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Breastfeeding and Insurance

Beginning August 1, 2012 the Affordable Care Act (ACA) requires all health plans to cover breastfeeding equipment and supplies (breast pump) “for the duration of breastfeeding” without cost sharing. Insurance plan may offer to cover either a rental or a new one for you to keep. Insurers have flexibility over the types of breast pumps and supplies covered; however, insurers often follow the recommendations of doctors’ on what is medically appropriate. Pre-authorization from physicians may be necessary.

Every health insurance has different coverage. The first step you should take is to find out what your insurance covers. Most insurance companies have a toll-free customer service number you can call and ask questions. Look on the back of your insurance card for the phone number.
When calling your insurance plan, you may ask the following questions:

  • What brand of pump can I get? (Ameda, Medela, etc.)
  • What type of pump can I get? (hospital grade rental pump, double or single electric, battery or manual pump, etc.)
  • When can I get my breast pump? (before I have my baby? After delivery?)
  • Where can I get my breast pump?
  • Where can I receive lactation counseling services? Is there an approved list?
  • Is there a limit on the number of visits with a lactation consultant?

You may also receive breastfeeding support from your local Women Infant and Children (WIC) office. In some medical cases, Medicaid may also pay for breastfeeding supplies.

The ACA also requires employers with 50 or more employees to provide reasonable break time and a private, non-bathroom space for nursing mothers to express breast milk durin gth workday for up to one year after the child's birth. A breastfeeding mother should talk to her employer about this benefit.