It takes some leg work, but you can use your provider to help get a free device.
Breastfeeding can be a beautiful but sometimes challenging journey, and having the right tools can make a big difference. While I had a smooth experience nursing my first four children, my last baby surprised me. She was born five weeks early and refused to nurse, which meant I had to find a way to provide her with breast milk without direct breastfeeding. That’s when I turned to exclusive pumping (EP).
At first, I used a traditional double electric pump that plugged into the wall. However, with five children to care for—including school drop-offs and daily household responsibilities—I quickly realized I needed a more convenient solution. I started looking into wireless, hands-free pumps like the Elvie, but they were expensive. That led me to explore whether I could get a breast pump covered by my health insurance. If you’re in a similar situation, here’s what you need to know about getting a breast pump through insurance.
Can You Get a Breast Pump Through Insurance?
Yes! Thanks to the Affordable Care Act (ACA), health insurance plans—including Medicaid—are required to cover the cost of a breast pump. This means that, in most cases, you can get a pump at no cost to you. The only exceptions are a few grandfathered insurance plans, which don’t have to offer coverage but sometimes still do.
According to Natasha Cantrell, director of individual and family sales for eHealth, insurance plans must cover breast pumps and related supplies without co-pays. However, the type of pump covered and how you receive it may vary depending on your specific plan.
Are Breast Pumps Completely Free With Insurance?
In many cases, yes, but there are some things to keep in mind:
- Some insurance plans cover only certain types of pumps, such as manual or basic electric models.
- Some plans may allow you to rent a pump instead of purchasing one.
- If you want a more expensive pump, like a hands-free or wearable model, you may have to pay the difference out of pocket.
- Some plans require you to buy the pump first and then submit a receipt for reimbursement.
For example, my insurance covered a traditional pump in full. However, because I wanted the Elvie, I bought it myself, submitted the receipt, and received reimbursement for part of the cost.
How to Get a Breast Pump Through Insurance
If you’re wondering how to go about getting a breast pump covered by insurance, here are the steps you need to follow:
Step 1: Check Your Insurance Coverage
Every insurance plan has different rules, so it’s important to find out what your specific plan covers. Here’s how:
- Log in to your insurance provider’s online portal or app.
- Look under benefits related to “pregnancy” or “breastfeeding.”
- If you can’t find the information online, call your insurance provider’s benefits department.
Some insurance companies will also reach out to you if you notify them about your pregnancy. For example, after enrolling in a pregnancy wellness program, one mother, Gretchen Bossio, received a call from her insurance provider at 32 weeks pregnant to set up her breast pump delivery. After confirming her choice from the approved list, the pump arrived in the mail within a week.
If you have commercial insurance, you may also have the option to “upgrade” to a more expensive pump by paying the difference.
Step 2: Follow Your Insurance Plan’s Process
Each insurance company has its own process for getting a breast pump. Here are some common requirements:
- Some plans require a prescription from your doctor.
- Others have a list of approved pump brands and models.
- Some work with third-party providers where you can order a pump online.
For instance, Erin Heger, a mother of two, used Edgepark, a third-party company that partners with insurance providers. She entered her insurance details, chose a Spectra 9 pump, and received it in the mail a few weeks later—completely free.
Third-party providers can make the process easier by verifying your insurance details and even requesting a prescription from your doctor on your behalf. However, if your insurance plan has specific timing rules—such as only allowing the pump to be shipped after your baby is born—you’ll need to follow those guidelines.
Step 3: Be Aware of Any Restrictions
Some insurance companies have specific rules about when and how you can get a pump. For example, some plans only provide a pump if you apply after giving birth.
Katie Waite, a mother of five, learned this the hard way. When she was pregnant with her first child, she called her insurance company and was told she couldn’t order a pump until after birth “just in case the baby didn’t make it.” Understandably, this was upsetting. While the way she was informed was inappropriate, the policy itself was firm.
Most insurance plans cover one pump per pregnancy, but some have limitations, such as only providing one pump every few years. Checking your plan details ahead of time can help prevent surprises.
What Breast Pump Brands Are Covered by Insurance?
The pumps covered by insurance will vary depending on your provider. Popular brands often included are:
- Medela
- Spectra
- Ameda
- Lansinoh
- Evenflo
Wearable pumps like Elvie and Willow are typically not fully covered due to their higher price. However, you may be able to receive partial reimbursement if your plan allows it. More affordable wearable pump options are also becoming available, so it’s worth exploring your options.
Other Frequently Asked Questions
How Long After Birth Can You Get a Breast Pump?
Most insurance plans allow you to request a breast pump for up to 12 months after your baby is born. However, some have different time frames, so check with your provider.
Does Medicaid Cover Breast Pumps?
Most Medicaid plans do cover breast pumps, but there are some exceptions. Some state Medicaid programs that didn’t accept federal funding under the ACA don’t have to follow the same coverage rules. In these cases, Medicaid may only cover a pump if it’s medically necessary (e.g., for premature babies or infants with feeding difficulties).
What If You Don’t Have Insurance?
If you don’t have insurance, you still have options:
- Pay for a pump out of pocket.
- Use a Flexible Spending Account (FSA) or Health Savings Account (HSA) to purchase a pump.
- Check with your local Women, Infants, and Children (WIC) clinic—they may provide free pumps or rental options for eligible families.
Final Thoughts
Getting a breast pump through insurance can save you money and make your breastfeeding or pumping journey much easier. The most important step is to check your insurance plan early to understand your coverage options. Whether you’re looking for a standard electric pump or hoping to upgrade to a wearable model, knowing the rules in advance will help you get the best pump for your needs.
If you’re expecting or currently breastfeeding, take the time to explore your insurance benefits. A good breast pump can make all the difference in balancing motherhood and feeding your baby!
