Well mama, mine is in the mail, so I'm going to tell you how you can get one too. Scroll to the bottom of this post if you're impatient.
*My aside: I really hate calling them free. The Affordable Care Act requires that insurance companies provide them now, and who pays for my insurance? My husband and I do. And his employer too. I'm sure that this is one of many reasons why our insurance went up quite a bit this year, not only in premiums but in copays. But that's besides the point. And I will add that this is probably one way that our elected officials are trying to help our nation reach the goals of Healthy People 2020.
Why do I need a breast pump?
My husband initially heard about insurance covering breast pumps through NPR and immediately called me so that I could look into it. I'm still nursing exclusively and while I rarely use my pump right now, there have certainly been scenarios with each of my first two babies when I needed to pump often. If anyone needs a good pump, I do.And I have one. It's a high quality, $300 Medela breast pump. It's also 8 years old and will die any day now. I've expected to have to purchase a new pump for the past year and a half or so, yet somehow, the thing keeps running. My old pump belonged to my sister-in-law, who used it while she was working and nursing her two children. I've used it for three babies and I've loaned it out to two other moms. That's a total of 7 kids! I'm also passionate about breastfeeding, I'm usually able to nurse through the first year and beyond, and Lord willing, this won't be my last baby. So I need a pump!
The painful process of trying to get a breast pump
First, I did the obvious thing and called my insurance company. The representative said that I would need to find an "in network provider" of "durable medical equipment." She instructed me to do the following:
- Go to their website, www.bcbsnc.com and click "Find a Doctor."
- Extend the search to within the entire US. Click "Other Facilities and Services."
- Find companies who sell "durable medical equipment."
- Call them to find out if they sell breast pumps and then order one for myself.
Not so much. I called a few companies on the list and none sold breast pumps. The conversations went like this.
Me: "Do you sell breast pumps?"
Them: "Respiratory pumps?"
Me: "No, BREAST pumps."
Them: Nope, sorry.
It was like looking for a needle in a haystack. Or like looking for two matching socks in my toddler's sock drawer. It just wasn't happening.
But no worries. The BCBS rep also gave me the phone numbers to 3 companies to call. So call them I did.
None of the companies carry breast pumps. At all. Ever.
So I called BCBS again. I told them my dilemma and was given the following excuse:
There is currently a shortage of breast pumps, so it might be hard to get one.
But I can buy one at Target? Or Walmart? Yet there's a shortage? Maybe a shortage of pumps through their suppliers, perhaps. But even so, I could not find a single company who carried breast pumps. So I asked for help.
After much searching, she found a company who sells pumps and has some in stock. The BCBS rep put me on the phone with the company. The rest was easy peasy.
How can you score a breast pump without all the headache?
If I had to do it all over again, knowing what I know now, I would just call the medical supply company directly. They will contact your insurance to make sure it's covered and do all of the work for you. They'll also make sure that you only get a pump that is covered by your insurance, because they don't want to lose money on the deal.- Call a supplier of durable medical equipment that sells breastpumps. My insurance company put me in touch with Edgepark. Note that their website says they are only ordering pumps over the phone.
- Give them basic information, such as your name, phone number, address, birth date of your baby, insurance data, and the name and phone number of your doctor. I gave her my OB/Gyn's name instead of my PCP because he's my favorite doctor, I know him pretty well personally, and since he delivers my kids, he knows I breastfeed for at least a year.
- Sit back and wait. Edgepark said that it will take 3-5 days to confirm my information through the insurance company and obtain a prescription from my doctor. Then it will take 3-5 days for processing and shipping.
Do check out Edgepark's FAQ page if you've got any questions. It was worth the hassle and all of the phone calls to get a *free $300 breast pump.
Are you planning on getting a new breast pump now that they're covered by insurance? If you've already ordered yours, what did you think of the process? What company did you go through? We'd love to hear any tips or advice.
If you enjoyed this post, you can follow on Facebook and sign up to receive MamaGab in your inbox.
does the edgepark company sell any manual breastpumps? I have blue cross blue shield of Rhode Island and they will only cover the electric pump if it is "medically necessary"- #1 I won't know that until after the baby is born, #2 I would hope that the baby could nurse perfectly fine, and we could use the pump simply because I am going back to work etc. I havent been able to find a single company that offers the breast pump- let alone a manual one....HELP!!!!
ReplyDeleteI'm not sure if they do. That's pretty silly on the part of your insurance company. Very frustrating! The question is how do they define "medically necessary?" I would think going back to work would qualify you for it.
ReplyDeleteI have medical do you think ill qualify, I read on others that it does and some that it doesny. I want to breastfeed but going back to school has me a lil stressed about buying a 300 pump machine, I seen them today at the store :/
ReplyDeleteThanks in advance
I don't know. It wouldn't hurt to call and check! I know that WIC gives them away for free too, if you're working or in school, so if that's an option, I would look into it.
DeleteI had EXACTLY the same experience, and wrote about it in my blog, too!
ReplyDeleteHopefully insurance companies can start streamlining the process soon so it doesn't take multiple phone calls for expectant moms to get what they need!
http://buckiddo.wordpress.com
The best was getting an EOB in the mail saying it was NOT covered and I would be billed for the amount! So I called them to check on it and it was miscoded. They could not figure out a single reason for the mistake--it was clearly covered by insurance.
DeleteHi, just wondering we have BCBS UT Selected and they told me they will cover a breast pump 100% as long as is not more expensive than $150.... hmmm... so I call the same medical supply company you did and order the medela and they told me it was covered and if there will be a copay, they will let me know before shipping....so today I got in the mail the breast pump but I havent open it, because there was some paper work taped on the top of the box, saying that the breast pump cost $450.95!!!!!! and that my costumer responsibility was $0
ReplyDeleteHowever also has a note in the bottom that says: A claim has been or will be submitted to your insurance on your behalf........... OH no!??? does that mean I'm going to get a bill from the insurance of $300????? did you get a paper like that on your order too??
The Edgepark website says:
"If the breast pump you requested is approved through your health insurance without additional co-pays and currently in stock, then you will receive your order (usually within a week of calling)."
so shall I worry about it>??? SHall I call my insurance still and ask, before I open it??
I'm not sure what to tell you, Magamok! Mine was covered 100%, period, with no price stipulations. However, I received the same information: a bill from the company saying that a claim had been filed, which means they are getting your insurance company to pay for it and they expect nothing from you at this point. So it sounds like good news to me!
Delete