Did you know that some hospitals consider breast milk “medically necessary” for your premature or medically compromised kiddos therefore requiring you to purchase a breast pump?
Did you know that that nursing mothers of multiples often get the full cost of their breast pump covered by their insurance company?
Here are a few things you need to do if you think you might qualify to get your breast pump covered.
-Call/Read your policy: Read through your policy or call the insurance company before you EVEN have your multiples. While you're on the phone, ask if your coverage will include a visit from a lactation consultant as well. Some policies have one (or more) visit(s) built in to every delivery.
-Check your insurance company's rules.: What are the conditions which need to be present in order to get the pump covered. Do you need prior authorization before buying the pump? Will there be a co-pay? Do you need to meet a deducible first?
-What exactly is covered?: Will your insurance cover the entire cost of the pump? Will they only cover a rental? Are you limited to brand or type? What is the maximum amount they will cover? With pumps costing upwards of $300 will they cover the WHOLE amount WITH accessories?
When submitting your claim, you will often need a medical code to include. Occasionally the desk in the nursery, or NICU, will have a pre-formatted letter for you to submit. Put asking about this on your “ToDo” list while still in the hospital or inquire about it if/when you take your hospital tour.
If you are submitting the form yourself, here is a list of common medical codes which may help you get your pump covered.
- Child Cleft palate/lip749
- Abnormal tongue position750.1
- Down’s syndrome758
- Neonatal candida infection771.7
- Breastmilk jaundice774.39
- Other transitory neonatal775.5
- Feeding problems in newborn779.3
- Abnormal loss of weight783.2
- Feeding difficulty – infant783.3
- Failure to thrive784.4
- Suck reflex abnormal796.1
- Mother Twin pregnancy post-partum condition or complication651.04
- Abscess of nipple675.03
- Infections of nipple675.04
- Abscess of breast675.1
- Nonpurulent mastitis675.2
- Other specified infection of breast and nipple675.8
- Unspecified infection of the breast and nipple675.9
- Retracted nipple676
- Cracked nipple676.1
- Engorgement of breasts676.2
- Other and unspecified disorder of breast676.3
- Suppressed lactation676.5
- Other disorders of lactation676.8
- Unspecified disorder of lactation676.9
- Dermatitis contact692
Good luck! We hope you have great success in getting your breast pump covered.