Insurers' coverage of breast pumps, lactation services varies
Amid all the talk about the reform law's insurance implications is a little known provision that requires a new benefit for insurers to cover--breast pumps and lactation consultant visits--that went into effect Jan. 1, The New York Times reported.
Insurers have been working to comply with the regulation, which doesn't specify whether they must cover certain breast pump brands or types but does state that they must pay for the costs of renting breastfeeding equipment after a baby's birth.
"There are various interpretations from the insurers," Rachel Mennell, a spokeswoman for Medela, one of the country's largest makers of breast-feeding equipment, told the Times. "There appear to be more questions than answers from not only the insurers, but moms as well."
That's because covering breast pumps and lactation services is part of a paradigm shift that insurers are undergoing when it comes to women's health. Instead of focusing on diagnostic treatments of disease, insurers are moving toward disease prevention and wellness promotion, FierceHealthPayer previously reported.
UnitedHealth, for example, is covering both rentals and purchases of breast pumps. "The law states that we must provide rental pumps," said UnitedHealth Spokesman Matthew Stearns. "We are providing women the option of getting a personal pump in lieu of renting the more-expensive pump."
But Blue Shield of California, however, has chosen to only pay for breast pump rentals.
Insurers also are expanding their provider networks to include lactation consultants, who provide breastfeeding support and counseling to new mothers. Aetna wrote to lactation consultants last summer, inviting them to join its expanding "network of international board certified lactation consultants," the Times noted.
To learn more:
- read the New York Times article
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