Does Medicaid Cover Breast Pumps?

Does Medicaid Cover Breast Pumps if You Choose Breastfeed?

Last Updated on February 28, 2022 by Anne-Sophie Reinhardt

You might be curious if your Medicaid plan will cover breast pumps if you are pregnant. In most cases, yes. But, Medicaid will not pay for breast pumps if you and your baby aren’t registered under Medicaid.

The Affordable Care Act (ACA) requires that federal insurance programs, such as Medicaid, cover breast pump costs. While there are a few conditions, most women will be eligible for a free breast pump if they have insurance.

Although Medicaid programs can vary from one state to the next, most Medicaid programs will cover the cost of a breast pump. To find out if you are eligible for a breast pump, or to locate a supplier, call your local Medicaid office. You don’t have to be worried if you have a Medicaid program. This review will help you find and order a breast pump for free.

Do You Need a Prescription for Medicaid to Cover Your Breast Pump?

Many Medicaid programs require that you have a doctor’s prescription before you can get a breast-pump. These programs stipulate that the mother must wait until her baby is born to receive the pump.

While this is something to be concerned about for moms, it’s not a reason to panic. Most hospitals will have temporary pumps available for you to use during your stay if necessary.

The hospital must consult lactation services before prescribing a breast-pump. There are many types of breast pumps on the market.

What Are the Terms of Getting Breast Pumps Under Medicaid?

It can take a while to procure a breast pump through your Medicaid plan. It can take up 10 working days for suppliers to approve the delivery of the pump. You don’t have to be anxious; you can reach out directly to the supplier to speed up the process.

Some state Medicaid programs may not offer free breast pumps, as required by the ACA. They only provide breast pumps in medically required circumstances like inverted nipples and extended stays in ICU.

Some states stipulate that a pump will only be provided to a mother and her child if they are separated for long periods of time due to work or school. If your Medicaid plan does not cover breast pumps in these cases, you will need a prescription and documentation showing the hours worked.

You must provide your personal insurance card if you have both a Medicaid and private plan. Insurance guidelines dictate that your personal insurance plan must be billed before your Medicaid plan.

Which Breast Pumps Does Medicaid Cover?

The supplier you choose, your state, and your Medicaid plan will all affect the options for breast pumps. Do not be afraid to compare different suppliers and the breast pumps they offer.

Types of Breast Pumps 

  1. Manual breast pump – A single-user pump that can be used for occasional or daily milk extraction.
  2. Single electric breast pump – A single-user pump that can be used occasionally.
  3. Double electric breast pump – A single-user and is ideal for moms who plan to return to school/work or who want to continue using it for a long time. Double electric pumps can be used during short breaks, but not like single electric pumps.
  4. Hospital-grade breast pumps – A multi-user pump that can be used for short-term and long-term purposes. This pump is recommended for mothers who wish to preserve their milk supply after giving birth.

There are many brands and models available from each breast pump supplier. The Signature Pro Double Electric Breast Pump and Smartpump 2.0 Starter Kit are two of the most popular breast pumps that Medicaid covers. These breast pumps can be moved easily and are lightweight so you can pump at your own pace.

These pumps have an extension and adjustable suction settings that allow you to match your supply to the baby’s eating habits.

Does Medicaid Pay for Breast Pump Replacement Parts?

Some Medicaid programs may cover replacement parts and additional breast pumping equipment. To help moms get the breast pumps they need, many manufacturers offer warranties. You can order replacement parts from the manufacturer of your breast pump if your plan does not cover them.

How Can You Know Which Breast Pump Is Ideal for You?

It can be daunting to choose a breast pump, especially if it’s your first. When choosing the right breast pump for you, there are many factors to consider.

Consider how often you will need the pump. Some mothers plan to be at home for many years after giving birth, so they only need the pump occasionally. Some moms need to return to work or school, so they must use the breast pump often because they are going to be away for a while.

The suction power you require from your pump should also be considered. A breast pump that has powerful suction is a must, as you will only be extracting milk for a few minutes.

Other moms have different priorities, such as silent and discrete and portable and lightweight, display and screen, and so on.

Final Thought

All in all, the majority of Medicaid plans will cover breast pumps. However, coverage depends on where you live. Most states do not cover breast pumps that are hospital-grade, but will pay for the cost of renting or purchasing a double electric breast pump. To find out which breast pump your plan covers, contact your local Medicaid office.

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