Your insurance plan likely covers breast pumps at no cost to you
The Affordable Care Act requires most health insurance plans to cover breast pumps as preventive care. This means your plan should pay for a pump without charging you a copay, coinsurance, or deductible — but you have to request it through the right channel, and the process varies by insurer. Most people get their pump by contacting their insurance company directly, choosing from an approved supplier, and waiting one to three weeks for delivery.
The catch is that insurers do not advertise this benefit widely, and many people never ask. If you do not know your plan covers pumps, you might buy one out of pocket and miss the coverage entirely. This guide walks you through finding out what your plan covers, ordering through the right supplier, and what to do if your insurer denies the request.
Key Takeaways
- Call your insurance company's customer service line and ask specifically about breast pump coverage under preventive care — do not assume they will mention it unprompted.
- Your insurer will direct you to one or more approved suppliers; you cannot straightforward buy a pump at a store and submit a receipt for reimbursement.
- You will need your member ID, date of birth, and sometimes a prescription or statement from your doctor confirming you are pregnant or postpartum.
- Delivery typically takes one to three weeks, so contact your insurer before you give birth if possible, or within the first few weeks after.
- If your insurer denies coverage, you can file an appeal or contact your state insurance commissioner's office for help.
Call your insurance company and confirm coverage before ordering
Start by calling the customer service number on the back of your insurance card. Tell them you want to know about breast pump coverage under preventive care. Have your member ID and date of birth ready. The representative should tell you whether your plan covers pumps, what types are covered, and which suppliers you can order from.
Write down the supplier names and any restrictions — some plans cover only manual pumps, others cover electric pumps, and some offer a choice. Ask whether you need a prescription or a doctor's note. Some insurers require a statement from your OB-GYN or midwife confirming you are pregnant or postpartum; others do not. If the first representative cannot answer clearly, ask to speak with someone in the preventive care or durable medical equipment department.
If your plan does not cover breast pumps, ask whether you can purchase one through a health savings account (HSA) or flexible spending account (FSA) if you have one. These accounts let you set aside pre-tax money for medical expenses, including breast pumps, which effectively reduces what you pay out of pocket.
Contact the approved supplier and place your order
Your insurer will give you the name and phone number of at least one approved supplier. Call that supplier directly — do not order online without confirming your coverage first, because the supplier needs to verify your insurance information before shipping. Have your insurance member ID, plan name, and date of birth ready.
The supplier will ask which type of pump you want (if your plan offers a choice) and may ask for a prescription or authorization from your doctor. Some suppliers can contact your insurer directly to confirm coverage; others will ask you to provide a copy of your insurance card. If your insurer requires a doctor's note, you can usually fax it to the supplier, or your doctor's office can send it directly.
Once the supplier has verified your coverage and received any required documentation, they will ship the pump to your address. This usually takes five to ten business days. The supplier will send you a tracking number so you can monitor delivery. You should not be charged anything at the time of order or delivery.
What happens if your insurer says the pump is not covered
Some older plans or plans from small employers may not cover breast pumps, though this is becoming rare. If your insurer denies coverage, ask them to explain which part of your plan excludes it. Request the specific policy language in writing. Then contact your state insurance commissioner's office — most states have a consumer information program that can review the denial and push back if the insurer is wrong.
You can also file a formal appeal with your insurer. Ask for the appeals process and submit a written request that references the Affordable Care Act's preventive care requirement. Include a copy of your insurance card and any documentation from your doctor. Appeals typically take 30 to 60 days, but some insurers will expedite if you explain you need the pump soon.
If the appeal fails and your state insurance commissioner cannot help, you still have the option to purchase a pump out of pocket and claim the expense through an HSA or FSA if you have one. Some employers also offer backup information programs for situations like this — ask your HR department whether yours does.
Understand what types of pumps are usually covered
Most insurance plans cover either a manual pump, an electric pump, or both. A manual pump is hand-operated and costs less; an electric pump runs on batteries or plugs in and is faster but more expensive. Some plans let you choose; others cover only one type. A few plans cover a hospital-grade rental pump if you need one for medical reasons, though this is less common.
Ask your insurer specifically whether they cover accessories like extra bottles, flanges (the part that attaches to your breast), or a carrying case. Most plans cover the pump itself but not the extras, though some do include one set of replacement parts. If accessories are not covered, you can usually buy them separately at a drugstore or online.
Timing matters: order before or shortly after birth
If you know you are pregnant, contact your insurer during your third trimester. This gives you time to verify coverage, choose a supplier, and receive the pump before you give birth. If you wait until after birth, you can still order, but delivery will take longer and you may need to use a borrowed pump or rent one in the meantime.
Some insurers have time limits on when you can request a pump — typically within a certain number of days after birth. Ask your insurer what the window is. If you miss it, you may have to wait until your next plan year to request coverage, though you can appeal if there was a good reason for the delay.
If you are adopting or using a surrogate, the same coverage usually applies. Call your insurer and explain your situation; they will tell you what documentation they need and whether the timeline is different.
What to do if the pump arrives damaged or does not work
When your pump arrives, open the box and inspect it for damage before signing for delivery. If something is broken or missing, refuse the delivery or contact the supplier when ready. The supplier will send a replacement at no cost to you.
If the pump works but you do not like it or it does not fit properly, contact the supplier to ask about exchanges. Some suppliers will swap it for a different model or type; others will not. Check the supplier's return policy before you open the box. Your insurer should cover only one pump per plan year, so if you exchange it, make sure the replacement is also covered before you return the original.
Frequently Asked Questions
Do I need a prescription from my doctor to get a breast pump through insurance?
It depends on your insurer. Some require a prescription or a written statement from your OB-GYN or midwife confirming you are pregnant or postpartum; others do not. Call your insurance company to find out what they need before you contact the supplier. If a prescription is required, your doctor's office can usually send it directly to the supplier by fax or email.
Can I buy a pump at a store and have my insurance reimburse me?
No. Insurance covers breast pumps only when you order through an approved supplier that your insurer has contracted with. If you buy a pump at a drugstore or online retailer, your insurer will not reimburse you, even if the pump would normally be covered. Always verify coverage and order through the supplier your insurer names.
What if I need a pump before the supplier can deliver one?
You can rent a hospital-grade pump from a lactation consultant, hospital, or medical supply company while you wait for your covered pump to arrive. Some insurers cover rentals; most do not. Ask your insurer whether rental is covered, and ask the rental company whether they can bill your insurance directly. Once your covered pump arrives, you can return the rental.
Can I get a second pump if I need one for work or travel?
Most insurance plans cover one pump per plan year. If you need a second pump, you will usually have to buy it out of pocket. However, some plans make an exception if you have a medical reason — for example, if you are exclusively pumping and need a backup. Call your insurer and explain your situation; they may approve a second pump or may not.
What happens if my insurance changes after I order the pump?
If you order through your current insurer and your coverage changes before the pump arrives, contact the supplier when ready and let them know. The supplier will work with your new insurer to confirm coverage, or they may ask you to reorder through the new plan's approved supplier. Do not assume the new plan covers the same pump or supplier — coverage varies.