Let's start with the downright awesome news for new mamas: The Affordable Care Act (ACA) requires insurers to cover breastfeeding support. As long as you are not covered by a grandfathered plan (before 2010), you should receive support like breast pumps and lactation services at 100% coverage, without co-pays or cost sharing.
But did you know that 82 percent% of moms expecting new babies do not know their breastfeeding rights under the Affordable Care Act and what must be offered by their existing insurance plans? Even though the process is complicated, you don’t need to get left behind! In this blog we're covering some important items to know to prepare to breastfeed without breaking the bank.
Here’s the top 4 things you should know about your rights:
If you have insurance, you are entitled to lactation consulting and services.
All moms are required to be offered lactation counseling, or lactation consulting, pre-delivery and post-delivery, at no cost. Each insurance company has a bit of a different policy, but that support can be crucial to get the care and support you need to be successful.
If you have insurance, you are entitled to a breast pump at no cost.
Most mom’s don’t know that insurance companies are required by federal US law to cover the cost of a breast pump. To get access, you can call your insurance directly.
There’s a bit of a catch: some insurers require you to get your breast pump from a specific company chosen by your insurer. That company may cover used pumps, and might only have particular models. Other insurance plans only cover manual pumps. But that leads to the next thing to know….
You can work with a service to see what’s covered by your plan without the hassle.
We know calling insurance can be a huge headache. Luckily, in the last year there are two new services that can help.
Aeroflow Breastpumps and Acceleron specializes in helping pregnant and nursing moms qualify for their breast pump through insurance. All you have to do is choose your first choice pump, enter your insurance information, and they will contact your insurance to verify coverage and reimbursement, explain your options, and gather and submit all required paperwork.
If you want a pump outside your plan, you can access the Hela Health platform for exclusive discounts.
We cover the best, most innovative pumps and accessories available today. if you’re already a mama rushing between meetings, struggling to get your work done before you dash home, or don’t have access to a private lactation room at work, you may need a more discreet or specific option.
Almost everything found on the Hela shop isn't covered by insurance, but you can get exclusive discount codes and apply your FSA/HSA directly from our Femtech shop. And if you’re on a premium plan, you can even access all those tools without any out of pocket costs, and none of the insurance headaches.
ACOG Public Resources: Breastfeeding Support and Supplies
The National Women's Law Center's Breastfeeding Toolkit clearly explains Medicaid and insurance coverage of breastfeeding support, supplies, and counseling and offers tools to women who encounter problems with this coverage.
The National Women's Law Center's free Cover Her Hotline assists women who are having trouble getting coverage for breastfeeding or other women's health needs as required by law.
State of Breastfeeding Coverage: Health Plan Violations of the Affordable Care Act report from the National Women’s Law Center goes in-depth into coverage of the ACA’s breastfeeding benefits and found that women face widespread barriers to getting coverage of breastfeeding support and supplies. It includes women’s stories gathered through NWLC’s Cover Her hotline.
HealthCare.gov also lists benefits and services covered by insurance:
The National Conference of State Legislators lists state-specific breastfeeding laws as well as information on federal requirements.