Does Missouri Medicaid Cover Breast Pumps


Does Medicaid Pay For Breast Pump Replacement Parts

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Some Medicaid programs cover replacement parts or additional breast pumping gear. However, most breast pump manufacturers provide their own warranties to help moms get what they need.

If your plan doesnt cover replacement parts, you can order them from the breast pump manufacturer so long as they are included in the warranty.

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Should You Buy A Breast Pump For Your Partner

The answer to this dilemma is a breast pump. A breast pump is a mechanical device that lactating mothers use to pump and store their milk in bottles. By doing so, you can easily juggle your responsibilities as a mother and as an individual. You can relax a bit more and also make your partner an equal shareholder in this task.

How To Get A Breast Pump Through Insurance

While that all probably sounds great, youre probably wondering: How do you actually get a breast pump through insurance? There are a few steps you can take:

Step 1: Find out what your insurance covers.

Every insurance plan will be different for what exactly it will cover, so youll want to check the specifics for your plan. If you have an online account or app, check the benefits guide under pregnancy or breastfeeding. I was able to find my information very easily in the online benefits guide. If you cant find it online, you can also just call your insurances benefits number.

Some insurance plans may also reach out to you if you inform them of your pregnancy. For instance, after enrolling in her health insurance plans pregnancy wellness program, mother of five Gretchen Bossio, received a phone call from a benefits coordinator when she was 32 weeks pregnant to arrange for her breast pump. After confirming the pump she wanted was on the approved list, she was all set. The pump arrived in the mail a week later, says Bossio. Super easy! I was so grateful!

Step 2: Follow your plans steps to apply for the pump.

Again, every plan will be different, which is why its important to check with your specific plan about coverage rules. For instance, some plans may require a doctors order or preauthorization, some may cover only certain brands or types of pumps, and others will have you apply for a pump through a third-party site.

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If You Pump Enough That The Breast Undergoes The Transformation Required For Milk Production Then It Is Of Course Possible For A Breast Pump To Increase Breast Size

A federal government website managed and paid for by the u.s. However, benefits vary by state and the women often ask whether medicaid covers a particular service during pregnancy and shortly after birth. It depends on your unique situation, really. You may be able to get a breast pump if you already.

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What If Your Health Insurance Doesnt Cover A Free Breast Pump

Breast Pump: Breast Pump Schedule

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When Youre Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.

  • What to Expect the Second Year, Heidi Murkoff.
  • Caring for Your Baby and Young Child, 6th Edition, Birth to Age 5, American Academy of Pediatrics, 2014.

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Healthy Children And Youth Program

The Early Periodic Screening, Diagnosis and Treatment program was renamed the Healthy Children and Youth Program in Missouri. The HCY program provides services for eligible children and youth, age 0-20 years. The changes were the result of federal legislation contained in the Omnibus Reconciliation Act of 1989 .

Diagnosis and treatment services had previously been available to MO HealthNet eligible children under an EPSDT program, however, treatment services were limited to those covered under MO HealthNets medicaid state plan.

The expansion of the EPSDT program under HCY provides that all medically necessary services identified as a result of an HCY screen that are above the scope of the “medicaid state plan” must be covered by the state. As a result, services in some existing programs have been enhanced and several new provider groups have been added.

HCY programs:

Additional benefits have been added for children in the following programs:

  • Orthodontic care
  • Durable medical equipment

Claims Payment And Encounter Data

Claims for medical services performed by fee-for-service providers and encounter data submitted by MO HealthNet Managed Care health plans are processed by a fiscal agent. The fiscal agent is selected through a competitive bid process. Under the direction of MHD, the fiscal agent operates a computerized claims processing system using claims and reference subsystems, claims data, provider and client eligibility data and an extensive system of edits and audits.

Fee-for-service claims are adjudicated by the fiscal agent to a “pay” or “deny” status and the provider is notified by a remittance advice. The provider is issued a check by the State of Missouri. Providers may select direct deposit of their checks.

Encounter data is submitted electronically by the MO HealthNet Managed Care health plans in the same layouts used for fee-for-service claims. The MO HealthNet Managed Care health plan is responsible for payment of covered benefits for MO HealthNet Managed Care members. The encounter data provides the state with a record of those services that have been provided.

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How Much Does A Breast Pump Typically Cost

Under the ACA, insurance companies must cover a breast pump and supplies at no cost to pregnant members or members who just gave birth and are breastfeeding. The challenge is that the ACA doesnt say what kind of breast pump insurers must cover, including its price range. As a result, breast pump coverage varies widely depending on the insurance you have.

I Am Covered By Medicaid And Another Insurance Plan Why Cant I Get My Insurance

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States require that Medicaid be used as your secondary insurance if you are covered by Medicaid and another insurance provider . If your primary insurance does not provide any coverage of a breast pump , you may be eligible to receive one through Medicaid.

The only exception is when a mom has Medicaid and TRICARE coverage. In such cases, Medicaid becomes the primary insurance.

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Double Electric Breast Pumps Now Covered Under Colorado Medicaid

Date Posted:

Thanks to the passage of HB22-1289, Cover All Coloradans, double-electric breast pumps are now a covered benefit for all Colorado Medicaid enrollees. Both manual and double-electric breastfeeding pumps are now covered for Coloradans as early as 28 weeks into their pregnancy and at any time during the postpartum period without prior authorization. Previously, Medicaid in Colorado only covered breastfeeding pumps in limited cases, and the Women, Infant, and Children program was the primary provider of pumps to Coloradans on Medicaid.

If you are enrolled in Medicaid and need a breast pump, talk to your doctor or health care provider about getting a pump. Your provider will be able to write you a prescription or give you a referral to a pharmacy or other location where you can pick up your pump. Providers are encouraged to reach out to Haylee Rodgers at for any questions on this policy and can learn more about the benefit criteria through the Colorado Department of Health Care Policy & Financings provider bulletin.

Contact Your Insurance Company

Since there are no standard guidelines, calling your insurance company is the best way to find specific details about your coverage.

I tell my patients to call their insurance company by their third trimester, says Lisa Paladino, a certified nurse midwife and international board-certified lactation consultant in private practice in Staten Island, New York.

In Paladinos experience, most insurance companies have a dedicated maternal child specialist who can explain the process and the coverage to which youre entitled. But start by calling the Member Services phone number on the back of your insurance card.

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Expectant And Nursing Mothers With Aetna Better Health Plans Are Eligible To Receive A 100% Covered Breast Pump


The Affordable Care Act requires insurance providers to cover personal use breast pumps for new and expectant mothers. Therefore, if you are covered by Aetna Better Health, Aetnas Medicaid health insurance provider, you can be sure that your personal use, double electric breat pump will be covered.

How Long Should I Breastfeed

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The World Health Organization and the American Academy of Pediatrics recommend that mothers exclusively breastfeed their infants for the first six months after giving birth. The WHO suggests that this should be followed by breastfeeding with complementary foods two years or older, while the AAP recommends breastfeeding with complementary foods for one year or more. Ultimately, it is up to you and your baby to start weaning .

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Aeroflow Works With Your Doctor And Insurance Company To Submit All Required Paperwork

Does medicaid cover breast pumps in sc. In most instances, the answer is yes. To find out specifics, visit the cms website.if you are a resident of north carolina, check out the special supplemental nutrition program for women, infants, and children for alternative support programs. Qualify for your free breast pump today.

Free job training and financial education classes, age 18 and older First choice may cover additional days until your disenrollment or a maximum of 120 calendar days. Be at or below 200% of the federal poverty level not be eligible for another medicaid eligibility group

Breast pumps are covered by medicaid and you can get a breast pump if you and your baby are eligible members of medicaid. Where i am from wic does not offer breast pumps anymore they direct you to your insurance company. Our team has years of experience working with the various insurance companies and groups, including indiana medicaid as well as anthem blue cross.

Typically, medicaid programs will not cover the breast pump until the baby is born, but we can help you get the process started so all you have to do is let us know when the baby arrives! Medicaid could pay for plastic surgery for breast reductions. Will medicaid provide a breast pump?

Diagnostic, preventive, restorative and surgical benefits Adult inpatients will be allowed 1 visitor during the day (9 a.m. Note that your baby is automatically eligible for medicaid from birth to their first year.

Medicaid Covered Breast Pumps

When Can I Get My Breast Pump

Medicaid has a timeline that they usually uphold for all state coverage. Many policies require that expecting mothers wait to receive their breast pumps until their baby is born. Some states allow mothers to receive their breast pump early, but most Medicaid coverage options take two weeks to four weeks after delivery in order to submit the paperwork and obtain it. If youre worried about getting your breast pump in a timely manner, talk to your hospital about options for temporary pumps.

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Coverage Of Breast Pumps

Your health insurance plan must cover the cost of a breast pump. It may be either a rental unit or a new one youll keep.Your plan may have guidelines on whether the covered pump is manual or electric, the length of the rental, and when youll receive it .

But its up to you and your doctor to decide whats right for you.

Medicaid Breast Pump Coverage Terms

Nursing moms return to work

Obtaining a breast pump through Medicaid can be an extensive process. Please note that it can take up to 10 business days before we receive authorization to move forward with providing the pump. No need to worry, our Specialists are here to help facilitate the process!

Some state Medicaid health plans will not cover a free breast pump per the Affordable Care Act at all. Rather, they cover them under medically necessary circumstances such as long stays in the NICU, inverted nipples, etc.

Certain states have stipulated that if the mother and baby will be separated for extended periods of time , a pump will be covered. When your policy only covers the pump under these circumstances, a prescription will be required as well as documentation surrounding your work or school hours.

Aeroflow Breastpumps will work with you and your health care provider to gather the correct information for your insurance! If you have both a commercial insurance plan and a Medicaid plan, it is important to provide us your commercial insurance. Insurance guidelines require that a patient’s commercial/primary insurance be billed prior to their Medicaid plan.

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Ways to earn include getting a fu shot, a wellness checkup, or a health screening.

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Medicaid Coverage For Breastfeeding Mothers

States must cover breast pumps and consultation services for Medicaid expansion beneficiaries under the Affordable Care Act. Many ACA plans offer both electric and manual breast pumps. While Medicaid offers services that help initiate breastfeeding, most services stop when the mother goes home from the hospital.

Below is a table displaying states reporting breastfeeding-related coverage under traditional Medicaid. The table represents survey findings on behalf of KFF and the Family Planning Report from 40 states and Washington DC that responded. DC is counted as a state in this table.

Breastfeeding Services by State under Medicaid

Breastfeeding Education


Electric Breast Pumps in Traditional Medicaid Program


Lactation Consultation in Hospital


Lactation Consultation in Clinic and/or at Home

AR, CA, CO*, CT, DC, DE, HI, MN, MS, NC*, NY, OH, OK*, OR, VA*, WA*

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What Does Nc Pregnancy Medicaid Cover

Medicaid for Pregnant Women covers only services related to pregnancy: Prenatal care, delivery, and 60 days postpartum care

Does NC state health plan cover breast pump?

Benefits for breast pumps and related supplies included with breast pumps are now available to members during their last trimester of pregnancy or after they have delivered. Supplies, such as milk storage bags, nursing bras, or creams are not covered.

Are breast pumps covered by insurance?

Coverage of breast pumps Your health insurance plan must cover the cost of a breast pump. It may be either a rental unit or a new one youll keep. Your plan may have guidelines on whether the covered pump is manual or electric, the length of the rental, and when youll receive it .

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Breast Pumps And Insurance Coverage: What You Need To Know

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During National Breastfeeding Month in August, we heard lots of questions about breast pumps and insurance coverage. The decision to breastfeed is a personal one, but with everyone from Grandma to girlfriends giving you advice, it can be overwhelming to sort out all of the facts. Weâre here with the information youâre looking for on breast pumps and health insurance. Check out these commonly asked questions .

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Big Winner In Obamacarebreast Pump Industry

Conservative criticism that the Affordable Care Act aka Obamacareis just a way for liberal Democrats to make Americans dependent on the teat of the state may be literally true, as the law is causing a sales boom for the breast pump industry. Along with controversial items like the mandate that insurers pay for contraceptive care, the ACA also includes a provision requiring insurance companies to cover breast pumps and visits to lactation consultants at no cost to the patient.

Women use breast pumps to store milk for later feeding to babies, to stimulate lactation for mothers with low milk supply and to relieve engorgement when their breasts are overfull.

Previously, 31 states required Medicaid to cover breast pumps, and some private plans included coverage for a fee. Now, Obamacare requires insurers to cover comprehensive lactation support and counselingand costs for renting breastfeeding equipment in conjunction with each birth.

Since insurers began offering the new requirement, it has taken off with consumers. Were getting a lot of calls from prospective mothers and new mothers, Bruce Frishman, president of a medical equipment supplier in Washington, DC, told The Washington Post. Weve started stocking a lot more pumps that would be purchased through insurance.

-Matt Bewig

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