With the inclusion of Women’s Preventive health benefits in the Affordable Care Act, new mothers can access no charge breast feeding support and the rental or purchase of a breast pump to support her newborn.
Offer valid only with health insurance
This benefit is available to mothers who are enrolled in an Individual and Family Plan or Employer Group Plan that was initiated after the Affordable Care Act took effect in September of 2010 or a grandfathered plan (before the ACA) that has chosen to include the new breast feeding benefit.
How do I know if I am eligible for a free breast pump?
The simplest way to find out if you are eligible is to check your Evidence of Coverage booklet or the updates that are sent out yearly. If that paperwork isn’t lying around, you can call your Human Resources department or call your health insurance company directly. Some of the retailers of the breast pumps will also call on your behalf to see if your policy covers the breast pump. This is a preventive benefit and just like the yearly Well Women Visit, there is no copayment, coinsurance, or deductible costs.
The sample language in your EOC might look like this:
Blue Shield Secure Plus 2000 Evidence of Coverage
Breast pump rental and purchase is only covered if obtained from a designated Participating Provider in accordance with Blue Shield medical policy. For further information, call Customer Service or go to www.blueshieldca.com.
Different insurance different benefits
Each health insurance carrier is approaching the benefit in different ways. Some will only cover rental costs of a breast pump, while others have contracted with some retailers to purchase the machine and send it to the member. Insurance carriers have also brought on lactation consultants to help new mom’s breast feed for those who don’t want a breast pump. They are all trying to comply with the regulation that creates the least cost to the plan.
While I have seen some language limiting the breast pump to new mothers, I have to believe that if the mother wasn’t covered by a health insurance plan with the benefit, but her partner was and was also the father or supporting spouse, the insurance company might just cover the breast pump in that situation. Until someone contests the benefit under those circumstances, we may won’t have a definitive answer.
My real question is, what will this do to the baby formula business model?
Other stories on the breast pump frenzy
National Public Radio: Free Breast Pumps And The Cost Of Health Care
Washington Post: The breast pump industry is booming, thanks to Obamacare