Medicaid and Breast Pumps
Medicaid plans vary by state, and navigating plans can be challenging for someone receiving health insurance benefits under one of these plans. To understand your breast pump coverage under Medicaid, you may need to do some research—but given how little time expecting and new parents have, navigating health insurance plans likely isn’t how you want to spend that time. That’s where The Breastfeeding Shop comes in. Our team has years of experience working with Medicaid across a variety of states, so we know exactly what it takes to help you get an insurance-covered breast pump. Even if you haven’t contacted your healthcare provider to get a breast pump prescription or prior authorization yet, get in touch with us because we can help with that too. We strive to make this process as easy as possible for expecting and new parents.
Typically, yes, most state Medicaid plans will cover the cost of a breast pump. However, since Medicaid isn’t a health insurance provider in the Marketplace, these plans may not have to follow the rules set by the Affordable Care Act (ACA), which requires insurers to provide patients with a free breast pump (up to a certain dollar amount). Medicaid’s breastfeeding support benefits can vary widely from state to state, and you may be required to provide specific documentation from your OB/GYN or possibly even your employer in order to receive benefits (but don’t worry, The Breastfeeding Shop can help you determine exactly what is needed).
If a breast pump is included in your Medicaid coverage, your options will likely be limited to a standard double electric breast pump or a manual breast pump, as hospital-grade pumps for personal use are not usually included in Medicaid insurance coverage. Depending on your benefits, brands that you can order through The Breastfeeding Shop and may be Medicaid-eligable include:
Spectra
Ameda
Ardo
Baby Buddha
EvenFlo
Medela
Motif
Lansinoh
Zomee
Similar to lactation support services, breast pump accessories (like milk storage bags and bottles), and other types of postpartum support, eligibility requirements for breast pumps are specific to the state where you receive your benefits. You will likely need a prescription from your health care provider, as most Medicaid plans require this. Additionally, you may be asked to provide documentation that verifies you need a pump because you will be separated from your infant for long periods of time (due to work, school, or some other reason).
Most Medicaid policies require new parents to wait until after they’ve given birth to obtain a breast pump. In some cases, you may be able to order the pump before your baby is born as long as you are within 14 days of your anticipated due date. If you do have to wait until after your baby has arrived to order and receive your breast pump through Medicaid, you can most likely rent a pump from your hospital in the meantime.
If you find that your Medicaid plan won’t cover the cost of a breast pump, you may be able to get or rent one through your state’s WIC program. To learn more about eligibility requirements and benefits, contact your local WIC clinic.
The Breastfeeding Shop Is Here To Help You Find The Right Medicaid Breast Pump
We are your source for Medicaid-covered breast pumps, including EvenFlo, Elvie, Medela, Lansinoh, and more. Whether you’re looking for a double electric pump or a manual pump, we’ve got you covered—and if you don’t really know which pump you want to get, that’s okay. We’ll gladly break down the differences between a Medicaid Spectra S2 and an Ardo Calypso or a Medicaid Elvie and Willow. Just give us a call and we will help you find the best breast pump for your specific needs.
