Breast pump for pregnant or new moms

Pregnant women and new moms are eligible to obtain a free pump if they are going to breastfeed their infant.

Benefit guidelines:

  • Pregnant women and new moms who intend to breastfeed their infant are eligible for a breast pump up to 30 days before their due date through 56 days after the baby is delivered.
  • Pregnant women and new moms can use any participating network durable medical equipment supplier that stocks manual or electric breast pumps, with a prescription from their physician.
  • If the physician orders a hospital-grade breast pump, it will require prior authorization. If approved because of medical necessity, the breast pump is available to rent.

Types of pumps covered with a prescription:

  • Manual breast pump (CPT code E0602): A non-electric pump that works by vacuum suction. This benefit covers one breast pump per year.
  • Standard, electric breast pump (CPT code E0603): An electric pump that works by creating a pulsating suction, usually by pneumatic action against a diaphragm. This benefit covers one breast pump every three years.

Types of pumps covered for rental, pending prior authorization:

  • Hospital-grade heavy duty electric breast pump (CPT code E0604): A piston electric pump with pulsatile vacuum suction and release cycles.

If patients request more information, please direct them to Member Services at 1-800-682-9090 (TTY 711).

Published on: August 6, 2019, 08:49 AM ET
Last updated on: August 7, 2019, 03:18 AM ET