https://boards.hellobee.com/ Pregnancy, Baby and Parenting blog, by Hellobee en Wed, 29 Apr 2026 13:42:39 +0000 https://boards.hellobee.com/topic/prescription-for-a-breast-pump#post-181948 Thu, 07 Jun 2012 12:57:11 +0000 sorrycharlie 181948@https://boards.hellobee.com/ <p>thanks for the links!</p> <p>just for the record (in case anyone is confused), I spoke with the insurance person on the phone, so I already know that I need a letter and a diagnosis - that it's medical need and not convenience. I have one of the "diagnoses" listed above that @mrs. bird helpfully included (thanks!!), so I was just curious about others' experiences getting an Rx. If the doctor is good about it, if they require you try other things (i.e., shields, etc.), that type of thing. </p> <p>I'm sure there are doctors who will write an Rx without a need, but that's their decision, imo. Same with any other decision in life - you gotta deal with your own consequences of your own actions. If you bullied a doctor into giving you a note/Rx, then yes, that's "mean"...but doctors are totally capable of making their own decisions, no? =)</p> <p>I totally did NOT intend for this to be a judgy thread or anything. Just wanted some experience sharing =) </p> https://boards.hellobee.com/topic/prescription-for-a-breast-pump#post-181730 Thu, 07 Jun 2012 10:28:19 +0000 Mrs. Tricycle 181730@https://boards.hellobee.com/ <p>Here's another article from Slate: </p> <p><a href="http://www.slate.com/blogs/xx_factor/2011/08/02/breast_pump_rentals_to_be_covered_by_insurance_under_obamacare.html" rel="nofollow">http://www.slate.com/blogs/xx_factor/2011/08/02/breast_pump_rentals_to_be_covered_by_insurance_under_obamacare.html</a> </p> https://boards.hellobee.com/topic/prescription-for-a-breast-pump#post-181425 Thu, 07 Jun 2012 06:46:34 +0000 littlek 181425@https://boards.hellobee.com/ <p>I bought a pump but since I have a preemie who is in the NICU and pumping is a big part of helping my preemie we are renting a hospital grade pump. With a preemie there are a bunch of special rules (bottles you can pump into, etc). The rental fee is really inexpensive, like under $100 for a month. I didn't even think about insurance covering the pump, I was just like we need the pump and I didn't even think about insurance covering it. My guess is if you have Flexible Spending and you have a preemie it would be an eligible expense, but I'm not positive. </p> https://boards.hellobee.com/topic/prescription-for-a-breast-pump#post-181411 Thu, 07 Jun 2012 05:55:13 +0000 mediagirl 181411@https://boards.hellobee.com/ <p>I went ahead and just bought my pump. We have an FSA that I used the money from. Our insurance doesn't cover them and I'm worried about too many other things right now to ask my OB for a prescription for one. </p> https://boards.hellobee.com/topic/prescription-for-a-breast-pump#post-181334 Wed, 06 Jun 2012 22:31:48 +0000 Mrs. Sunglasses 181334@https://boards.hellobee.com/ <p>Hmm I wonder if it's the same in Canada. </p> https://boards.hellobee.com/topic/prescription-for-a-breast-pump#post-181322 Wed, 06 Jun 2012 22:07:40 +0000 GrapeCrush 181322@https://boards.hellobee.com/ <p>Your insurance may request a letter of medical necessity along with the RX to verify that you need it. I work for an insurance company and thats what is normally requested. A pump is considered a 'convenience' item and not normally covered. </p> https://boards.hellobee.com/topic/prescription-for-a-breast-pump#post-181283 Wed, 06 Jun 2012 21:24:11 +0000 littlebug 181283@https://boards.hellobee.com/ <p>Here is the only piece of information I could really find on the new law and covering breast pumps. It does say that under the new law, breastfeeding supplies and resources will be more accessible, but it doesn't really outline how. Will definitely have to keep an eye on this over the next few months and see how it rolls out. </p> <p><a href="http://www.healthcare.gov/news/factsheets/2011/08/womensprevention08012011a.html" rel="nofollow">http://www.healthcare.gov/news/factsheets/2011/08/womensprevention08012011a.html</a> </p> https://boards.hellobee.com/topic/prescription-for-a-breast-pump#post-181278 Wed, 06 Jun 2012 21:08:19 +0000 littlebug 181278@https://boards.hellobee.com/ <p>@AmeliaBedilia: I totally agree with you. Except that doctors WILL just write scripts without thinking about it. I work in a hospital and you would not believe the things patients ask their doctors to write scripts for. And many doctors will just do it to appease the patients! </p> <p>As for "I'm all for cheating the system..." - This is WHY insurance is so expensive. </p> https://boards.hellobee.com/topic/prescription-for-a-breast-pump#post-181228 Wed, 06 Jun 2012 20:18:44 +0000 mrs. bird 181228@https://boards.hellobee.com/ <p>@AmeliaBedilia: I don't think that is what is being suggested. Having a baby be able to latch properly to a flat nipple is a challenge for many women &amp; utilizing a breastpump can be beneficial them. Wondering if this would fall under 'medically necessary' is completely understandable. 'Retracted nipple' is a covered diagnosis, so I don't see why the dr would see it as mean or wrong to ask for the script. </p> https://boards.hellobee.com/topic/prescription-for-a-breast-pump#post-181213 Wed, 06 Jun 2012 20:11:00 +0000 sorrycharlie 181213@https://boards.hellobee.com/ <p>@AmeliaBedilia: well I obviously don't have a diagnosis yet because I haven't had the baby -- but I am anticipating problems latching due to flat nipples. I'm interested in hearing what others have experienced as far as getting an Rx--if the doctor is willing to write an Rx or makes you try other things to work on latch first. I plan to ask my doctor about how they do things in their office. If a doctor has no problem writing an rx (like a PP said) then that's up to the doctor to run that risk.</p> <p>I'm interested in hearing more about the healthcare law thing - the woman on the phone didn't mention it. I wonder if it's because they're holding out hope it won't last? When do they think theyll know if it is def going to go into effect? </p> https://boards.hellobee.com/topic/prescription-for-a-breast-pump#post-181111 Wed, 06 Jun 2012 18:30:23 +0000 AmeliaBedilia 181111@https://boards.hellobee.com/ <p>To get it covered, doctors have to give a diagnosis. If they lie, they could lose their license, and no doctor is going to risk their license they worked hard for to save you $250. I think asking them to do this WHEN YOU DON'T HAVE A DIAGNOSIS is wrong and mean to your doctor.</p> <p>Is that really true that all insurance companies will pay for breast pumps starting August 2012? </p> https://boards.hellobee.com/topic/prescription-for-a-breast-pump#post-180749 Wed, 06 Jun 2012 13:34:38 +0000 regberadaisy 180749@https://boards.hellobee.com/ <p>Doesn't hurt to ask! I asked mine and got a letter no problem.<br /> My issue is I bought it first so I'm going to try and get reimbursed. </p> https://boards.hellobee.com/topic/prescription-for-a-breast-pump#post-180746 Wed, 06 Jun 2012 13:32:31 +0000 sorrycharlie 180746@https://boards.hellobee.com/ <p>Interesting! I have my next appointment in a few weeks so maybe I'll ask the doctor then. I'll try to be casual and ask what types of things require an Rx and see what he says - I see a different doctor each time, so maybe if one of them is totally cool about it I'll bug them particularly for an Rx, lol! </p> https://boards.hellobee.com/topic/prescription-for-a-breast-pump#post-180741 Wed, 06 Jun 2012 13:30:40 +0000 duckduckkristen 180741@https://boards.hellobee.com/ <p>I can't imagine your OB would have a problem writing the Rx. I'm all for cheating the system btw. Haha. Insurance is expensive and they should cover stuff like this!</p> <p>I actually just called CareFirst about this yesterday and they told me they would only cover a pump if the baby was in the hospital. :( We do have a medical reimbursement plan through DH's work though and they said they would reimburse us for the pump. </p> https://boards.hellobee.com/topic/prescription-for-a-breast-pump#post-180737 Wed, 06 Jun 2012 13:28:47 +0000 matador84 180737@https://boards.hellobee.com/ <p>I actually know a lot of girls who have gotten their pump as a result of an rx from their ob. They said to make sure I don't buy a pump because chances are it will be covered...so I am just taking my chances on their rec and will talk to my dr. about it as I get closer to delivery. </p> https://boards.hellobee.com/topic/prescription-for-a-breast-pump#post-180725 Wed, 06 Jun 2012 13:20:07 +0000 purrpletulips 180725@https://boards.hellobee.com/ <p>If the Supreme Court keeps the new healthcare law, your insurance may have to cover a breast pump. When I signed up for the additional resources for pregnancy with my insurance the nurse I spoke with told me that as of August 2012 all insurance providers will be required to cover either pump rental or cost of a pump (regardless of whether or not there is a medical problem with BF). </p> https://boards.hellobee.com/topic/prescription-for-a-breast-pump#post-180704 Wed, 06 Jun 2012 13:11:29 +0000 mrs. bird 180704@https://boards.hellobee.com/ <p>here's what i found via google. i was curious as i live in MA, currently have a really crappy BCBS plan, and have same nipple issue (hoping getting pregnant might correct them, but not holding my breath):</p> <p>"When explaining why your breast pump is medically necessary, your doctor will use an ICD-9 Code to communicate your diagnosis to your health insurance company.</p> <p>Breastfeeding Related ICD-9 Codes<br /> Child<br /> Cleft palate/lip 749<br /> Abnormal tongue position 750.1<br /> Down’s syndrome 758<br /> Neonatal candida infection 771.7<br /> Breastmilk jaundice 774.39<br /> Other transitory neonatal 775.5<br /> Feeding problems in newborn 779.3<br /> Abnormal loss of weight 783.2<br /> Feeding difficulty – infant 783.3<br /> Failure to thrive 784.4<br /> Dysphagia 787.2<br /> Suck reflex abnormal 796.1<br /> Mother<br /> Twin pregnancy post-partum condition or complication 651.04<br /> Abscess of nipple 675.03<br /> Infections of nipple 675.04<br /> Abscess of breast 675.1<br /> Nonpurulent mastitis 675.2<br /> Other specified infection of breast and nipple 675.8<br /> Unspecified infection of the breast and nipple 675.9<br /> Retracted nipple 676<br /> Cracked nipple 676.1<br /> Engorgement of breasts 676.2<br /> Other and unspecified disorder of breast 676.3<br /> Suppressed lactation 676.5<br /> Other disorders of lactation 676.8<br /> Unspecified disorder of lactation 676.9<br /> Dermatitis contact 692"</p> <p>info copied from : <a href="http://www.breastpumpsdirect.com/breastpumps_covered_by_health_insurance_a/148.htm" rel="nofollow">http://www.breastpumpsdirect.com/breastpumps_covered_by_health_insurance_a/148.htm</a> </p> https://boards.hellobee.com/topic/prescription-for-a-breast-pump#post-180677 Wed, 06 Jun 2012 12:46:29 +0000 Shutterbug 180677@https://boards.hellobee.com/ <p>Interesting... no experience with this (not even preg) but I do have BCBSMA and flat nipples (tmi), so I'm interested to hear how it goes for you </p> https://boards.hellobee.com/topic/prescription-for-a-breast-pump#post-180669 Wed, 06 Jun 2012 12:42:44 +0000 sorrycharlie 180669@https://boards.hellobee.com/ <p>So I really hope this post doesn't sound like I'm cheating the system. LOL. But honest answers here, folks - I won't report anyone ;)</p> <p>I spoke with my health insurance carrier today (BCBSMA) and they said they do cover an electric breast pump for medical necessity..i.e., a preemie or if baby can't 'suck'. They will cover the cost with the Rx from my OB.</p> <p>Did anyone do this? Was your OB strict about the Rx? I have a feeling it'll work out because I have flat nipples (sorry! tmi..) but I'm just curious if anyone's OB wrote them an Rx even without latch problems or a preemie. </p>