How does it work. When I had LO 4 years ago, I just bought a pump because the law hadnt taken a effect that requires insurance companies to provide them. How do you go about getting your pump through insurance. Did you buy it an get reimbursed? I'll have to go call my insurance eventually but just curious how it works for everyone
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For mine, I just called and found out the durable medical equipment supplier to use. I took my Rx from the Dr to the supplier and got the pump...
Definitely call to make sure you follow the correct process.
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I doubt you buy and get reimbursed - at least not for most insurances...they would almost always have a "insurance" model that is a negotiated price...not the retail stuff in some cases...
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You need to call your insurance. It works quite differently for different plans. I was able to get mine before LO arrived and they billed my insurance, but other plans make you wait until baby is delivered.
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They wouldn't issue one until I was 30 weeks. Once I hit 30 weeks I called my insurance. They had my doctor's office fax the prescription to the supplier they use and I got it later that week. I would definitely call to see how your insurance provider prefers to issue them.
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It was a little bit of a process for mine but not too bad. I called before baby was born and they told me I had to wait until after she arrived and that I needed a prescription. I asked for the prescription while I was in the hospital after having LO, and I did end up having to ask a few people before someone would give me one (the first nurse said something like "it's too early for us to know if it is medically necessary"). After I had that, I called the insurance company and they gave me a list of medical supply companies. Then I called the closest one to me and told them I had the prescription and what my insurance was, and they said to come on in and pick it up. They didn't give me any choices, but I ended up with a Medela PISA. The medical company invoiced the insurance company directly so I never had to pay them.
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I tried calling my insurance and they weren't helpful. They did confirm I had coverage but had no idea what companies they covered pumps for,
On the medela website there's a place to look up companies based on your insurance and I found byram. They contacted my insurance and Doctor and eventually (months later actually) they billed me for the amount I owed.
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Last time I was able to get mine before the baby was born (2 years ago). This time I had to wait till after. Both times i contacted a medical supply company (Edgepark) and they did the work. I just made sure there was a referral in the system.
You should look it up with your insurance but it's also worth seeing what company is in your area and letting them do the work for you. They get paid by insurance so it is in their interest to make sure you get your stuff.
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I called my insurance company, and they gave me the numbers for 3 medical supplies companies that I could call. I had to wait until about a month before my due date to call them, gave them my doctor's number and insurance info, and which model I wanted, and they took care of the rest. I think I had it in about a week?
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Mine said they only covered a manual
if I hadn't gotten an electric pump from a friend, I probably would have asked to speak to another agent or fought it more.
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I had to wait till after LO was born and I wasn't able to get it till a few days after. I needed a prescription, and was able to get it at the supply store in the hospital. I did have to pre-pay and insurance reimbursed me, basically it was that much less I had to pay on my deductible. ($300)
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Same as @Mrs D: - I had to get it through my insurance durable medical equipment provider. The insurance website listed the sites I could use, and the provider sites make t pretty easy to order through them. Don't buy it yourself for sure.
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I did have to wait until I had proof of live birth for K (3 years ago)...with E (this year) I was able to get it at 32 weeks.
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Thanks everyone
I have been on my insurance website and it looks like i have to go through a DME. This means I wont be able to get another Lansinoh pump as those arent available from the DMEs. I will call them up to verify. Since I am 31 weeks now I guess I qualify to get it already -
@lovehoneybee: My experience was the same as yours. United Healthcare?
Random story. I was in an elevator when I was like 30 weeks pregnant with 2 men I didn't know (and they didn't know each other). One of them in his mid 30s just says "you get a breast pump yet?" And at first I thought there was no way he was asking me so I ignored. And then he said again "yout get a breast pump yet?" And I looked at him with such a confused look because a strange man was asking me about a pump. And he finally realized how awkward it was and looked really embarrassed and said "oh, I'm not weird! I work for an insurance company in the breast pump division!" (I'm paraphrasing because I don't remember exact wording, he didn't say breast pump division but his job was somehow related).
The other man in the elevator got all shifty too. It was super weird at the time but now it makes me laugh. -
My insurance gave me a list of various suppliers that I could use, and I ended up buying mine online from one of them--I just typed in my insurance info as the payment info
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My insurance had 2 suppliers I could use. I just had to send the supplier the prescription within 60 days of my due date and they mailed it directly to me.
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Echoing to call your insurance and see what is offered. On my husbands plan I was able to order one of three choice of pumps from a list of their medical suppliers.
My insurance, however, will reimburse me for the purchase of a manual pump - up to $30 - which is basically a joke. Not all plans are going to be the same, so you'll have to call to find out.
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My insurance had a website I ordered through. They gave me 4 choices and then contacted my Dr for approval. It was really easy!
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@Mrsbells: I'd contact Aeroflow. They did all of the insurance paperwork and were much easier to work with than the place my insurance recommended: http://www.breastpumps.aeroflowinc.com/
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I 2nd @Pollywog:'s recommendation. They made it SO easy.
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For my first pregnancy, they reimbursed me up to a specific dollar amount. For my second pregnancy (different health insurer), I had to use one of their suppliers and the supplier took care of billing insurance.
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I went through Aeroflow too. I did have to call them to follow up on some paperwork being processed, but overall it was really easy.
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Thanks everyone I finally called them and was told I need to get a prescription first and then its covered 100%
Now I just need to decide which one I want
if I hadn't gotten an electric pump from a friend, I probably would have asked to speak to another agent or fought it more.
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