If you’re a new mom, or pregnant and thinking about becoming one, you may be wondering if your insurance covers lactation services. You might also want to know what supplies are covered by your plan. We’ve got the information for you here!
Find out if you’re eligible for breastfeeding services and supplies through your health insurance plan by reading this article.
Breastfeeding is a matter of public health, and it often isn’t treated as such.
Many women feel they have to forego getting breastfeeding support because they can’t afford it. It’s not normalized to have breastfeeding supplies and support as part of a typical postpartum experience and many don’t even realize that the resources exist to help them through this time.
Fortunately, health insurances now are required to provide breastfeeding support, counseling and equipment and supplies to help support the breastfeeding mother. This has been the case for several years now, however, many don’t even realize this!
While the specifics may depend on your insurance plan and who is governing it, here are a few things you should know about lactation services and equipment being covered by insurance.
Breastfeeding Equipment and Supplies Covered by Insurance
I think most people know that breast pumps are often covered by insurance, and that is definitely the most common expense you will see covered by insurance, so let’s talk about that first.
HHS.gov says this in regards to breast pump coverage:
“Yes. Under the Affordable Care Act, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts. They also can’t charge women more than men.
The only exception to the pre-existing coverage rule is for grandfathered individual health insurance plans — the kind you buy yourself, not through an employer. They don’t have to cover pre-existing conditions.”
One thing to keep in mind is that the ACA does not dictate what type of pump your plan has to cover. In my experience, most DO cover an electric pump, some will only cover a manual pump, a single pump, or a certain brand. Most do not cover hands-free pumps like the Willow or Elvie. It is possible that you may have to purchase another pump out of pocket if they don’t cover one that covers your needs.
While you can go directly through your insurance, I always recommend working with Aeroflow. They check your benefits for free and provide you with all the information on what pumps and other breastfeeding supplies are covered through your insurance. It’s a free service, and you can learn more by clicking here or the button below.
Once you’ve determined your coverage, make sure you check out our pump buying guide. If your insurance doesn’t provide the coverage you need, I personally recommend checking out the BabyBuddha Breast pump.
Are breastfeeding supplies covered by insurance?
Now does insurance cover other breastfeeding supplies such as bottles, pump parts, storage bags, nursing bras, etc.? In most situations, probably not, nor are they required to under the ACA. However, some insurances, such as Tricare, sometimes do, so it’s worth checking.
If you have an HSA, you can often use that to pay for these types of items, though!
Many women find themselves needing to ship milk for one reason or another, and while insurance may not cover it, the company that you work for might! There are companies that cover milk shipment costs through FedEx or Milk Stork, such as Ernst and Young and IBM.
Comprehensive Lactation Support and Counseling
Are Lactation Consults covered by insurance?
Lactation supports must be covered for the entire duration of the time a mother is breastfeeding. They may have in and out of network providers, but you are entitled to lactation support, counseling, and education through insurance.
This isn’t one answer for every insurance company on what services they will cover or what type of lactation consultant they will cover. Some are great with virtual consults, others aren’t. Some will allow you to see a private practice IBCLC while others will not.
Your insurance should cover any lactation services that you get in the hospital, such as seeing an IBCLC, using a breast pump, or even using donor milk during your stay.
Definitely check with your insurance to see what they will cover. You may have to get a superbill to submit if your lactation consultant isn’t in network. Some insurance providers will cover unlimited visits, even.
If you aren’t sure where to even start, be sure to check out The Lactation Network! They can help you navigate insurance and breastfeeding consults to make sure get all the care you deserve and need!
There isn’t an exact definition to “comprehensive lactation support and counseling” but some do include breastfeeding classes as part of your insurance coverage. Typically these will need to be classes done by a hospital or doctor’s office.
Our online breastfeeding classes aren’t covered by insurance, though you can use your HSA to pay for them. They are very affordable though and offer a lot of extra support that you may not get from a traditional class.
When can I take advantage of these services?
The law says they must cover you during the duration of your breastfeeding journey. Some insurances will allow you to get your pump before you give birth and have a prenatal consult (which we offer!) Others do not – again, work with your insurance to see what and when they cover things.
Is donor milk covered by insurance?
When you are in the hospital, donor milk is almost always going to be covered as part of your stay. However, once you leave, you likely won’t be able to get donor milk covered, even if it’s from an official milk bank.
It can be very expensive – I think when I got donor milk with my second child from a milk bank, it was $4 per ounce. I ended up opting for peer-to-peer milk sharing, which was free (though you need to take certain precautions when it comes to donor milk).
What if my plan was grandfthered before this went into affect?
I’m not sure how many plans are still left that were grandfathered before the ACA, but if you happen to be on one, they aren’t subject to the same rules.
Does this requirement apply to Medicaid insurance subscribers?
This will depend on the state you are in. Some will cover lactation services and equipment while others will not. Some states will refer you to WIC instead for these services, though definitely check with your specific state.
Have you had any trouble getting lactation services covered? Share your experience below!
Other Posts You May Enjoy:
- How to Get a Breast Pump Through Insurance FOR FREE!
- 17 Truths About Breastfeeding: The Good, The Bad, and Everything In Between
- 20+ Ideas for a Breastfeeding Station Basket for New Moms
- The Ultimate Relactation Guide – How to Get Your Breast Milk Back
- The Best Breastmilk Freezer Storage Ideas All New Parents Need to Know!
Katie Clark is a Certified Lactation Educator, Certified Breastfeeding Specialist, and IBCLC student. She has helped thousands of mothers and families around the globe navigate breastfeeding challenges and questions since 2015. She has a passion for creating research-based, helpful breastfeeding education and helping parents find a way to make breastfeeding work for them. Katie is a mom of three little boys and lives in the great state of Colorado. She also has a degree in Communications with an emphasis in print journalism.