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Breast pumps and the health care reform act

post #1 of 34
Thread Starter 

Did you know the health care reform act made it such that women with health insurance can get a free breast pump? I just called my insurance, Empire BCBS and they confirmed this is accurate. You have to buy through a medical wholesaler they work with and the company submits the claim to the insurance so there's no paying out of pocket and getting reimbursed. 

 

My neighbor upstairs told me about it and she said she wound up getting one that was like $300 or so. 

 

Not sure about all insurance plans but if you plan to pump (which I haven't even decided on but, if it's free, can't hurt to have the pump) and need a breast pump, call your insurance! 

post #2 of 34
Bummed our insurance won't pay for one. We have Tricare and technically it's a military benefit, not insurance (not sure how they get away with that distinction) so the law doesn't apply to them. greensad.gif. I used a pump a lot with Maddox (really nice loaner one from WIC) to help with a ridiculous over supply. I didn't pump enough to increase my supply, just enough to relieve engorgement and help prevent clogged ducts. I had mastitis repeatedly and pumping was the only thing that helped until my supply regulated, so I may be able to get a prescription after the baby is born. Maddox never had a bottle, but it was also nice to be able to give the extra milk to a mom who needed it. Hope I'll be able to get one this time around.
post #3 of 34
Yup, I called my insurance mid-January and they provide through 3 different companies. I'm going to go with the one that will get me a Medela PIS which is not a cheap pump, all I need is a prescription, so I will see if my OB can write me one if not I'll have the pediatrician do it after and just use my pump from DD until then.
post #4 of 34
Obviously I'm in uk so I have to buy my own pump but what's people's experience of best pump.. Value is important too but I'm looking at getting it on offer or second hand so best pump generally would be good.. I have reasonably large boobs (well large but I'm petite) i think with my pain management I will have to pump off milk when I take my meds aswell as for feeds perhaps in the future when I need a hand or a break or whatever.. So It's definately a must.. I think I'm gonna go with electric .. I'm a complete novice so yes any advice would be wonderful smile.gif
post #5 of 34

I have been meaning to call my insurance company, that is a really awesome benefit! I need one as I will be going back to work, but if I have to get a prescription, that will be a big pain, since I am only working with a midwife. I am hoping I can just go thru the supplier. Any tips anyone has on the details of this stuff would be very helpful!

 

Even if you don't plan to "need" a pump, it is a great idea to have one. When my milk came in with dd, I was so engorged she couldn't nurse and I was in serious pain. I didn't have a pump yet and ended up having to manually express in a hot shower, which sucked.

 

I have no idea about different kinds/brands of pumps, I was lent one last time and will prob just decide based on what my insurance will cover this time. The one I used before was electric, so that is all the experience I have. It was hard to pump at first, I could hardly get any milk out and not a lot of hind milk, even when pumping for a long time...I didn't pump much since I was SAH, but what I did pump did come in handy. I had a night once where I had no production and dd was so hungry! I was so glad I had some milk stored up. Supply was back within hours, but it was weird and I don't know what I would have done if I didn't have any breast milk stored. So I will need to be sure to get this down this time since I will be gone at least two 8 hr days each week starting around 13 wks.

post #6 of 34
Thread Starter 
Quote:
Originally Posted by adventuregirl View Post

I have been meaning to call my insurance company, that is a really awesome benefit! I need one as I will be going back to work, but if I have to get a prescription, that will be a big pain, since I am only working with a midwife. I am hoping I can just go thru the supplier. Any tips anyone has on the details of this stuff would be very helpful!

 

 

Oy, I'm using a midwife too, I hope it won't be a problem if I need a prescription! She's a CNM though so maybe she can write one? I guess I'll have to call the insurance co. back and ask if I'd need a script.

post #7 of 34
Honestly, the insurance company may not know, I had to call the suppliers and find out from them and they all told me different things, everyone seems a bit confused since this is so new, one reason I want to try to start the process sooner rather than later to hopefully have the pump a bit before birth so I can read the instructions and get it set up. They are pretty simple devices, but still, you don't want to be figuring it out while sleep deprived if avoidable! Will you take your baby to a pediatrician or family doctor to get them checked after birth at some point, I'm sure they could write the prescription if you need one.

As for pump recommendations, I had an Ameda Purely Yours double electric as my workhorse with DD since I pumped while working FT from 4 months - 13 months of age with her. Loved it except when I burnt out the motor, but Ameda replaced it quickly (it was under warranty) and also covered my pump rental while I was without a pump for a couple days. I also had Avent manual pump which I left at home once I was working (the Ameda stayed at work) and I used it when I wanted to relieve engorgement as I sucked at hand expression. It is a good hand pump, but hand pumping sucks to do more than just occasionally IMO. I think if you want to pump at all regularly, definitely consider an electric and a double electric for sure if you are going to be working and pumping, even PT IMO.
post #8 of 34

This is awesome news!  I'll have to check it out.  I have a breast pump, but it is getting kind of worn.  I would love to replace it.  By the way, it is a Medela Pump in Style and it lasted through pumping for 4 babies over 8 years...so I highly recommend it!  I pumped a lot too--several times daily for a year with each baby.  (After a year, I supplemented nursing with raw goat's milk. While all the babies went on to nurse for 2 - 3.5 years, I just couldn't take the pumping for longer than a year.  It's the only part of having babies that I don't like.)

post #9 of 34

I called a while ago and my insurance (UHC) gave me three suppliers to call, all of them are out of stock and have no idea when they'll get stock back in. One won't even put your name on the waiting list until after the birth, one makes you wait until 30 days before the birth to be put on the list and the third is just plain saying they are out of stock. 

post #10 of 34
Quote:
Originally Posted by timesway View Post

Obviously I'm in uk so I have to buy my own pump but what's people's experience of best pump.. Value is important too but I'm looking at getting it on offer or second hand so best pump generally would be good.. I have reasonably large boobs (well large but I'm petite) i think with my pain management I will have to pump off milk when I take my meds aswell as for feeds perhaps in the future when I need a hand or a break or whatever.. So It's definately a must.. I think I'm gonna go with electric .. I'm a complete novice so yes any advice would be wonderful smile.gif

I used a Medela Pump In Style last time and was happy with it.  You might not need something that heavy duty if you'll only pump occasionally though.  It's a double pump, so you can do both sides at once, and has different settings for pumping, etc.

 

Size of your breasts isn't so important as size of your nipples.  You'll need to buy the right size nipple shield.  Also, if you are thinking of buying used you will want to at least seriously consider buying all new parts that come into contact with the milk (tubing, nipple shields, etc.) and what those parts are will depend on the pump you buy.  Another option may be for you to rent a pump.  I don't know if you have insurance or what is covered by that in terms of pumps in the UK.  In Canada I'm pretty sure none of it is covered.

post #11 of 34
Thread Starter 
Quote:
Originally Posted by SteeleTig View Post

I called a while ago and my insurance (UHC) gave me three suppliers to call, all of them are out of stock and have no idea when they'll get stock back in. One won't even put your name on the waiting list until after the birth, one makes you wait until 30 days before the birth to be put on the list and the third is just plain saying they are out of stock. 

YUK! That is as DH would say "el-shtoonko". That means that stinks :P

 

Your in BK so I wonder if your suppliers are the same. Do you mind sharing with me which suppliers you contacted? 

post #12 of 34
Quote:
Originally Posted by timesway View Post

Obviously I'm in uk so I have to buy my own pump but what's people's experience of best pump.. Value is important too but I'm looking at getting it on offer or second hand so best pump generally would be good.. I have reasonably large boobs (well large but I'm petite) i think with my pain management I will have to pump off milk when I take my meds aswell as for feeds perhaps in the future when I need a hand or a break or whatever.. So It's definately a must.. I think I'm gonna go with electric .. I'm a complete novice so yes any advice would be wonderful smile.gif


As another big boobed woman I agree that its more about the nipple size. I have a Phillips Avent Isis iQ double electric breast pump. (It's a UK based brand) I really like it and its nice and compact and very quiet. I only used it very occasionally until DS2 (got it when he was born) decided he wanted his milk from a straw sippy instead of direct from me when he was 9 months old, and then I exclusively pumped ALL his milk for 4 months with it. With DS1 I rented a hospital pump for 10 days when he was first born as we had trouble getting him to latch (long story etc) and I actually had better results with the Avent than the hospital grade one. It has been updated to a new model, so here is the new model on amazon.co.uk I really like the cushioned nipple shield part, as it made it a lot more comfortable for me.

post #13 of 34
Oh yes, definitely get the right flanges for your nipple size, breast size doesn't really matter. If you aren't sure, have a LC help you!

And for me, the hospital rental did not work any better than my Ameda either, I know in most BFing books they say you should go with a hospital rental if you are going to be pumping exclusively, for me the only reason for that would be the motors on those are much more robust so they won't burn out on you smile.gif but others may have different experiences. The rental pumps are so much larger which sucks if you are lugging it back and forth or for travel (I did travel with my pump a few times when I traveled for work, only driving trips though).
post #14 of 34
Quote:
Originally Posted by Loogiejane View Post

Your in BK so I wonder if your suppliers are the same. Do you mind sharing with me which suppliers you contacted? 

I was told to contact Edgepark (800-321-05910), Byram Healthcare (877-902-9726) and Lucinacare (www.lucinacare.com). 

post #15 of 34
Thread Starter 
Quote:
Originally Posted by SteeleTig View Post

I was told to contact Edgepark (800-321-05910), Byram Healthcare (877-902-9726) and Lucinacare (www.lucinacare.com). 

Bleeeeerg. Those are the same mine told me. Hm, so if I can't get a free pump maybe ill just go without and be a nursing machine. Seems easier (read: I am lazy) But aw, then DH will never be able to feed our babe til he/she starts on solids

post #16 of 34
Quote:
Originally Posted by Loogiejane View Post

Bleeeeerg. Those are the same mine told me. Hm, so if I can't get a free pump maybe ill just go without and be a nursing machine. Seems easier (read: I am lazy) But aw, then DH will never be able to feed our babe til he/she starts on solids

It's really not that bad...my DS refused a bottle from 3 mos on and only had it a handful of times before that.

 

If dad can't feed baby, he can at least change all the diapers....winky.gif

post #17 of 34
Thread Starter 

I feel like I'd want a pump though in case I'm a milk producing machine and it's more than my baby can eat..or something. Or if I had engorgement issues....or something.  Gotta get me to a LLL meeting. 

post #18 of 34
Quote:
Originally Posted by Loogiejane View Post

I feel like I'd want a pump though in case I'm a milk producing machine and it's more than my baby can eat..or something. Or if I had engorgement issues....or something.  Gotta get me to a LLL meeting. 

Well, if you want to donate milk, a pump would be good.  If you don't, then your body will adjust to produce less milk and if you needed to pump off a bit you could always just get a hand pump.  Or, you can express by hand.  I've done that when I was travelling for work and didn't have my pump and was getting uncomfortable.

post #19 of 34

I talked to my health insurance company three times this week - they're saying it's so new that they don't have a lot of official info yet to give out. Everyone I talked to told me something slightly different.

 

They said I can have a free breast pump as long as it is not hospital grade and if I get it through one of their in network durable medical suppliers. No clarity on whether prescription is needed - one rep said yes, another said no (as in no proof of medical need required; just that you be pregnant or have given birth in past 6 months or year, I don't remember).

 

They gave me a list of 5 different durable medical suppliers and I went to all their websites. The only site that even has breast pumps in their online catalogs is EdgePark. And on EdgePark's site, it looks like there's a small selection of pumps: https://www.edgepark.com/shopcatalog/searchresults.cfm?keyword=breast+pump&source=header

 

The only one listed that seems to be quality is the "Evenflo Company Purely Yours Breast Pump" - which per google is the same as Ameda Purely Yours. I see this has good reviews on Amazon on on various Mothering forums. I will talk to my La Leche league group to see if people like this one. Also I suppose the lactation consultant will have an opinion!  (Also, when I contact Edgepark directly, maybe their customer service person can tell me more/maybe they have larger selection than what is listed online.)

 

Any of you have experience with Ameda Purely Yours?

 

I'd like to get this ordered and in the house sooner rather than later!

post #20 of 34

Another question -- is it a bummer at all that the free pumps available thru insurance aren't hospital grade? I will be pumping at work so I know double electric is great. How much does "hospital grade" matter though?

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