Breastfeeding is your right. And the benefits aren’t just healthy, but monetary. Many women decide how they are planning to feed their baby before birth. There are also a lot of women who think “I’ll give breastfeeding a shot and if it doesn’t feel right I will switch to formula.” One flaw with that thinking is that it leaves out a great possibility of pumping. You can pump and feed breast milk no matter the latch, social pressures, or other reasons.
To make things simple I will 1. outline the intent of the Affordable Care Act with regard to breastfeeding equipment and support. 2. I will outline the best ways to make sure you will be 100% covered with the equipment you buy. ( I am not a healthcare expert or legal expert regarding ACA law, all advice is in good faith and from my personal experience with the law and its provisions). You can refer to your insurance and the ACA guidelines at www.healthcare.gov.
- The Affordable Care Act was passed with the intent to provide breastfeeding support and counseling both before and after the baby is born. That may include one-on-one visits with a lactation consultant or other expert in the plan’s network of providers. Reasons why a mother might want support is in the case that her baby isn’t latching well, the mother’s supply seems to be low, the mother is uncomfortable with the latch, or the baby is not gaining weight. Lactation consultants and other experts are to be covered.
THE ACA and equipment and support:
The ACA protects breastfeeding in two ways. According to WebMd, “The first is in the workplace. Mothers who are eligible for overtime pay now have the right to both time and a private place that is not a bathroom to express, or pump, their milk at work. Many moms are going back to work, but it’s not always a place that is friendly to breastfeeding. The law now requires many businesses to provide accommodations on-site. The law also requires most insurance plans to help with the cost of breastfeeding support and equipment.”
The ACA now requires that most health insurance plans cover the cost of breastfeeding equipment, including pumps. According to the government website, “Your health insurance plan must cover the cost of a breast pump. It may be either a rental unit or a new one you’ll keep. Your plan may have guidelines on whether the covered pump is manual or electric, the length of the rental, and when you’ll receive it (before or after birth). But it’s up to you and your doctor to decide what’s right for you.”
You might want to rent a high quality pump or buy one for your own situation. There is much to take into account. Examples of reasons people might prefer certain methods are
- A mom who needs a rental-grade pump to keep her supply up while her baby is hospitalized
- A mom of twins who needs to pump at work and needs it to be quick will need a double electric pump
- A woman who finds that electric pumps are cumbersome or doesn’t need to pump often might want a manual pump for their own circumstances
2. Equipment coverage must-knows:
Now we are talking about the government here, so of course there are some loopholes, and of course there are some inefficiencies. Don’t be discouraged! You will save a lot of money by skipping formula!
Grandfathered plans= loopholes. If you have grandfathered plan, you might not be entitled to a free breast pump or other support. Check with your insurance provider. Though these are uncommon, it could be a costly mistake to get a pump for $300 only to pay out-of-pocket.
Check with your insurance provider to see how pumps are covered. My insurance company has a list of preferred pumps and locations where I could buy one. I then sent them my receipt and they reimbursed me for the pump. Some other providers ask you for a doctor’s prescription that can be filled by your OBGYN and then taken to a Walgreens or Target. Make sure that you get the exact recommended pump. There is a prescription Medela Pump in Style Advanced that looks exactly like the retail one, but insurance will only cover the prescription! Be very careful!
Some pump brands have help for you to trouble shoot your insurance. I bought a Medela and they had a helpful page on their site to check for my insurance. Check it out here!
DO NOT OPEN YOUR PUMP (or it cannot be returned). If you are not sure that your pump will be covered, do not open it until you have received the notification from your insurance company or doctor letting you know that the transaction is complete. If you do open the pump, you are liable and will have to pay for it out-of-pocket. (this goes for stores where you return it, too) Pumps cannot be tampered with or they are not returnable!
Hope this helps you to navigate the wild world of breast-feeding and support. Feel free to comment or shoot me an email with any other questions! Also check out my posts about breast pumping hacks for working moms and 12 reasons why breast milk rocks!