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That breast pump might be free!

March 2, 2012

Here is a little known fact: that expensive breast pump you need might be covered by your health insurance.
One mom-to-be in Downtown Brooklyn found out how to do this and shared her advice with us. Here is what she found out:

I worked with a national durable medical equipment (DME) company, and they took care of all of the paperwork, the authorization from my doctor, and the pump shipped for free. I did not have a co-payment, or any other cost for that matter. I wanted a Medela pump, and I was offered the option of 6 or 7 models, one being the one I wanted. I have insurance with Empire Blue Cross Blue Shield EPO but it is very likely that breast pump authorization will vary by insurance carrier. It is important to know that this may work with other DME companies, I just happened to be referred to Edgepark by a friend. You may have a DME company  that you already have a relationship with, so check with them about breast pumps.

Here’s the series of steps I went through to get it covered:

1. I called Edgepark Medical Supplies, a company that works nationwide (1.800.321.0591).  It’s better to first work with a representative on the telephone, as there are specific questions to answer.
2. When you get a representative on the telephone, be prepared with your insurance card as they will ask for ID number, group number and various other information on your card. You should also have all of your OB’s contact information, including address and telephone number. Your doctor will most likely have to authorize this request.
3. Edgepark will ask if your baby has arrived. Some insurance companies will require that the baby already have arrived before they authorize the pump. I am due in February, so the insurance type I have did not require this.
4. They will ask you for your diagnosis. This threw me off- but the representative offered some options, such as going back to work after baby is born and needing to supplement, or the baby having trouble latching.
5. They will ask you what model of pump you would like to order. Be ready with the model that you want, but also be ready with backup choices. I was in front of a computer, and was able to Google the options given to me to make the most informed choice. The representative was very patient with me.
6. You are able to provide your e-mail address for updates on the status of your order.

After you’ve completed your call with Edgepark, you then wait for news to see if your pump is authorized by your insurance company. This process took about 3 days between the initial call and the authorization from my doctor, and my pump will arrive in a few days. Incidentally, Edgepark has terrific customer service, and I received e-mail updates every step of the way.