Does my health plan cover breast pumps?
Who is this for?
If you're looking to find out if your health plan covers breast pumps, this information can help.
Having a baby is a life-changing event. The last thing you need to worry about is whether or not your health plan covers your breast pump.
Under the Affordable Care Act, breastfeeding supplies such as breast pumps are considered an essential health benefit. That means that certain health plans have to cover them. But there are some plans that will only cover a portion and others that have opted out of coverage.
Breast pumps are covered as durable medical equipment. This means that they’re basic equipment that you can use at home. In order for your plan to cover your breast pump, your doctor will have to write a prescription for it.
Your health plan will cover your breast pump if you bought your plan on healthcare.gov. If you work for a small company that gets insurance through a SHOP plan on the exchange, your breast pump will also be covered. You can find out from your employer if your plan qualifies.
Blue Care Network HMO members
If you’re a Blue Care Network HMO member, you’ll need prior authorization for your plan to cover a breast pump. And since breast pumps are considered durable medical equipment, Northwood, Inc. will fill your prescription. If you need to find a local Northwood provider, call 1-800-667-8496 from 8:30 a.m. to 5 p.m. Monday through Friday.