Can I Get a Breast Pump Through Insurance?

Under the Affordable Care Act (ACA), major medical insurance plans are required by law to cover breast pumps if you are nursing a baby, although health insurance companies have some leeway when it comes to deciding what types of pumps to cover and at what point you can become eligible for coverage.

Read on to learn more about getting a breast pump through insurance including how you can make sure your breast pump will be covered and what your costs may be with and without coverage.

On This Page

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  Are Breast Pumps Covered by Insurance?

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  What Types of Breast Pumps Are There?

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  How Far Along Do I Have To Be To Get a Breast Pump Through Insurance?

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  How Much Are Breast Pumps Without Insurance?

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  Can My Insurance Company Refuse To Cover Breast Pumps?

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  FAQs

Are Breast Pumps Covered by Insurance?

ACA-compliant health insurance plans are required to cover breastfeeding supplies with no cost-sharing, meaning you can get a free breast pump through insurance without paying a copay or coinsurance regardless of whether you’ve met your deductible for the year.^[1]

However, specific coverage details can vary from plan to plan because insurers are allowed to set their own guidelines for breast pump insurance coverage such as what type of pump is covered, whether you can get a pump to keep or must rent one, how long rental pumps are covered and whether you can receive your pump before giving birth.^[2] In general, health insurance carriers only cover one breast pump per pregnancy, although you may have up to one year after giving birth to claim your insurance-covered breast pump.^[3]

Do You Need a Prescription To Get Breast Pumps Through Insurance?

You will generally need a prescription to get a breast pump covered by insurance. Medical professionals who may be able to give you a breast pump prescription include obstetricians and gynecologists (OB/GYNs), primary care physicians, midwives, nurse practitioners and pediatricians.^[3]

How Do I Know if My Insurance Covers Breast Pump Parts?

Some breast pump providers such as Aeroflow may coordinate with your insurance company and notify you if your health insurance plan covers replacement breast pump parts.^[4] Otherwise, you may need to reach out to a representative from your insurance carrier directly to find out whether your plan covers extra parts.

What Types of Breast Pumps Are There?

There are four major categories of breast pumps you can use to express and set aside breast milk for your child:^[5]

• Electric: While electric breast pumps are among the strongest types of breast pumps, they generally must be plugged into an outlet to function. You may be able to get a single electric breast pump to pump milk from one breast at a time or a double electric breast pump to pump milk from both breasts at the same time.
• Battery-operated: Battery-operated breast pumps are similar to electric pumps but they trade a bit of suction power for portability since they don’t require you to have access to a wall outlet.
• Manual: You must actively use your hands to pump milk with a manual breast pump. Despite this inconvenience, manual breast pumps tend to be lighter and cheaper than other types of breast pumps.
• Hospital-grade: These high-powered breast pumps are primarily recommended if your circumstances severely inhibit your ability to breastfeed. For example, you may need a hospital-grade breast pump if you gave birth to triplets or have a medical condition like mastitis. Keep in mind that these breast pumps are designed for multiple users and a hospital-grade pump may only be available to rent.

What Kind of Breast Pumps Are Covered by Insurance?

The ACA does not dictate what type of breast pump health insurers must cover, so coverage can vary depending on your insurance company’s requirements. For example, your plan could exclusively cover manual pumps, in which case you would have to pay for your breast pump out of pocket if you wanted an electric variant.

How Far Along Do I Have To Be To Get a Breast Pump Through Insurance?

Many people opt to order breast pumps through insurance toward the beginning of the third trimester but the exact timeline may depend on your insurance provider’s guidelines. For example, some health plans won’t cover breast pumps until 30 days before your due date, while others will only cover them after you give birth.^[3]

How Much Are Breast Pumps Without Insurance?

Without insurance, breast pump prices largely depend on the type of pump you decide to purchase. For example, you may be able to get a manual pump for as low as $15, while the cost of electric pumps often ranges from $150 to $500.^[5]

Can My Insurance Company Refuse To Cover Breast Pumps?

It is possible for a health insurance company to refuse to cover a specific breast pump if it doesn’t fit within the guidelines the insurer has set for breast pump coverage. However, your insurance provider can only deny coverage for breast pumps altogether if you have a grandfathered plan.^[2]

Grandfathered health plans are individual plans sold before the ACA took effect on March 23, 2010, or job-based group plans that have not substantially changed their costs or benefits since that date. Although these plans officially count as qualifying health coverage under the ACA, they are not required to adhere to all of the provisions established by the ACA like Marketplace plans sold since 2010 are.^[6]