Tricare Breast Pumps

How Do I Qualify For A Tricare Breast Pump?

If you have TRICARE, you qualify for a breast pump and supplies for every baby you have. Simply get a prescription from a TRICARE-authorized doctor, physician assistant, nurse practitioner, or nurse-midwife. The prescription should specify if you’re getting a standard electric pump or a basic manual pump. For a hospital-grade pump, you’ll have to work with your regional contractor and provider for a referral and authorization. You don’t need to specify a brand on your prescription. Have your provider include a diagnosis code on your prescription if you’re going to get your breast pump from a durable medical equipment supplier or network provider.

First, you’ll need to get a prescription through a Tricare-authorized provider. Once you’ve received this, send us your prescription and we will work with Tricare to find out which breast pumps are fully covered under your plan. Once you’ve selected a pump, we will do the rest! You’ll have your pump, accessories, or breast pump kit sent directly to your home.

Tricare covers one breast pump per birth event. So if this is your second (or third, or fourth!) pregnancy, you can get a new breast pump fully covered by your insurance plan. If you need to replace your current breast pump because it broke, a replacement may be covered under certain circumstances. Our customer service team can contact Tricare for you to find out if you’re eligible for a replacement.

At this time, Tricare’s breast pump coverage is not limited to a specific manufacturer, brand, or model, so you will have a variety breast pump options to choose from—including double electric models. (Note: Some high-end pumps may require an upgrade fee.)

Tricare has a limit to how much it will pay towards durable medical equipment (which includes breast pumps). If you choose an Elvie breast pump, The Breastfeeding Shop can help you navigate your plan benefits to determine whether or not there would be a leftover balance that you’ll have to pay.

Tricare will cover the cost of 100 breastmilk storage bags every 30 days following a birth event.

To figure out if a certain breast pump is covered by your insurance plan, you’ll need to get in touch with Tricare to go over your specific benefits. This can be an overwhelming task, though, and the customer service team at The Breastfeeding Shop is experienced in navigating Tricare plans, so we can contact them for you and help guide you through your benefits.

Tricare Prime offers the same pregnancy benefits as other Tricare plans, but you must get a referral from your primary care manager before seeking medical care.

What Accessories are Covered by Tricare?

TRICARE Health Benefit covers:

• One breast pump kit per birth event. The kit may not be separately billed for and reimbursed.
• Standard power adapters: 1 replacement per birth event, and not within 12 months of the breast pump purchase date.
• Tubing and tubing adapters: 1 set per birth event.
• Locking rings: 2 every 12 months
• Bottles: 2 replacement bottles and caps/locking rings every 12 months following the birth event
• Bottle caps: 2 every 12 months after the birth event
• Storage bags: 90 bags every 30 days following the birth event
• Valves/membranes: 12 for every 12 months following the birth event
• Supplemental Nursing System (SNS): 1 per birth event when a physician prescribes
• Nipple shields/splash protectors: 2 sets (2 shields/set) per birth event when a physician prescribes

What Items are NOT Covered by Tricare?

Tricare doesn’t cover (unless part of a breast pump kit):

• Breast pump batteries, battery-powered adapters, and battery packs
• Regular “baby bottles” (bottles not specific to pump operation), including associated nipples, caps, and lids
• Travel bags and other similar carrying accessories
• Breast pump cleaning supplies
• Baby weight scales
• Garments and other products that allow hands-free pump operation
• Ice packs, labels, labeling lids, and other similar products
• Nursing bras, bra pads, breast shells, and other similar products
• Over-the-counter creams, ointments, and other products that relieve breastfeeding-related symptoms or conditions of the breasts or nipples