Patient Protection and Affordable Care Act and Free Breastpumps; Are Medical Supply Companies Taking Advantage of Insurance Companies?

I have not been sponsored to write this post. I have been provided with a review item featured here and this article is based on my honest opinion and experience. Yes, this bag is amazing.


     If you’re a breastfeeding Mom, or are planning to be, then you are probably aware of legislation that allows for free breast pumps to nursing Moms. The Patient Protection and Affordable Care Act  is a 906 page document that has made breastfeeding easier for Moms working both inside and outside of the home by requiring insurance companies to provide breast pumps, and by requiring employers to provide both private space and time for pumping.
     “The Patient Protection and Affordable Care Act (“Affordable Care Act”) amended section 7 of the Fair Labor Standards Act (“FLSA”) to require employers to provide reasonable break time for an employee to express breast milk for her nursing child for one year after the child’s birth each time such employee has need to express the milk. Employers are also required to provide a place, other than a bathroom, that is shielded from view and free from intrusion from coworkers and the public, which may be used by an employee to express breast milk” (1)
     This is wonderful for breastfeeding/pumping Moms!”Employers with more then 50 employees are required to provide a reasonable amount of break time to express milk as frequently as needed by the nursing mother. The frequency of breaks needed to express milk, as well as the duration of each break, will likely vary. However, employers are not required to pay you for pumping time outside of the allowed breaks and lunch periods ( 2 – 15m breaks (paid) and 1 – 30 min. break during an 8 hour shift). (2) A younger infant often eats more frequent meals, and pumping ever 2 hours may be ‘reasonable,’ but an older baby may eat every 3-4 hours allowing for longer breaks between pumping sessions. Some Moms are able to train their supply for work-pumping and are eventually able to pump all their baby needs in just a few sessions!
     So….can you get a free breast pump? Insurance plans may or may not cover a pump. Many plans have been grandfathered allowing them to not cover pumps, however they are slowly losing their grandfathered status and many lost this protection in 2013. (3) This is good news because that means that over time more and more plans will be required to cover pumps. The best thing you can do is turn your insurance card around and call the 1-800 number on the back. This may be the best way to find out about coverage options. My provider even gave me phone numbers to medical supply companies they participate with. In order to receive a pump, you will need a prescription from your doctor and different insurance companies allow coverage at different times. My provider allowed 30 days before my due date, but some plans require that you get a prescription after birth.
     What type of pump will you get? The type of pump your plan covers varies by plan type. I was very surprised to get the bill that Edgepark Medical sent to my insurance company prompting the question; Are Medical Supply Companies Taking Advantage of This Legislation? My insurance was billed $335.61 for the pump you see below for $137.79. I didn’t even receive a pump bag!! I called and spoke directly to my insurance company to report this discrepancy. The Geseinger representative I spoke with reported that they gave the company $254+ for this pump. I hope that in the future insurance companies allow customer to purchase their own pump and get reimbursed because as you see below, I could have purchased a delux kit with a bottle bag, carry bag, and the works! Some plans cover manual pumps, however the local supplier I spoke to reported that they even provide a double electric pump to Moms on Medical Assistance!! Awesome right?!

     So, have you taken advantage of an insurance covered breast pump? Do you plan to? As always, thank you for stopping by and I’m happy to answer any questions and chat! You can contact me with the contact square to the right and or comment below. Have a great day!


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