One Insurance Company Is Slashing Breast Pump Coverage—Here's What You Can Do About It
March 26, 2018
If you’re planning on getting a breast pump through insurance, you’re going to want to read this. Every plan and insurer is different, but thanks to the Affordable Care Act, you should be eligible for a standard electric breast pump either for free or with a co-pay. That standard, however, may have to lower for some new moms, since Anthem Blue Cross Blue Shield plans to cut its reimbursement amount for electric pumps nearly in half.
The change, set to take place April 1, was announced to Anthem’s medical equipment providers earlier this year. Essentially, Anthem will lower the reimbursement rates they pay providers from $169.15 to $95. While that doesn’t directly correlate to retail price, it’s still worth noting a good breast pump is going to cost more than $95.
Anthem covers over 40 million people across 15 states: California, Colorado. Connecticut, Georgia, Illinois, Indiana, Kentucky, Maine, Missouri, New Hampshire, Nevada, New York, Ohio, Virginia and Wisconsin. In an effort to help moms in those states, the Alabama Breastfeeding Committee is stepping up to remind people how their state was faced with—and fixed—the same exact problem in 2016.
“The same issue was faced in Alabama in late 2016, involving Blue Cross/Blue Shield of Alabama. The reimbursement fee of $95 was found to be unacceptable by most IBCLCs,” says the Alabama Breastfeeding Committee (ABC) in a recent post. “Since only the most very basic pumps could be purchased for this amount, professionals feared that first time breastfeeding mothers would soon become frustrated with the inadequacy of the pump provided and cease to breastfeed for this reason.”
ABC wrote a letter outlining these concerns and suggesting a more reasonable coverage amount: $150. A social media campaign ensued.
“After further negotiations, Blue Cross Blue Shield retracted their previous recommendation and announced that the new reimbursement would be $150,” ABC says.
To fight this latest Anthem Blue Cross Blue Shield coverage drop, Alabama is encouraging moms in other states to make some noise.
“With the appropriate outcry from the public, we, in Alabama, know that other states can turn this around,” the post says. “To this end, we are trying to raise awareness. It is recommended that coalitions in the affected states email the Chief Medical Officer, Craig Samitt. ([email protected]), and have supporters post on their social media feeds and on well-read mom/ baby sites so that the awareness gets raised.”