I'm just curious:
have any of you been able to get Medicaid to pay for a breastpump? I know many HMOs do, but MassHealth (MA Medicaid) does not... Medicaid isn't my primary insurance but they are the coverage I have for durable medical equipment which is what breastpumps fall under.
It makes me wonder why! - if a person needs a pump and is income-eligible for medicaid they may not have the "income" to buy a fancy pump if they need to work, go to school, etc...
I know that MassHealth patients are also WIC eligible. WIC will pay for formula, but if we are talking overall long-term costs, wouldn't it be cheaper (and healthier!) for the state medicaid budget to kick in a couple hundred dollars to rent/buy a pump then to pay on a monthly basis for formula? I know WIC and Masshealth are two different state budgets, but I watch a lot of overall budget cuts and how cutting one affects the other. it just seems like this is an area where they can save $$$ - by providing a breast pump rather then by paying more for formula for a mother who wishes to breastfeed instead of telling her that they can provide formula instead...
If there is "medical necessity" sometimes they can get covered the hospital social worker told me. Often they pay in the case of preemies since mom isn't there 24/7 and since some babies can't suck that early.
I know that medicaid does not cover childbirth education classes or parenting classes either here. again I found that odd since people on medicaid may not be able to dump $200+ on a class. Some hospitals offer sliding scale classes of course, and I think mine has a $15 class for teen parents. and I don't "need" a class in the same way I may need a pump if I'm sick/hospitalized but it just strikes me odd because I'm sure a lot of medicaid patients do NEED classes for whatever reason - even just to reduce anxiety which anyone might face about what will happen. Some might need access to a parenting/infant care class because they've never cared for a newborn. I'm fine reading, but plenty of people struggle with reading and would do better listening to a person explain or doing hands-on learning.
I've just been contemplating this lately and was wondering how other states medicaid programs work issues like breast pumps and childbirth/parenting prep classes. anyone know???
In Texas, WIC rents pumps. Maybe look into that!
Breastpumps can be rented from some hospitals I wonder if medicaid is assuming that they do not need to provide pumps because there are other resources to get a pump... you would think they would be interested in cutting costs and providing a pump would be a good way to do that. hmm...
Masshealth/Commonwealth Care has specific insurance providers in contracts, yes? (Network Health, Neighborhood Health, etc.) Some of those providers will supply breast pumps to expecting mothers,
For instance, this one does: https://www.network-health.org/Members/NH-Together/Benefits-and-cost/Extra-benefits/Extra-benefits.aspx
I believe, though, that they only offer single breast electric pumps, which are not super effective for full-time working mamas.
If your Masshealth plan does not offer breast pumps, you can request to switch providers.
When's your due date, though? I have a really nice PIS that I could potentially pass on to you if the timing works. I live in MA too, so it would be easy enough. PM me if you're interested.
Oh, and in terms of the larger access issue, you make a really good point here: " it just seems like this is an area where they can save $$$ - by providing a breast pump rather then by paying more for formula for a mother who wishes to breastfeed instead of telling her that they can provide formula instead."
I gave birth to my first baby in Oregon, and the hospital gave me a free pump, but it was just a little handheld. The hospital also rented pumps on a sliding scale, but I never utilized it.
Medicaid covered the rental of a medela symphony with my first and provided a medela personal double pump for free with my 2nd (same as a pump in style).. but I also had preemies.
With my 3rd, I used the medela from #2 until it started dying and WIC lent me a medela lactina until they could get me a new medela personal double advance pump (for free).
From what I understand medicaid will only cover them in the cases of preemies and special needs babies that cant nurse, but WIC (at least in WI) will provide a free pump to anyone who needs it (work, school, etc).
I got a medela electric double pump from WIC when I was pregnant. They do it for anyone who is full time breast feeding. Its a great program and the pumps they give out are AMAZING! I'm in Arizona.