed. This means they've verified the info with my insurance company and the pump will be shipped in 5 business days. Hopefully you'll get similar notifications soon!

Ooo yay!  I guess they do have a 30-day window.  That'll be here before I know it, yikes.

[sunshine608]

I just got mine yesterday. I have a BCBS HMO and submitted the order a little over 30 days out from my EDD. At almost 30 days, I got an email it shipped and it arrived yesterday. I got the Medela PISA but without the nice bag, cooler and ice pack. I registered for it, but don't think its worth the $100. I might just piece together my own bag and cooler.

With my insurance the Amedela came with a bag but not the Medela. I hemmed and hawed and went with the Medela b/c of the better reviews from people I know.

[pitterwoo]

Apr 25, 2014 10:38:07 GMT -5 oceanspray said:

Apr 23, 2014 6:35:55 GMT -5 pitterwoo said:

Mine will only cover a manual pump.

That blows Could you try registering for one?

I've had my shower and gotten everything from the registry except for bottles. It's all working out though. I found a new Ameda PY on craigslist. It's new as in all the parts are still in sealed bags and comes in the original box with the DVD and everything. We're supposed to meet up tomorrow.