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For breastfeeding mothers, a breast pump can come in handy. Pumping can help build up your milk supply and enable someone else to feed your baby when you cannot. If you want your baby to have breast milk after you go back to work, for instance, a pump is a must-have item, as it allows you to express breast milk for a caregiver or partner, who can feed your baby when you’re not there.
The good news is, thanks to the Affordable Care Act (ACA), new moms are entitled to a free breast pump and supplies through their insurance. Here’s how you can get yours.
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 doesn’t 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.
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 Paladino’s experience, most insurance companies have a dedicated maternal child specialist who can explain the process and the coverage to which you’re entitled. But start by calling the Member Services phone number on the back of your insurance card.
Before you make the call, gather your questions. Here’s a list to help you get started, along with what you can expect the representative to say:
If your insurance company offers several options, you will need to decide what kind of pump works best for you. Here’s a brief overview.
When you can get your pump varies. Each insurance company has different guidelines as to when your breast pump can be shipped. If you don’t get it while you’re pregnant, you can get it after you give birth. But Paladino suggests getting it in your third trimester, if possible. “It’s one less thing to worry about,” she says.
If your insurance company says that your coverage doesn’t include a free breast pump, the most likely reason is your plan is considered a “grandfathered” plan. These are plans that existed before March 2010 (when the ACA was enacted) and haven’t changed substantially since then. Grandfathered plans are not obligated to comply with certain provisions of the ACA, including the coverage of preventive services at no cost.
If you’re denied a breast pump and you think your plan isn’t a grandfathered plan, you have the right to appeal. The appeals process should be clearly stated in your member handbook or on the insurance company’s website online. If you need help, contact your state’s Department of Insurance or Consumer Assistance Program.
Breastfeeding Benefits: Understanding Your Coverage Under the Affordable Care Act. National Women’s Law Center. Accessed 04/24/2021.
Breast Pumps and Insurance Coverage: What You Need to Know. U.S. Department of Health & Human Services. Accessed 04/24/2021.
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Kate Kelly is a Pittsburgh-based writer who specializes in health and parenting. She is passionate about empowering women with good health information. She was an editor at Parents, American Baby and Shape magazines. She likes hanging out with her three sons and her cat, Maisy, and she’s thinking about getting a dog.
Sarah is an experienced writer and editor enthusiastic about helping readers live their healthiest and happiest lives. Before joining Forbes Health, Sarah worked as a writer for various digital publications including LendingTree, theSkimm, CNBC and Bankrate. When she isn’t writing or editing, you can find Sarah with her nose in a book or enjoying the outdoors with her French bulldog, Honey.