Understanding Medicaid Covered Breast Pumps
If you arent currently insured and youre looking for coverage options, Medicaid can be a good place to begin. Medicaid provides health coverage to over 70 million Americans, including low-income adults, children, pregnant women, elderly adults, and people with disabilities. To help those who need it, Medicaid works to cover a broad range of different health services in an effort to limit out-of-pocket costs. It was signed into law in 1965 in conjunction with Medicare and is overseen by the federal government. With that being said, each state administers their Medicaid program differently, which means that Americans experience varied coverage based on where they live. This makes understanding Medicaid covered breast pumps a little confusing.
In 2014, the Affordable Care Act gave the authority to expand the eligibility for Medicaid coverage and created a more standardized process for determining eligibility and providing benefits. Within this expansion of coverage, all Health Insurance Marketplace® and Medicaid plans are required to cover pregnancy and childbirth, even if your pregnancy begins prior to the start of coverage. This coverage varies depending on specific rules in each state but works to help with pre-natal care and delivery costs.
I Am Covered By Medicaid And Another Insurance Plan Why Cant I Get My Insurance
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.
Welcome To Wellcare For Women
The women’s health portal from SunMED Medical Solutions.
Wellcare for Women is a dedicated e-commerce portal for breast pump equipment and accessories, maternity and newborn products, and a range of support and compression garments.
- You can use your health coverage for ordering eligible products.
- All products on the Wellcare for Women portal are HSA/FSA eligible.
- You also benefit from product upgrades and over-the-counter items at discounted prices.
Also Check: Medicaid Community Choices Waiver Program
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.
Now Covered Through Most Health Plans
Breast pumps are covered through all health plans including Medicaid, CHIP, and Tricare. Some plans offer additional breastfeeding support services such as breastfeeding consultations.
Breast pumps can be issued to both mothers and babies enrolled in Medicaid or CHIP. If the mothers eligibility has expired in Medicaid, the pump can be issued under the babys coverage. As soon as you know the mother needs a breast pump, have her call her health plan to get the process started.
Recommended Reading: Can I Work And Still Get Medicaid
How To Secure Your Insurance
At The Lactation Network, we work hard to make this process totally seamless for you. We are a Durable Medical Equipment provider, which means we provide public access to medical equipment and devices for in-home use. As real moms ourselves, we know you have a lot on your plate, so we make initiating the process of getting a pump super straightforward. You simply choose which breast pump you want, and we take it from there.
Not sure which breast pump is right for you? Take a quick quiz on our site to help you narrow in on the breast pump that best fits your lifestyle and needs. You can also send us an email or give us a call to talk through the different pumps and get some real-mom insights.
Our new checkout process makes securing your pump as easy as any add to cart online shopping experience. Simply select your state and your health insurance from the drop-down menu. We will show you the pumps that are included in your plan at no cost, as well as any pumps available for an upgrade fee. Click on a specific pump to read more details and then add the pump you want to your cart. If you choose a pump with an upgrade fee, no payment is collected until we confirm all the details with your insurance company.
Are You From North Carolina
We are the exclusive breast pump provider for UHC Community Plan NC Medicaid, however, the rest of North Carolina Medicaid does not cover breast pumps. We recommend you contact your local WIC program to find out if they have a breast pump program. Additionally, we understand how pricey it is to bring a little one into the world and we want to help, so we offer a 15% discount on all breast pumps for North Carolina Medicaid mothers!
Recommended Reading: Are Hearing Aids Covered By Medicaid
Breast Pump Through Health Partners Insurance
If you have a baby on the way, you may be wondering how can I get a breast pump through Health Partners Insurance? You probably think that convincing your insurance to give you something for free is going to be a challenging task. On the contrary, its very easy to get your breast pump covered through Health Partners when you turn to the team at The Breastfeeding Shop. Were here to help make the breast pump ordering process as easy for you as possible. And, we can help you get free breast pumps and supplies!
We understand that an expecting mom and dad probably have a lot on their plate at the moment. You may be baby proofing your home, picking out baby caps and clothes, or reading a baby book or two. So, let us get your Health Partners breast pump for you. All you have to do is fill out a simple form, and well handle the rest. And you can do all of this before your delivery date. This way, you know that it will all be taken care of. But your Health Partners insurance breast pump wont be shipped until after the baby is born.
Unitedhealthcare Connected For Mycare Ohio
UnitedHealthcare Connected® for MyCare Ohio is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees. If you have any problem reading or understanding this or any other UnitedHealthcare Connected® for MyCare Ohio information, please contact our Member Services at from 7 a.m. to 8 p.m. Monday through Friday for help at no cost to you.
Si tiene problemas para leer o comprender esta o cualquier otra documentación de UnitedHealthcare Connected® de MyCare Ohio , comuníquese con nuestro Departamento de Servicio al Cliente para obtener información adicional sin costo para usted al de lunes a viernes de 7 a.m. a 8 p.m. .
This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the Member Handbook. Limitations, copays, and restrictions may apply. For more information, call UnitedHealthcare Connected Member Services or read the UnitedHealthcare Connected Member Handbook. Benefits, List of Covered Drugs, pharmacy and provider networks and/or copayments may change from time to time throughout the year and on January 1 of each year.
Recommended Reading: What Is The Number To Apply For Medicaid
Provider Search Tool Frequently Asked Questions
What is the provider search tool?
The Department of Health Care Policy and Financing website offers a Find a Doctor provider search tool for Health First Colorado and Child Health Plan Plus members to search for and contact health care providers including physicians, clinics, and dentists. Members who use this tool to search for providers should keep in mind that they also need to contact the individual provider to confirm the provider is accepting new patients.
Why is there a need for a provider search tool?
The Department maintains all Health First Colorado provider information and works to make this information accessible so that members can find providers to deliver covered services.
What information does the provider search tool contain?
The provider search tool search results provide a list of providers sorted by providersâ names:
- Provider legal name / Doing Business As name
How frequently is provider information updated?
The data is updated daily.
How do members use the search tool?
Members can search for providers by location, provider type, specialty, and/or name.
Here Are Options For Finding A Breast Pump At A Low Cost
Looking to get a breast pump? There are a variety of ways to find a pump at low cost, like through your private insurance or Medicaid, your local hospital, and some WIC clinics. Some moms get to keep their pumps forever, and some moms rent their pumps while they are breastfeeding. Talk to your WIC clinic about which option is best for you.
You May Like: How Much Does Medicaid Cover For Childbirth
The Wellcare For Women Support Team
Expert support representatives are just a toll-free phone call away. We are standing by to advise you on the most appropriate breast pump equipment and accessories, handle health coverage verification and claim submission for you and answer any questions you may have about your new equipment.
Dont see a product you need? Call the support team at . We will research cost and availability for you.
Quick links to Popular Brands and Products
About SunMED
SunMED Medical Solutions is a national provider of specialty medical equipment and enhanced clinical support for the treatment of patients of all ages and conditions. We provide the most clinically superior brands and sought-after models of each product we carry.
SunMED was founded in 2002. Located in Marlton, New Jersey , our over 150 employees serve patients nationwide. We are a Medicare provider, hold over 200 insurance company contracts, multiple workers compensation contracts and we are a Medicaid provider in 20 states.
Navigation
Breast Pumps And Breastfeeding Education
Breast Pumps
Breast pumps are available at all local health units at no cost for women who are on Arkansas WIC as partially breastfeeding or exclusively breastfeeding. Click here to find your nearest health unit or call 1-800-445-6175 for more information.
To obtain a breast pump, call your local health unit to make a WIC appointment and tell the WIC staff that you are breastfeeding and would like a breast pump.
Based on your needs, qualified WIC staff can help obtain a pump that is right for you. Manual pumps for occasional or short term pumping are available. The personal Double Pump is available for mothers of premature infants, mothers going to work or school, and women with breastfeeding complications. Demonstration on breast pump assembly and how to get a breast pump from Arkansas WIC available upon request.
Breastfeeding Educational Materials
Arkansas WIC Breastfeeding offers a variety of educational materials on an array of breastfeeding topics. The following information is available upon request.
Recommended Reading: Dentists In Grand Island Ne That Accept Medicaid
Also Check: Aetna Better Health Of Ohio Mycare Ohio Medicare Medicaid Plan
Are Breast Pumps Covered By Medicaid
Yes, most Medicaid plans cover breast pumps, although exact coverage details differ depending on state policies. While Medicaid may not cover hospital-grade breast pumps, many plans will cover the cost of owning or renting a personal double electric breast pump. In most cases, Medicaid requires a prescription from a medical professional to cover the price of a breast pump. Pumps for Mom experts can get in touch with your doctor and help you get a prescription if needed. Additionally, because Medicaid benefits vary by state, some states or plans may not cover the breast pump that moms need. In these cases, moms can get in touch with their local WIC clinic to see if they have a breast pump program or work with Pumps for Mom to get a breast pump without insurance coverage.
Welcome To Insurance Covered Breast Pumps
Insurance Covered Breast Pumps is a full service online breast pump provider. As a BOC accredited provider, we strive to provide outstanding customer service. We take pride in supporting mothers through the Affordable Care Act , which requires health plans to cover breastfeeding support and supplies. We try to ensure that mothers get the best quality breast pumps and supplies with little or no out of pocket cost. We are contracted with most commercial insurance companies, and will help you choose the right breast pump covered by your health insurance plan. We will work with your insurance company to determine benefits for your insurance covered breast pump and file an insurance claim on your behalf. We will obtain a prescription from your doctor to meet the requirements of your health insurance provider. If your insurance company does not cover a breast pump, we will work with you to find an affordable option. Our main goal at Insurance Covered Breast Pumps is to ensure that the process of obtaining an insurance covered breast pump is as easy as possible for all mothers. Rest assured, we will take care of the administrative process so you can focus on other important activities such as taking care of your family.
Recommended Reading: Holistic Doctors That Accept Medicaid
Information Regarding Medicaid Breast Pump Coverage Terms
As with all federal programs, state coverage varies. In some instances, the process for obtaining your Medicaid covered breast pump can take a considerable amount of time and effort. In some states, breast pumps arent covered under the Affordable Care Act. While this doesnt mean that you wont be able to receive one at all, you may need to enter information about why a breast pump is medically necessary. For some women, this can be difficult to explain. Some of the reasons for medical necessity, as defined by Medicaid plans, include inverted nipples, premature birth, oral defects, breast infections, or an inadequate milk supply. If your baby needs to stay in the NICU for prolonged periods of time or cannot latch properly, you may also be eligible for coverage. Work with your doctor to better understand your nursing needs and determine what, if any, your medical eligibility is.
You may also be able to obtain eligibility if you and your baby will be separated for extended periods, such as in the case of attending school or going back to work. Under these conditions, Medicaid will provide breast pump coverage. However, you will need to present documentation to show that you are legitimately in need. This is where Medicaid differs from private health insurance. While it can be frustrating, working with Byram Healthcare can make the process easier. If youre worried about your coverage, talk to your doctor to learn more about how you can obtain a prescription.
Pregnant Women Frequently Asked Questions
If I have a health question or concern, who should I call?
Health First Colorado offers a free 24-hour, 7 days a week Nurse Advice Line at 1-800-283-3221. Help is available in both English and Spanish.
What is the Nurse Home Visitor Program?
The Nurse Home Visitor Program is a special program for qualifying women who are pregnant with their first child. The program is also for these first children up to their second birthday. NHVP offers case management and health education services to moms and their first babies in order to help them get the medical and social services that they need.
How much are my co-pays?
You have no co-pays for Health First Colorado-covered services and prescriptions while you are pregnant and for two months after your pregnancy ends.
Can I get help to quit smoking?
- Contact the Colorado QuitLine at 1-800-QUIT-NOW for free coaching and support.
- Talk with your health care provider about the benefits and risks of taking smoking cessation medications while you are pregnant. Health First Colorado covers two 90-day courses of smoking cessation medication with counseling to help you quit.
Are prenatal vitamins covered?
Prenatal vitamins are a free benefit for all pregnant women. Talk with your health care provider about the benefits of taking a prenatal vitamin every day. A prescription is required.
Can I get transportation to my appointments?
Can I get help for depression?
How do I enroll my newborn in Health First Colorado?
Are breast pumps covered?
Read Also: Medicaid Eligibility For Green Card Holders
Purchasing Your Breast Pump Through Insurance In Charlotte
Up until recently, nursing mothers were expected to pay out of pocket for breast pumps and breastfeeding accessories. Now, the Affordable Care Act requires most health insurance companies to pay for breast pumps like it does for other medical equipment. To file your insurance well just need a prescription from your doctor, your insurance information and the date of birth of your child .
Who Offers Breast Pumps In Durham
If you have a baby on the way, you may be looking at the pros and cons of pumping, direct feeding, and formula feeding. Here at The Breastfeeding Shop, we believe that breast milk is the best nutrition source for a developing baby. Just because your child is having trouble latching, or youre not expressing enough milk that doesnt mean that breast milk isnt an option for you. Our breast pumps in Durham can help make the process easier for both mom and baby. Additionally, having some breast milk stored in the fridge allows mom to share feeding duties with dad, other relatives, or the babysitter.
Read Also: Who Qualifies For Medicaid In New Jersey
How Do I Submit My Breast Pump To My Insurance
Youre going to call your insurance provider. Ask them which pumps you might be eligible for and whether you need a prescription and at which point during your pregnancy they can ship you the pump . You are then going to call an in-network durable medical equipment provider and order your breast pump .
