Can You Get A Breast Pump Through Medicaid? How To And Some Alternatives

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manny

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Published on April 3, 2020

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A Young Mother Breastfeeds Her Baby And An Electric Breast Pump

For new moms out there who are looking for a way to get a breast pump for free, you might be eager to know if Medicaid covers this kind of medical device.  Fortunately, Medicaid covers a breast pump for those new mothers who meet the qualifications. Therefore, here is a brief explanation on how to get one.

To get a breast pump through Medicaid, both the mother and the baby must be enrolled in Medicaid. You must have a prescription that you need a breast pump so that the application process will start since it takes up to 10days before you will be authorized to get a pump.  

Breast pumps are helpful for nursing mothers like you to store breast milk so that your little one still has the chance to get the benefits of breastfeeding even if you just got back to work to support your family. Another benefit why most postpartum mothers use a breast pump is that it can help with lactation by increasing milk supply. Moreover, using breast pumps are helpful for alleviating pain in the breast (mastitis) and for breastfeeding mothers with flat or inverted nipples

However, not all have the budget allocated to buy a breast pump that is why some new moms are looking for ways on how to get it for free, starting off with the basics, which is through Medicaid since it covers most health care services. Later on, you will learn other alternative ways to get it for free or at a discounted price. 

Can You Get A Breast Pump Through Medicaid?

Breast pumps are covered by Medicaid and you can get a breast pump if you and your baby are eligible members of Medicaid. 

Note that your baby is automatically eligible for Medicaid from birth to their first year. After that, you can enroll your child into the Medicaid program at any time

Hence, here’s some helpful information you must know beforehand when requesting a breast pump to Medicaid.

Breast Pumps Requires Prescription

The hospital, community supporters, and providers taking care of these postpartum mothers must be knowledgeable about the process on how to get a breast pump through Medicaid. Hence, these institutions working with these new moms play a vital role in the application process since they will be the ones who will write the prescription requesting the need for the new mother’s personal use of the breast pump. On the prescription, they must also indicate the baby’s due date since most policies take 2 weeks to 4 weeks after giving birth to obtain the breast pump.

 In short, Medicaid will not grant you immediately a breast pump not until the baby is born.

Because of this delay, it becomes alarming to postpartum mothers; however, worry not, since most hospitals offer temporary pumps, which can be used by new mothers while they stay at the hospital. 

In addition when prescribing a breast pump, the hospital or the provider must coordinate with the lactation services to know which type of breast pump is suited for the mother’s condition since there are a variety of breast pumps off in the market. This is applicable for New York State Medicaid Coverage of breast pumps. 

  • Manual pump: this is for single-user only; it is suited for daily milk extraction or for occasional use only. 
  • Double electric pumps: for personal use only; it is intended for moms who are planning to return to work or school right away and anticipate long-term use. Whereas for a single electric pump, they are not effective for extracting long-term milk supply nor can be used during short breaks such as during short 15-minute break at work
  • Hospital-grade pumps: this is a multi-user pump designed for both short-term and long-term use. They are recommended for postpartum mothers who need to maintain their milk supply. 

Coverage Terms Of Medicaid

As you know that requesting a breast pump to Medicaid is not as simple as ABC wherein after you gave birth to your baby, a free breast pump will just come your way. Well, sad to say, it’s not like that. 

It is hard to define Medicaid guidelines regarding breast pumps since different states have different policies; therefore, as a piece of advice, make sure you have called the nearest Medicaid in the state where you reside to get a gist on how the process works. 

There are certain states wherein Medicaid will not grant you a breast pump according to the Affordable Care Act, (ACA) where it mandates commercial insurance plans (if you have) to foot the bill for a breast pump. Instead, breast pumps will be covered by Medicaid if these women seeks immediate medical attention such instances wherein postpartum mothers are required to stay at the NICU for longer period of time, they have flat or inverted nipples wherein they cannot produce milk through breastfeeding, and other situations wherein the immediate need for a breast pump is a must.

For other states, a breast pump will be covered if the mother and the baby will be separated for a longer period of time. For example, the mother needs to go back to school or at work since her maternity leave was over. It is important to know that if your policy works under this certain condition, you need to present a prescription and a documentation that states your working/schooling hours that proves your time is not sufficient to breastfeed your baby.

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. 

Alternative Ways To Get A Breast Pump

Talk To Your Insurance Company

First things first, before you request a breast pump to anyone else, you must talk to your health insurance company in regards to their policy about breast pumps. Well, thanks to ACA that mandates insurance companies to cover the cost of breast pumps, lactation counselling, and other breastfeeding support programs. 

Once you have talked with your insurance agent, he/she will provide you the list of different types of pumps and different suppliers they are accredited with. You may also ask their policy about lactation counselling so that you can get the chance to talk to a lactation consultant about the do’s and don’ts during lactation.

One good thing about being insured is that you can buy your own breast pump and let your insurer reimburse the cost of the breast pump by submitting all the necessary documents such as the official receipt that proved you bought a new one. 

Work With A Breast Pump Supplier

There are several breast pump suppliers that you can directly work with to get a free breast pump. This works through this way: The breast pump supplier you work with will submit the claims to your insurance company so that you will get a reimbursement. 

Hence, listed below are the three main breast pump suppliers you can work with.

Edgepark

This supplier specializes in medical supplies delivery such as breast pumps from Ameda, Medela, and TOMY. To place an order, you may do it online by filling up the form. Make sure to provide your contact information since a sales representative will contact you to confirm your order. 

Byram Healthcare

This supplier, just like Edgepark, specializes as well in medical supplies delivery such as breast pumps. They also offer Ameda, Medela and Hygeia breast pumps. They also have an online form to place your order.

Lucina Care

A.k.a “the mother of all breast pumps”. This supplier specializes in breastfeeding accessories such as breast pumps. They offer a variety of pumps from different manufacturers such as Rumble Tuff, Philips Avent, Hygeia, Lansinoh, Nuk, and Melodi.

What is good about this online supplier is that their site is very informative and you have different choices of breast  pump which is suited for you. Since this is an online supplier, you can have a live chat with their agents if you have questions regarding your order and delivery. 

Get A Pump Through WIC

If you fail to get a pump through Medicaid or to your health insurance company, one of the best possible solutions is to get it for free or rent it through WIC. If you are enrolled in WIC, just ask your local WIC clinic on how to avail the WIC’s breastfeeding support program. Otherwise, if you are not yet enrolled, you may check this site to know if you are qualified to enroll. 

In A Nutshell:

The WIC offers to provide breast pumps to mothers who satisfies the following criteria:

  • They failed to get a breast pump from their health plans
  • They are uninsured
  • They are unaware of the benefits of their insurance plan regarding breast pumps policy
  • They received a  breast pump from their plan but the pump does not satisfy their needs

Aside from breast pumps, the WIC program provides information on how to use the pump properly. The basics on how to assemble, clean, and operate the breast pump. They also provide information on how to establish and maintain breast milk supply after the mother came back from school or work. 

In simple terms, the WIC supports all postpartum mothers and babies on their breastfeeding needs.

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