Breast Pump Information
Most medical insurance policies will include coverage for one double electric, non-hospital grade breast pump per pregnancy, provided it comes from an in-network durable medical equipment (DME) provider. Some policies (markedly most policies through Quartz and Blue Cross Blue Shield of Illinois) will cover re-supply of breastfeeding related products at certain intervals. Madison Women’s Health is dedicated to making sure patients are aware of this benefit and can take full advantage, since breast pumps, accessories, bags, and breastfeeding in general, are a huge investment!
For this reason, it will be standard routine to address breast pumps at the 32 week visit. Based on positive experiences, variety of pump options, and a wide range of network coverage, for most patients, we will utilize Lehan’s The Breast Pump Store, located in Illinois. The process will be as follows:
- At the 32-week visit, we will send patients with a flyer and an order for a breast pump.
- Patients will go to The Breast Pump Store
- On the website, patients should fill out the form located under the “Qualify Through Insurance” tab and upload their signed breast pump order to the form.
- Lehan’s will contact the insurance company and verify network and coverage.
- If in network, patients will be given pump options that are fully covered via a link. Patients should know that they almost always have the option to upgrade their pump if they do not like one of the fully covered options. *See below.*
- Once a pump is selected, Lehan’s will ship the pump and any qualified extras directly to the patient via 1-3 day shipping. If a patient qualifies for periodic supply re-stock, Lehan’s will notify the patient and add them to a follow-up list and facilitate re-stocking with these patients.
- If out of network, most patients will be notified, by Lehan’s, of an alternative DME where patients should receive a similar level of care. Some insurance companies will not release this information to Lehan’s. If this is the case, these patients will need to contact their insurance company to find out what DME might be in network. They should then fill out the form on that DME’s website (most DMEs utilize a similar process for pumps), and the new DME will fax an order form to us. **See below.**
*Lehan’s has a full list of pumps on their website. The majority of insurance companies will cover $100-$200 toward a pump (very limited options will be fully covered). Some, like most Quartz policies, offer a higher benefit. Patients should know that this will not change based on what DME they go through.
**Patients should NOT contact MWH to ask where they should go, as we are unable to verify DME network coverage. Of note, if Lehan’s is not in network, NEB medical covers some of the non-correlating plans and is another excellent option. United Healthcare is one plan that is out of network with Lehan’s but in network with NEB. They utilize a similar process, where patient fills out a form and they send the clinic an order form.
Any questions or concerns may be forwarded to Alexiyah, RN, IBCLC at Madison Women’s Health. She will have direct contact with Lehan’s management during this transition.
