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Breast Pump/Insurance Question

So I contacted my insurance company through the website and I don't know what to do with this response.  Do I need to try to do it through my doctor or do I need to try and call the clinical intake team?  I just wanted to know basically which ones were covered!  Did you ladies have to do anything special to find out this information?



Thank you for your recent inquiry submitted through the Message Center regarding your new plan available online. Humana values our relationships with our members, and we want to provide you with clear and effective communication.  I would like to apologize for any confusion and would like to thank you for your continued patience as we help provide guidance when you need it most.

 

Women have access to comprehensive lactation support and counseling from trained providers, as well as Breast-feeding equipment. The equipment has to be FDA approved.  I would suggest that you speak with your provider about what kind of pumps are available and they will call for authorization.  If you wanted to call our clinical intake team to discuss authorization of breast pumps, please feel free to call 1-877-853-7390.

 

In regards to breast pump providers here is a list of some of the providers we work with:

 

·         Direct Healthcare Supply aka Edwards

·         Carepoint medical

·         Apria healthcare

·         Byram healthcare centers

·         Edgepark medical supplies

For assistance finding an in-network provider, please use the Physician Finder tool on www.humana.com.  Our records indicate that your network is: Humana ChoiceCare Network. The steps to access Physician Finder Plus are:

 

1.     Access www.Humana.com.

2.     Click on "Start your search" located in the box labeled "Find a healthcare provider".

3.     Your plan should pre-fill into the tool if you're logged in online. If it does not, then enter the 9 digit Member ID number in the box and click the "Go" button.

4.     Verify the city, state, and zip code are correct.  Click the "Go" button.

5.     Click the drop down arrow under the "Choose provider type:" on the "Select a Provider Type" screen.

6.     Next, please select the type of provider you are looking for out of the dropdown box.  This is located in the box below the Provider Type selection box.

7.     Click "Search"

 

Choosing a provider from this listing ensures your provider or facility are in-network so that you receive your in-network level benefits. Out-of-network level of benefits is applicable if the plan is not displayed.

 

Thank you for contacting Humana where it is our vision to be the most trusted name in health solutions.  If you have further questions, please continue to use the Message Center or call our Customer Care Department at 1-800-833-6917.

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Re: Breast Pump/Insurance Question

  • When I did it I had to go to each website and put in my insurance information, then each company gave me a list of what I was eligible for. After that I just picked which one I wanted to go with and ordered it. Some companies you can order online and others you have to actually call them.
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  • I called one of the local breastpump providers they worked with, and just asked them if they knew what X insurance company covered.  They gave me what the options were along with the medical codes I could call my insurance with to see how much my portion was. Then I called back to the insurance company with the codes, and they let me know how much of each was covered.  

    *Yes, I did this a week after finding out we were expecting.  I'm too much of a budgeter to not know if I could get it covered or not.

    TTC since 1/13  DX:PCOS 5/13 (long, anovulatory cycles)
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  • When I called my insurance company all they did was send me a list of local pharmacies that I could go to.  I went to one this weekend just to see what brands they had. I saw Madela supplies on the shelf, along with another brand I can't remember. I asked the pharmacist and was told I need to get a prescription from my doctor and then they will order it.  No one said anything about certain brands/models, so I guess we will see.  I'm going to ask my OB on Thursday. I guess every insurance company handles it differently.  I have BCBS, if it matters.
    imageimage
  • When I did it I had to go to each website and put in my insurance information, then each company gave me a list of what I was eligible for. After that I just picked which one I wanted to go with and ordered it. Some companies you can order online and others you have to actually call them.
    This. I would also check about when they will allow you to order one. My insurance wouldn't let me order one until after I delivered. I had to rent one from the hospital because LO's were fed via tube and I had to pump to make my milk come in.
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  • My insurance told me that as long as I went through an approved provider they'd reimburse me. It was pretty easy.

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  • Mine was super simple. They had a number to call right in my policy. Called that number and they asked for my policy number and if I wanted a manual or double electric, confirmed my address and I had it a few weeks later.

    In your case I'd probably call the providers they work with and see if they knew what was covered then call insurance to double check once you know what you want and through who.

    .image

     

  • I called Edgepark and ordered mine. I was very happy with their service and I got the pump in less than a week.

    I had to wait until A was born to order it though.

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  • Call National Rehab, and they will tell you which breast pump your insurance plan covers and when you can get the pump. National Rehab has Medela and Ameda pump. You can see the pumps on their website http://www.nationalrehab.com or call 800-451-6510 and press the #9 to talk to cs.
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