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Am I Covered? Breast Pump Policy Updates and More

Breast Pump Coverage

By Dana Bretz

Last week’s discussion topic was quite popular and I received many questions asking more about TRICARE and the new breast pump coverage. What exactly am I talking about? Let’s see if I can break it down Cliffs Notes style and start from the beginning.

If you are a super fan of the House Armed Services Committee or have read the 2015 National Defense Authorization Act for fun, it might be no surprise to you about this new coverage. For the rest of us, this is HUGE! So, a bill was introduced to the House of Representatives and to the United States Senate called the TRICARE Moms Improvement Act of 2014. After being referred to the Committee on Armed Services, it eventually wound up as an amendment to the 2015 NDAA. After a signature from the President, boom, its official. For those of us familiar with Schoolhouse Rock, we recognize what a wonder it is for a sad scrap of paper to become a law. Everybody should be clapping at this amazing feat!

Huge shout out to Rep. Lois Capps (CA-24) for sponsoring the bill. She is quoted as saying “It was simply not fair that mothers and children who receive coverage under the federal TRICARE insurance program did not receive the same access to care that civilian moms do. This new law will change that, giving military families access to the same services that are available to those who have private insurance, and ensuring our military moms have the resources they need to feed and care for their newborns if they chose to breastfeed.” Don’t we all just want to give her a high five? I know I do!

Now to talk about what this means to so many of us. Many new spouses are also new parents and may not be familiar yet with TRICARE and what is available to them, particularly when it comes to breastfeeding. Many pregnant women plan to nurse their babies at birth, but some stop because of lack of support or instruction and limited access to lactation equipment. This new coverage makes it easier for new mothers to initiate and continue to breastfeed for as long as they had originally intended.

What do you need to do? You need to get a prescription from a TRICARE-authorized physician, physician assistant, nurse practitioner, or nurse midwife. What is covered? Not only are pumps covered, but it also covers up to 6 individual outpatient breastfeeding counseling sessions from an authorized provider. These sessions are in addition to the counseling you may receive during your inpatient stay, outpatient OB visit, or well-child care visit. All of these things are accessible before or after birth and this coverage is also retroactive to Dec. 19, 2014. Don’t panic and keep all of your receipts if you have already made purchases, you can file a claim for reimbursement and will need to include your prescription. I hope you’re cheering because this is all pretty fantastic!

Now, if you are an eligible beneficiary in need of a breast pump, supplies (yes some supplies are covered too) or breastfeeding counseling services, you need to contact your TRICARE contractor. You should be familiar with that term if you’ve been keeping up with my blogs. If not, go back and read “Keep Calm and Get Your TRICARE ON”. I have even had some women tell me that they were contacted about the new coverage! Yes, you could have knocked me over with a feather. I am loving that proactive approach, TRICARE!

For more information you can visit http://www.tricare.mil/Home/CoveredServices/IsItCovered/BreastPumpsSupplies.aspx

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1 thought on “Am I Covered? Breast Pump Policy Updates and More”

  1. I just got mine from The Breast Feeding Shop . Com . It was really easy and quick. I just had to fill out there online form. My pump was covered! =)

    Like

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