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Medicaid and Grandfathered Plans

By Sharon Bell

While most commercial plans began implementing breast pump coverage August 2012 in accordance with the Affordable Care Act, there are still a few exceptions to the rule. The level of coverage provided by commercial insurance plans differs with each interpretation of the law. Some plans provide extensive coverage with lactation counseling and hospital-grade pumps while others only cover a manual pump (Side note: Aeroflow can offer pump upgrades to double-electric pumps for mothers whose insurance covers manual pumps.) However, some insurance plans are “grandfathered,” and are not required to provide breastfeeding support, while other plans such as Tricare or Medicaid are not included in the law. Whatever the case for your insurance plan, Aeroflow Breastpumps has a way to help!

For Medicaid Mothers

If you have Medicaid or are on WIC benefits, your local WIC agency can help determine your coverage benefits. Often times, WIC can supply breast pump rentals or hand-held pumps at no cost to mothers who intend to breastfeed. And for mothers who cannot receive a breast pump through WIC, read on to learn what other options are available.

Grandfathered Plans, Tricare, or Uninsured Mothers

If you have a private insurance plan that does not include breast pump benefits, such as a grandfathered plan or Tricare, or cannot get a pump through Medicare, going through a DME is still your best bet. While it may be frustrating to learn that your insurance is out-of-network or does not include breastfeeding support, our intention is to help these mothers as much as possible.

Retailers such as Target, Babies R Us, and Wal-Mart do sell name brand breast pumps – however, shopping at a big box retail store often comes with high mark-up prices. We are able to list breast pumps at the lowest possible price that each pump manufacturer will allow. The reason we are able to do this is because Aeroflow Breastpumps is a Durable Medical Equipment (DME) supplier, so we receive special manufacturer pricing that cannot be extended to retailers.

 

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