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Aetna insurance covers breast pumps and supplies, including manual and electric pumps, breast shields, and storage bags, with a maximum allowance of $1,000 for a double pump and $500 for a single pump.
Aetna also covers additional supplies such as nursing pads, breast cream, and a pump cleaning kit.
To be eligible for coverage, you'll need to get a prescription from your doctor, which will help you get the most out of your insurance benefits.
Aetna's coverage for breast pumps and supplies is part of their Women's Health and Wellness program, designed to support new mothers in their breastfeeding journey.
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What Aetna Covers
Aetna insurance covers the cost of a breast pump, and most breast pumps are covered at little to no out-of-pocket cost. This is because breast pumps are considered a preventative benefit under the Affordable Care Act healthcare reform law.
You can get 100% coverage on your breast pump with Aetna, with no hidden costs, copays, or deductibles. This means you won't have to worry about paying extra for your breast pump.
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Aetna approved breast pumps come in a variety of styles to suit any mom's needs. These styles include basic manual breast pumps, standard electric breast pumps, double electric breast pumps, wearable breast pumps, wireless breast pumps, and hospital-grade breast pumps.
The types of breast pumps that may be provided to Aetna-specific insurance plans through Aeroflow Breastpumps are numerous, but you can check out their breast pump comparison chart for more information.
Aetna covers one breast pump per birth event, so you'll need to select and order the best breast pump for you and your baby.
Eligible Products and Services
If you're looking to purchase a breast pump with your Aetna insurance, you're in luck - many top brands are covered.
Medela, Ameda, Spectra, and Motif Medical are just a few of the many brands available.
Some of the specific products that are covered include breast pumps, compression garments, and accessories from top manufacturers.
Here are some of the eligible brands you can choose from:
- Medela
- Ameda
- Spectra
- Motif Medical
- EvenFlo
- Ardo
- Freemie
- Willow
- BabyBuddha
- Zomee
These products can be ordered with no out-of-pocket costs through Aetna plans, although some high-end pumps may require an upgrade fee.
Policy Details
Aetna insurance covers breast pumps and associated supplies for new health plans and non-grandfathered plans that begin on or after August 1, 2012. These plans must follow DHHS requirements for coverage.
If you have a grandfathered plan, it may not include breast pump coverage. Always check your specific insurance policy for details on provider participation and exclusions based on your group or employer.
Aetna's website recommends creating a personalized secure member account to monitor your claims, deductible, health history, and obtain personalized health information.
Here are some relevant CPT codes and HCPCS codes for breast pumps and associated supplies:
Scope of Policy
The scope of this policy is quite specific, and it's essential to understand what's included. This policy addresses breast pumps and associated supplies.
The policy applies to new health plans and non-grandfathered plans that are subject to DHHS requirements for coverage of breast pumps. Coverage begins in the first plan year that starts on or after August 1, 2012.
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You should check your benefit plan descriptions to confirm whether this policy applies to you. If it does, you can expect coverage for breast pumps and related supplies.
Here's a list of codes that are relevant to this policy:
- A4281: Tubing for breast pump, replacement
- A4282: Adapter for breast pump, replacement
- A4283: Cap for breast pump bottle, replacement
- A4284: Breast shield and splash protector for use with breast pump, replacement
- A4285: Polycarbonate bottle for use with breast pump, replacement
- A4286: Locking ring for breast pump, replacement
- A4287: Disposable collection and storage bag for breast milk, any size, any type, each
- E0602: Breast pump, manual, any type
- E0603: Breast pump, electric (AC and/or DC), any type
- E0604: Breast pump, hospital grade, electric (AC and/or DC), any type
These codes are important to note, especially if you're planning to purchase or replace breast pump supplies.
Policies Vary
Most insurance plans provide electric breast pumps for free to lactating and expecting mothers, but it's essential to check your specific policy for details.
You should always check your insurance policy for details on provider participation, as there may be exclusions based on your group or employer.
Grandfathered plans, which are considered "grandfathered in", may not follow healthcare reform and therefore may not include breast pump coverage.
To monitor your claims, deductible, health history, and obtain personalized health information, create a personalized secure member account through Aetna's website.
You can also check the following article sections for more information on insurance coverage and breastfeeding:
- Preventing Mastitis
- Do Medicaid and WIC Cover Breast Pumps?
- Heavy Metal Mamas: Breastfeeding with Nipple Piercings
Benefits and Support
Aetna insurance offers a range of benefits and support for breastfeeding mothers.
Aetna considers purchase of a manual or standard electric breast pump medically necessary during pregnancy or at any time following delivery for breastfeeding.
You can get up to 6 breastfeeding support and education sessions throughout your pregnancy and for the duration of your breastfeeding journey, covered by Aetna and provided through Aeroflow Breastpumps.
These sessions can be incredibly beneficial if you're pregnant and preparing for your baby's arrival, or if you're already breastfeeding and could use some help.
Aetna covers the cost of a breast pump, making it a preventative benefit with little to no out-of-pocket cost for most breast pumps.
You can choose from various support formats, including comprehensive coverage, bilingual services, expert guidance, and more, all provided by certified lactation consultants and other healthcare professionals.
A new set of breast pump supplies is considered medically necessary for women using a breast pump from a prior pregnancy, and this is true for each subsequent pregnancy for initiation or continuation of breastfeeding during pregnancy or following delivery.
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A replacement manual or standard electrical breast pump is considered medically necessary for each subsequent pregnancy.
Breastfeeding can increase the rate of weight loss in most nursing mothers and costs less than baby formula when combined with getting milk with a breast pump.
Here are the types of breast pumps covered by Aetna:
- Manual breast pump
- Standard electric breast pump
- Heavy duty electrical (hospital grade) breast pump (rental only)
Ordering and Coverage
You can get 100% coverage on your breast pump with Aetna, with no hidden costs, copays, or deductibles. This is thanks to the Affordable Care Act healthcare reform law, which considers breast pumps a preventative benefit.
Fill out the quick and easy Qualify Through Insurance Form to start the process of ordering a breast pump using your Aetna insurance. Once you've done this, you'll need to shop their curated selection of pumps.
Aetna requires a prescription from an authorized healthcare provider, such as your physician, nurse practitioner, or midwife, to cover the cost of your pump. This is a standard requirement for insurance coverage.
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You can get free breast pumps through insurance, as well as supplies and time with lactation consultants, at The Breastfeeding Shop. They specialize in supplying insurance-covered breast pumps to moms and mothers who want to breastfeed their babies.
Here are the types of breast pumps that may be provided to Aetna-specific insurance plans through Aeroflow Breastpumps:
You'll find the perfect fit with The Breastfeeding Shop, just contact one of their breast pump specialists and get an Aetna free breast pump today.
Insurance and Providers
Aetna insurance can be a great help when it comes to getting a breast pump. Aetna Health Inc has been providing innovative services and benefits to its customers since 1853.
To get a breast pump covered by Aetna, you'll need to have a prescription from an authorized healthcare provider, such as your physician, nurse practitioner, or midwife. This is a requirement by Aetna to cover the cost of your pump.
Aeroflow Breastpumps is a DME in-network provider contracted with certain Aetna policies, which means they can help you navigate the process of getting a breast pump through insurance.
Insurance Replacement Parts
Insurance Replacement Parts can be a lifesaver for many new mothers, ensuring they have a working breast pump throughout their breastfeeding journey. Aetna Insurance, for example, covers certain replacement parts and pump supplies for manual and standard electric pumps.
This means you can extend the life of your pump, keeping every component in working order. Most Aetna plans cover a free breast pump and a set of breast pump supplies.
Insurance Coverage Exclusions
Aetna Insurance Plans don't cover certain items related to breastfeeding.
Some examples of excluded items include baby weight scales, batteries, and breast pump cleaning supplies.
Breast milk storage bags, electrical power adapters for travel, and nursing bras are also not covered.
You can check the full list of excluded items in the Aetna Insurance Plans section.
Aetna specifically excludes creams, ointments, and other products that relieve breasts or nipples.
Travel bags and other similar travel or carrying accessories are also not covered.
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Here's a list of excluded items:
- Baby weight scales
- Batteries, battery-powered adaptors, and battery packs
- Breast milk storage bags, ice-packs, labels, labeling lids, and other similar products
- Breast pump cleaning supplies including soap, sprays, wipes, steam cleaning bags and other similar products
- Creams, ointments, and other products that relieve breasts or nipples
- Electrical power adapters for travel
- Garments or other products that allow hands-free pump operation
- Nursing bras, bra pads, breast shells, nipple shields, and other similar products
- Travel bags, and other similar travel or carrying accessories
About Aeroflow
Aeroflow Breastpumps is a DME in-network provider contracted with certain Aetna policies.
Aetna Health Inc, the company that partners with Aeroflow, was founded in 1853 in Hartford, CT.
Aeroflow Breastpumps has been working with Aetna to provide excellent customer service and products to mamas nationwide.
Information provided in blogs should not be used as a substitute for medical care or consultation, so be sure to follow up with a healthcare professional for personalized advice.
Is Milk and Mama's Baby an In-Network Provider?
Milk and Mama's Baby is an in-network provider for Aetna, which means if you're covered by Aetna, you can order your breast pump from them today.
If you're unsure about your insurance coverage, it's always a good idea to check with your provider directly.
Frequently Asked Questions
How to know if a breast pump is covered by insurance?
Check your health insurance plan for guidelines on breast pump coverage, including type, rental duration, and delivery timing. Review your plan's specifics to confirm coverage and understand any requirements or restrictions.
Sources
- https://thebreastfeedingshop.com/100-free-breast-pump-covered-by-aetna/
- https://www.aetna.com/individuals-families/womens-health/breast-pump-coverage-and-breastfeeding.html
- https://www.aetna.com/cpb/medical/data/400_499/0421.html
- https://aeroflowbreastpumps.com/blog/aetna-insurance-guidelines-for-breast-pumps
- https://milknmamasbaby.com/does-aetna-cover-breast-pumps/
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