Breast Pump Ordering Protocol
If you would like a breast pump, please follow these steps:
Contacting your Insurance
Contact your health insurance and ask what’s covered, how to get it, and what forms you need to fill out. Sometimes you may not even need to get a prescription from the doctor.
Good questions to ask the insurance customer agents:
What breastfeeding-related benefits does my plan offer?
What types of pumps are covered?
Can I get a specific brand of pump?
Is rental of an electric pump covered?
Do I need to buy or rent my breast pump from a certain supplier (i.e., a specific pharmacy, retailer, or medical supply company)?
Do I need a prescription from my doctor for my pump?
If You Need a Prescription
If insurance requires a prescription from the doctor, ask who is the specific medical supply company (sometimes called a “durable medical equipment” supplier, or DME), then create the order in Athena by clicking on “DME” and put the “supplier” info, otherwise the doctor can’t send it electronically. If your insurance doesn’t normally pay for an electric pump, they may be more likely to cover it if you are pumping for medical reasons, such as:
If the baby is a preemie
If the baby has other medical conditions that make it difficult for you to nurse
If You Have Milk Supply Issues
If any of these apply to you, let us know as you will will likely require a doctor’s note stating that an electric pump is medically necessary. And we will help to provide more specific diagnosis code to see if the pump can be covered or with a co-pay.