Hellobee Boards

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):

"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.

Breastfeeding Related ICD-9 Codes
Child
Cleft palate/lip 749
Abnormal tongue position 750.1
Down’s syndrome 758
Neonatal candida infection 771.7
Breastmilk jaundice 774.39
Other transitory neonatal 775.5
Feeding problems in newborn 779.3
Abnormal loss of weight 783.2
Feeding difficulty – infant 783.3
Failure to thrive 784.4
Dysphagia 787.2
Suck reflex abnormal 796.1
Mother
Twin pregnancy post-partum condition or complication 651.04
Abscess of nipple 675.03
Infections of nipple 675.04
Abscess of breast 675.1
Nonpurulent mastitis 675.2
Other specified infection of breast and nipple 675.8
Unspecified infection of the breast and nipple 675.9
Retracted nipple 676
Cracked nipple 676.1
Engorgement of breasts 676.2
Other and unspecified disorder of breast 676.3
Suppressed lactation 676.5
Other disorders of lactation 676.8
Unspecified disorder of lactation 676.9
Dermatitis contact 692"

info copied from : http://www.breastpumpsdirect.com/breastpumps_covered_by_health_insurance_a/148.htm

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.

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.

Is that really true that all insurance companies will pay for breast pumps starting August 2012?

@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 & 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.

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.

http://www.healthcare.gov/news/factsheets/2011/08/womensprevention08012011a.html

Hmm I wonder if it's the same in Canada.

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.