Will Medicaid Cover A Breast Pump


Pumps Should Be Prescribed In Coordination With Lactation Services To Determine Which Type Of Pump Is Best For The Mother

Medicare breast pump coverage
  • Manual pumps are appropriate for daily milk expression or occasional use, depending on the mother’s life schedule.
  • Personal use double electric pumps are intended for mothers who are returning to work or school, have an established milk supply, and are anticipating long-term use.
  • Personal use single electric pumps are not recommended since they are not effective in maintaining a long-term milk supply or when pumping during short time periods such as work breaks.
  • Hospital grade, multi-user pumps are designed for short and long-term use based on the mother’s and infant’s health situation, and appropriate for women who need to establish their milk supply.

Child Health Plan Plus Frequently Asked Questions

What is Child Health Plan Plus ?

Child Health Plan Plus is low-cost health and dental insurance for Colorado’s uninsured children and pregnant women. CHP+ is public health insurance for children and pregnant women who earn too much to qualify for Health First Colorado , but not enough to afford private health insurance. Get more information.

What kind of benefits are included in Child Health Plan Plus ?

See: About Child Health Plan Plus

When should I apply for Child Health Plan Plus ?

You can apply for Child Health Plan Plus at any time. CHP+ does not have an open enrollment period.

Are children of state employees eligible for Child Health Plan Plus ?

Yes, the children of Employees of the State of Colorado may qualify for Child Health Plan Plus . Employees of the State of Colorado must meet income and eligibility criteria for the program.

How do I apply for Child Health Plan Plus ?

See: About Child Health Plan Plus and HealthFirstColorado.com for more information.

How long will it take to find out if I qualify for Child Health Plan Plus ?

If you apply online through PEAK you may find out if you qualify immediately. If you apply by mail, it may take up to 45 days to find out if you qualify.

Is there an open enrollment period for Child Health Plan Plus ?

You can apply for Child Health Plan Plus at any time. CHP+ does not have an open enrollment period.

Are there co-pays or enrollment fees for Child Health Plan Plus ?

See: Child Health Plan Plus Fees

Do You Need A Prescription For Medicaid To Cover Your Breast Pump

Does Medicaid Cover Breast Pumps

Most Medicaid programs state that you should have a prescription from a physician before you get a breast pump. These programs also specify that moms must wait until the baby is born or a few weeks to their due date to get the pump.

This is a cause for concern for some moms, but no need to panic. If necessary, most hospitals have temporary pumps on standby for you to use during your stay.

When prescribing a breast pump, the hospital must liaise with lactation services to find out the kind of breast pump suited for a specific mothers condition because there are various kinds of breast pumps in the market.

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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?

The Right Breast Pump For You

Moms on Medicaid may soon have more options for breast pumps

Manual pumps: Manual pumps allow the user to control the suction rhythm by themselves. They dont rely on batteries or electricity, so they can be used anywhere. Typically they are single pumps, meaning they can only be used on one breast at a time. Great for on-the-go use, but a bit more labor-intensive for the user. These pumps are ideal for occasional use when youll be away from your baby for just a few hours.

Battery and electric pumps: As the name suggests, these pumps run on batteries, or are plugged into an outlet. They have automatic suction, so no manual pumping is required. Some of these pumps have the ability to mimic your babys natural nursing rhythm, which helps your body to express milk more easily. These are typically dual models, so you can get the most milk in one use. If you are on a strict schedule and need to pump quickly and get back to your life, these may be your best option.

HCD has a wide range of breast pumps and are able to provide you with the correct product for your needs. Sometimes Medicaid will only cover one type of pump, depending on your state and l needs. We are happy to help suggest a product to you and explain your insurance coverage.

Welcome to motherhood! Things might feel a little overwhelming, but you are not alone. Let HCD be one of the members of your new mom team. If youd like us to call you, enter your phone number at the bottom left of this screen.

Also Check: Income Needed To Qualify For Medicaid

Why Is A Breast Pump Free Now

As you may know, previously new moms had to pay for their pumps if they wanted to use them, but not anymore. It is a part of health insurance now due to the amazing benefits breastfeeding has for a child.

Breastfeeding is recommended by the Academy of Pediatrics and quality pumps can help doing it after getting back to work.

Once you get your new pump, you should practice using it and save breast milk before you get back to work.

Knowing you have milk in a freezer for your babe will make transition stress-free. And when mom is less stressed, the child is happy.

Get A List Of Providers And Choose One

Nowadays, there are breast pump providers that you can contact directly to get your free breast pump. The provider fronts the cost of the chosen pump and submits the claim to Medicaid on your behalf.

Qualified providers specialize in breastfeeding info and breast pumps. They have plenty of brands to choose from, such as Medela, Ameda, Nuk, Melodi, Phillips Avent, Lansinoh, Hygea and more.

You can find information on their website and compare their models with what other companies have. You can also contact their agent if you have questions.

Also Check: Choose A Health Plan Medicaid

A Prescription Is Required For Breast Pumps

Most Medicaid policies require that you have a prescription on hand before you get your breast pump. Most policies also require that moms wait until the birth of the baby or close to it to obtain the pump. This can cause some alarm for some mamas, but dont fret! If necessary, many hospitals will provide a temporary pump to new moms during their hospital stay.

Q: Will My Insurance Plan Cover A Rental Breast Pump What If I Want To Buy A New One Instead

Medicaid payed for my breast lift & breast reduction

A: Your health insurance company can tell you what specific types of breastfeeding equipment are covered under your plan. Some plans cover only rental pumps, and some plans cover new pumps but only specific types. Contact your health insurance company to find out what type of breast pump is covered.

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Types Of Breast Pumps Covered

As I have said, different states vary different Medicaid guidelines however, generally, most of the Medicaid guidelines will cover only these types of breast pumps: manual and standard electric pumps. There are only a few states such as in New York City that cover hospital-grade breast pumps.

Meanwhile, if you have been granted a breast pump, some Medicaid policies strictly recommend that breast pumps must have warranties and must conform to manufacturing standard and safety procedures.

Does Medicaid Pay For Breast Pump Replacement Parts

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.

Also Check: How To Renew Medicaid Ny Online

Doctor Visits & Screenings

Preventative care visits are covered by Buckeye Health Plan. This means visiting the doctor for a regular check-up, rather than waiting until you are sick.

Buckeye Health Plan covers an annual physical for adults.

Regular child check-ups are also covered for those under the age of 21. These doctor visits should occur at the below ages. Children also need a blood lead test at 12 and 24 months of age. We cover this. After that, if they are high risk, they need the blood lead test each year age 3 to 6.

  • Birth or neonatal exam

Q: I’m Having Trouble Using My Breast Pump And I Have To Go Back To Work In A Few Days Can You Help Me

How to Get an Insurance Billable Breast Pump

A: Yes. First, congratulations on practicing with your breast pump before you go back to work. It’s important to be comfortable pumping before you have to do it in an unfamiliar environment like work or school.

If you’re having trouble, you can call us toll-free at 800-994-9662, Monday through Friday, from 9 a.m. to 6 p.m. ET, to talk to a trained breastfeeding peer counselor in English or Spanish. A counselor can answer your questions about how to store pumped milk, teach you how to clean your breast pump, and give you tips to get the milk flowing when your baby isn’t there.

If you need more help with breastfeeding, ask your health insurance company for a list of providers who can provide lactation support. Most health insurance plans, including those in the Health Insurance Marketplace, must cover breastfeeding support and counseling for the duration of breastfeeding.

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Medicare/medicaid Frequently Asked Questions

I have Medicare . How do I get help with the Medicare costs?

Members can apply for assistance with their Medicare costs at the county department of human/social services where they live.

Will I get a refund of all the Medicare premiums I paid?

Maybe. If a refund is due, it will only go back to the month Buy-In began. Some programs can be backdated up to three months prior to the application date, if the member qualifies. The Qualified Medicare Beneficiary program begins the first of the month after the application date. QMB cannot be backdated.

When will I get my refund of paid Medicare premiums?

Usually within a month after the county approves eligibility. If it takes longer than a month, contact your county human services office, or the State Buy-In Officer.

How will I get my refund of paid Medicare premiums?

The refund comes the same way your regular social security payment comes, direct deposit or paper check. The refund can come any day of the month.

Will the Medicare Savings Program pay my Medicare deductible and co-insurance?

The Qualified Medicare Beneficiary Medicare Savings Program will pay the Medicare deductible and co-insurance. The other MSP programs will only pay the Medicare premiums.

How do I get help with my Medicare Part D costs?

Contact the State Health Insurance Assistance Program toll-free at 1-888-696-7213.

Where Can I Get A Free Medicare Breast Pump

The cost of raising a child seems to keep going up, especially if youre looking to get the best products and supplies for your child. Well, let us take one item off of your baby checklist for you. Our team makes it almost effortless to get your breast pump through Medicare. We have years of experience working with insurance providers on a daily basis.

You may be wondering, Can I get a Medicare breast pump near me? Here at The Breastfeeding Shop, we have all kinds of breast pumps. Whether you need a Medicare Spectra S1 or an Ardo Calypso, weve got you covered. This allows you to get access to a hospital-grade breast pump for a fraction of the usual cost.

And when youre not quite sure which pump is right for you, feel free to reach out to our company. We get it there are a lot of different options for pumping moms these days. But theres no need for you to go and research all of them by yourself especially since our knowledgeable team is here to help. Well gladly go over the pros and cons of getting an Elvie pump vs. a Freemie Independence mobile breast pump or a Medela. We just want you to have the right equipment you need to care for your baby. And we have more than just great breast pumps. We also provide compression garments, spare pump parts, bottles, storage bags, and more. Contact us today for more details!

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What If Your Health Insurance Doesn’t Cover A Free Breast Pump

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You’re 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.

How Can I Get A Breast Pump Through Medicaid

Insurance Covered Willow/ Elvie Pump || What kind of breast pump will my insurance cover? BEST DME!

New and expectant moms can use Pumps for Mom to get their breast pump through insurance, although its important to remember that many Medicaid plans will only process payment and ship your pump when the baby is born. Our qualification form makes it easy for moms to browse breast pumps that are covered by their Medicaid plan and order their pump when they are ready. The Pumps for Mom team can help you verify your insurance coverage, assist you in getting a prescription, and keep track of your breast pump when its on the way to you. When it comes to getting a Medicaid breast pump, were with you every step of the way.

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Healthcare Coverage For Your Baby

If your child is lives in a family with an income at or below the Medicaid eligibility level, your newborn will be enrolled in Medicaid for 12 months of continuous Medicaid coverage beginning on his or her date of birth. After the twelve months of coverage ends, you can apply through the state CHIP office to have your baby covered under the CHIP program. Learn how to apply for Medicaid services.

Does Medicaid Cover Breast Pumps

Simple question, right? But the answer isnt necessarily as easy. One easy way to find out is by completing our online application. EHCS will research your Medicaid plan and work with them to confirm your benefits and determine which breast pumps youre eligible for.

Lets start with defining Medicaid. Youd think that would be easy, but its not as black-and-white as youd think. The Health Insurance Association of America says that Medicaid is a governments-sponsored insurance program for individuals of any age whose resources and income are insufficient to cover health care. Under the Affordable Care Act, you can qualify for Medicaid if you make less than 133 percent of the federal poverty line. Currently nearly 70 million people are enrolled in a Medicaid plan or Childrens Health Insurance Program.


Medicaid programs are funded by state and federal dollars, but states manage their own programs, which is partly why its hard to say, yes, Medicaid covers breast pumps. Another issue is that some states used managed care organizations to administrate their Medicaid programs, and each of those has its own rules.

The good news is that many Medicaid and managed Medicaid programs cover breast pumps, and your local WIC office will be a great help in breastfeeding successfully.

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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.


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