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Old 03-14-2013, 02:47 PM   #1
Kelly3139's Avatar
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Join Date: Nov 2010
Location: Covington, LA
Posts: 707
Insurance Paid for my Electric Pump!

I just wanted to share this and hope that I may help some of you out who are looking to get a new pump.
According to the Affordable Healthcare Act insurance companies are now required to supply nursing mothers with access to a breastpump and lactation support.
The main thing is that your policy has to be effective on or after 1/1/2013.
If you have a new policy or your policy renews every year (ours does) then you should be eligible.

Simply call the customer support number on the back of your insurance card and ask what your policy effective date is. If it is after 1/1/13 a pump should be covered.

Ask if CPT Code E0603 (double electric pump) is covered.
E0602 is manual pump
E0604 is a hospital grade rental (mine offered the option of a free rental or purchase of a double electric).

You will also need to ask for a list of Durable Medical Equipment suppliers in your area. It has to come from one in order to be covered. There were no suppliers in our area so I ordered mine over phone from Cambridge Medical Supply and they charge $5 shipping and bill the insurance the rest.

The first time I called my insurance company the rep told me it would be covered on 2/1/13 when my policy renewed. I called on 2/11/13 to get a list of suppliers and was told that is was not covered under my policy. I was furious because I had already been told I was getting a pump. Then I figured out that BCBS had our policy effective date wrong in their system and that is why I was getting denied. Once we got that straightened out I was told I could purchase a double electric pump from any durable medical equipment supplier and it would be covered at 100% since I met my deductible. I wanted the Medela Freestyle which is an upgrade from the Medela Personal Double Pump that was covered so I spent $105 out of pocket and a Medela Freestyle was shipped right to my door!

I hope that this post will help some of you ladies out!
Married to DH of 9 years, Mommy of DD (10/10) and DS (1/13)!
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