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Thread: Coverage for Breast Pump Rental

  1. #1
    Join Date
    Apr 2008
    Posts
    30

    Default Coverage for Breast Pump Rental

    My insurance won't cover it and our flex direct spending account (pre tax dollar cafeteria plan) says the following:

    Breast pump
    Only eligible if to treat or mitigate a specific medical condition

    I've asked them to get back to me on what would constitute a specific medical condition...but before we put money in there I want to be sure it will be covered. We enroll in October for the following year, I'm due in September, and any money we commit to putting in the plan we will lose if we don't use.

    Anyone have any suggestions about what could constitute a specific medical condition?

    Thanks.

  2. #2
    Join Date
    Feb 2007
    Posts
    93

    Default Re: Coverage for Breast Pump Rental

    With our plans, a doctor's note usually covers any requirement. If your doctor will write a "prescription" for it, you should be covered.

  3. #3
    Join Date
    Apr 2008
    Posts
    30

    Default Re: Coverage for Breast Pump Rental

    Here's what I got back from them...

    "In accordance with IRS guidelines, breast pumps are not an eligible expense on your Health Care FSA, but may be eligible if a Letter of Medical Necessity is submitted with your claim or substantiation. The physician's certification should clearly indicate that the purchase, service, or surgery is medically necessary. If the treatment is on-going, the physician should notate the applicable time period."

  4. #4
    Join Date
    May 2008
    Posts
    213

    Default Re: Coverage for Breast Pump Rental

    My guess is that a medical condition would be a preemie or sick baby that needs/has to be on breast milk for medical reasons. Good luck getting approval...if you do, please share how you did it!
    Fran
    Mom to Anna, March 28, 2008

  5. #5

    Default Re: Coverage for Breast Pump Rental

    According to my insurance company, they will cover it if the baby is premature (born prior to 37 weeks).

  6. #6
    Join Date
    Jul 2008
    Location
    meh....wherever
    Posts
    7,065

    Default Re: Coverage for Breast Pump Rental

    Wow...Insurance companies really stick it to us don't they?

    What area are you in?

    I am in California and have Kaiser (they are in many other states too) and they have covered a rental for me since I gave birth in November! They cover for 2 months PP and longer if you have a medial reason. I had mastitis so they just keep covering it.

    Here's to hoping policies change in the somewhat near future!
    Last edited by @llli*nolies.mama; August 12th, 2008 at 08:16 PM.
    I'm Hillary
    Wife to Gualberto
    Mom to Nolan
    Born at 32 weeks-3lbs/10oz
    11-25-2007
    Our precious early angel


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