I called my insurance and I have no cap on the type of breast pump that is covered 100%. They also cover all supplies. The guy wasn't very sure how or where I needed to get one. Has anyone done this before? Where did you get yours? Did you need a prescription?
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My insurance company gave me three medical supply companies I was allowed to order from. I did not need a prescription. The medical supply company took my insurance and doctor's information and sent me my pump. That's awesome that you don't have a cap!
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We have BCBS and went through Edgepark. I think the insurance company suggested a couple of medical supply companies and that one was recommended by several bees. We spoke to lots of different people at our insurance company and the supply company and got lots of different, conflicting information, so if you don't get the answer you need I would try again the next day! The free breast pump thing seems to be very confusing to them. Edgepark took care of the details and contacted my doctor's office, they just had to fill something out and fax it back.
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Mine didn't give me a choice and they just mailed it to me.
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My insurance company provided several medical supply stores for me to contact and choose between for ordering. I had no cap on cost of pump, but my insurance company clearly stated that it had to be ordered through one of their approved medical supply stores or it would not be covered. I did need a prescription from my doctor prior to ordering the pump, but that was easy to obtain.
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Mine let me choose but I needed a prescription if i wanted it through Target or Babies R Us. I didn't need a prescription to go through a place like Edgepark. I got a Freestyle. All i did was fax in the receipt, the prescription, and a medical claim form. It was initially denied b/c someone didn't see the Rx, then it was denied again because they said Babies R Us wasn't in their in-network providers, and then i spoke with an informed manager who hand processed my claim and the refund came.
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I just called BCBS and they said that there is no specific pump they do not cover, except hospital grade pumps are typically not covered (we learned this the hard way with DS after they told us a hospital grade pump rental would be).
Basically the man said that if I wanted to order a Medela Freestyle, I could and it would be covered I just had to do the following: deliver baby first, have a prescription from my medical care provider, and order the pump from an in-network medical supply company. I am so doing this in a few months! I wanted to upgrade from my PISA to a Freestyle but didn't want to pay for another pump. Thanks for motivating me to call @ladybee:!
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Try calling your pediatrician - they gave me a place to get my rental from (insurance covered as well) and the company called my insurance company to confirm coverage before they provided me with it. It was easy.
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My insurance co sent me to a third party company who was able to provide my pump with no charge. I just had to fill out a form that my insurance company sent me afterwards. It came with all parts necessary for it to work for the average woman.
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@anbanan15: a friend gave me a PISA but ordering new parts would be like $60 or more and I really want the Freestyle. I'm ou 25 weeks and am on summer break so I wanted to take care of it now but my OB said I need to wait till 36 weeks. Overall, I'm pumped that its covered!
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@ladybee: yay! That's how I feel...I really wanted to get it out of the way too. I want to upgrade so bad
Love my PISA but wished I got the freestyle. I think I am going to call again closer to my due date to make sure we are told the same info. We were told multiple times before that the rental would be covered but ultimately they didn't because there was no "separation of infant" and they failed to leave that important part out every time we called.
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@anbanan15: good to know! They told me a hospital pump would be covered but ill call closer to my due date to make sure. It's $80 a month and I do not want to pay that.
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@anbanan15: I have BCBS and I didn't have to wait until I delivered. I got my pump @ 30 weeks.
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@tororojo: I have BCBS and also went through Edgepark. Pump should be waiting at home for me right now
Did they say anything to you (BCBS) about covering any other supplies? I saw OP gets any supplies covered so I'm just wondering if I could too?
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@Mommytotwois: we didn't get any other supplies, but I didn't ask. And I got mine back in Feb, so maybe they have streamlined the process better now. It never hurts to check!
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@tororojo: @Mommytotwois: I have BCBS (Horizon of NJ) and I had to order through an approved provider but it was shipped right to me ($5 for shipping). I couldn't get extra supplies though, it just came with the regular pump parts. I could have upgraded to a PISA or Freestyle for extra money, but I got a Medela double electric for no extra cost.
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Thanks for the info ladies!
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@ladybee: mine lets me get it 30 days before my due date or anytime after baby is born. It's covered 100% if I go through a hospital supply place. Luckily,we have a lactation store at our hospital that I ca get it from. Supplies like tubing and shields are covered. If I bought myself, I only get reimbursed up to $200.
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I got a prescription from my doctor, then sent it to my health insurance, who then contracted it out to a medical supply store, who then sent me a Medela advanced double electric pump with all the accessories. No out of pocket cost at any point.
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I have Aetna and I found a very helpful page on their website. It listed all the medical suppliers and i just went down the list until i found the pump i wanted I called just to get info at 16 weeks and the woman i spoke with at SunMed Medical supplies said she could process the order right away I had to fax back a form, she needed my dr's contact info and my insurance info and it was at my house within 7 days.
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The issue I had wasn't my insurance. The nurse at my doctors office said they wait till 36 weeks to write the prescription. I'm only 25 but I'm on summer break and am trying to accomplish a lot. I have an appointment at the end of the month so I'm going to ask my doctor directly. Hopefully he writes the prescription!
Love my PISA but wished I got the freestyle. I think I am going to call again closer to my due date to make sure we are told the same info. We were told multiple times before that the rental would be covered but ultimately they didn't because there was no "separation of infant" and they failed to leave that important part out every time we called.
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