In order to get a breast pump covered by insurance, you shouldn’t have to do anything. Barring exemptions for a small number of insurance plans which are “grandfathered-in,” health insurance providers are required under the Affordable Care Act (ACA), or Obamacare, to cover a rental or purchase of a breast pump and lactation counseling without imposing cost-sharing measures such as deductibles, copayments, or coinsurance. This means that you have the right to a free breast pump through insurance. The ACA also requires workplaces to provide private space (which can’t be a bathroom) and sufficient break time throughout the day to accommodate employees who are nursing and need to pump milk.
Other coverage details vary from plan to plan; because the ACA doesn’t specify what kind of breast pump has to be covered, some health insurance plans will only reimburse women for the cost of a manual pump – rather than an electric pump (which is more efficient and less labor-intensive than a manual pump). And many healthcare plans don’t cover the cost of other breastfeeding supplies, such as nursing bras, bottles, and milk storage bags.
A toolkit created by the National Women’s Law Center (NWLC) called New Benefits for Breastfeeding Moms: Facts and Tools to Understand Your Coverage under the Health Care Law provides an in-depth, comprehensive guide to understanding your insurance coverage as it applies to breastfeeding.
Taking the Next Steps
breast-pump-covered-by-insuranceYou can evaluate your health coverage and see if it’s the best option for your needs. If you’re unhappy with the breastfeeding benefits provided by your plan, then we can help you find a different one. Search our database of individual health insurance plans to find the right plan for you.