Getting Insurance Coverage for Pumps

Get a prescription from your baby's doctor for breastmilk (not a breastpump). Submit it to you insurance company with your receipts. (This falls under your durable medical equipment benefits) The company will automatically send it back. Send it back in. If a denied claim is questioned by the insured person, it has to be examined by a claims review board. Sometimes they pay. Most of the time they don't (even when babies are sick in the hospital). All it costs you is some time and postage and I think it's worth the effort. If insurance companies get enough bills for pumps they may change their attitude.

Well, first of all, contact your insurance co. If you are renting, almost all ins pay. If you purchased, most require a prescription and even then alot won't pay. However, the prescription makes it a tax deduction under medical expenses if you itemize. That was a big plus for us.

I have purchased two PIS pumps. The first one was paid for in full by Blue Cross HMO with a Rx for a breast pump (not breast milk). At first the claim was denied, but was paid once I filed a complaint with the Illinois Department of Insurance. The second one was paid in part (60% I think) by Blue Cross PPO with a Rx for a breast pump (not breast milk)-- no problems. My daughter was a preemie, however, who could not eat orally in the beginning and was never able to nurse. That may have helped but I don't know.

In Illinois, one can file on-line complaints regarding denied claims.

My insurance covers "durable medical equipment" which the breastpump is considered to be. But I have a $500 deductible, so my ins. won't cover mine.