Wonderful but frustrating breast pump news in Oregon - Mothering Forums

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#1 of 1 Old 10-13-2011, 06:18 PM - Thread Starter
 
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The good news: OMIP (the oregon high risk medical pool) and Blue Cross/Regence specifically (the plan that administers OMIP's programs) covers breast pumps as a covered service. The only qualifying requirement is that members be pregnant or breastfeeding and anticipate missing at least one feed during the lactation period. That's it. No prescription required.

 

HOWEVER... there's a catch. The catch is that they'll cover it as a standard benefit through preferred providers, but if you get a pump at a store, they'll only cover 60% up to a fairly hefty out of pocket max after you meet your deductible. So you can walk into a medical supply store that's a preferred provider and walk out with a Medela Pump In Style without a prescription and just get billed for 20% if you haven't met your out of pocket (though it's hard not to meet your out of pocket the year you have a baby!).


But if you don't respond well to the Medela pumps, and want a different brand, you're going to have to jump through some hoops, and end up paying at *least* 40% of the cost yourself.

 

Calling medical supply stores, they say, "Oh, we don't sell many of those, and we only carry Medela." Or they don't carry them at all.


They don't sell many of them because most women don't even think about the chance that insurance will cover the pump. But starting next summer, pretty much EVERYONE's insurance will cover pumps!

 

So demand is going to go up. What I really want to see is some of the already-preferred-provider medical equipment companies carrying more than just the Medela pumps. Hygeia anyone? Ameda?

 

Regence is huge in Oregon as an insurance provider. Check your coverage ladies... 

 

In Eugene, I've already mentioned to Fletchers that if there's a way they can become a preferred provider and bill insurance for pumps, it's possible they'll be able to move a lot more pumps.  But it would be nice for the medical supply companies to know that there's a demand. 

 

I'm thrilled that I can get a decent pump, free. I'm a little bummed that it's a Medela, as their shells just aren't great for my boobs.

 

 


Jenrose, Mama to DD1, born 1993, DD2, born 2005, and DS1, Jan. 2012. Babywearing, cosleeping, homebirthing mom with fibromyalgia and hashimotos.  DD2 has a rare chromosome disorder. 

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