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August is about hot weather, final summer getaways, and back-to-school prep. For new and expecting moms, it’s also Breastfeeding Awareness Month. A month dedicated to helping women understand the health benefits of breastfeeding while providing the support they need.

As expectant moms transition through pregnancy, their to-do list for baby’s arrival gets longer and longer.  Aside from exciting tasks like finalizing a name and setting up the nursery, if you decide to breastfeed, one major to-do is ordering a breast pump.

There are many benefits to owning a breast pump, including that the equipment makes it possible for you to continue to provide breastmilk for your baby while you are apart – whether you are out running errands or returning to work. Going back to work and breastfeeding can be daunting for new moms, but the benefits of breastfeeding prove to make the effort worth it.

The Blue Cross NC Process

This process goes into effect when you enter your third trimester (28-40 weeks). If you’re not quite there yet, bookmark this post for when you hit the 28-week mark.

Step 1: Your medical provider will write a prescription for the breast pump. This normally happens at your 28-week appointment. If your OB-GYN provider does not mention it then, be sure to request it.

Step 2: Log on to our Find a Provider tool or use the list at the end of this post to find a Durable Medical Equipment (DME) provider that is in-network with Blue Cross NC. A DME provider is basically a medical equipment supplier. A breast pump is considered medical equipment.

Step 3: Once you have the DME provider selected, you will have two options to order:

  1. Take the prescription to their physical location to be filled.
  2. Or, order online.

Step 4 (A): If you decide to fill the breast pump prescription at the DME provider’s physical location, they will follow the steps similar to filling a prescription at a pharmacy.

Step 4 (B): If you decide to order online, the DME provider’s website will prompt you to fill out an online form. The DME provider will contact your doctor for a prescription or you will be asked to send a copy of the breast pump prescription. TIP: Scanning is easy with today’s mobile technology. Free scanning apps that turn a picture into a PDF. For iPhone try Evernote Scannable and Android try Microsoft Office Lens.

Step 5: Once your insurance is verified, they will give you a list of breast pumps that you are eligible to receive.

Step 6: Select the breast pump option that best fits your needs and the DME provider will prepare the breast pump for shipping/delivery. If you want to upgrade your breast pump, you will be required to sign a waiver form indicating that you are aware of the amount that Blue Cross NC will cover and that you agree to pay the difference.

We recommend starting the process as soon as you get your prescription to make sure your breast pump arrives before your baby. 

Frequently Asked Questions

Many of our customers have questions about ordering breast pumps. We don’t blame you! Between the Affordable Care Act (ACA) mandate and necessary equipment, it can get a bit complicated, but we’re here to help. Here are answers to a few frequently asked questions:

 I heard I am covered for a  breast pump under the ACA, is that true?

When the ACA was signed into law in 2010, it had several universal mandates. Universal mandates are specific types of coverage that all ACA plans must offer. One mandate was that all ACA health plans had to cover breastfeeding support and supplies. For most pregnant mothers and lactating mothers, this means breast pumps are covered if you have an ACA plan. The mother must be covered on the plan.

Note, this benefit could change if the ACA is repealed or replaced. 

Which Blue Cross NC customers are eligible?

Coverage is available for lactating mothers or pregnant women in the third trimester. This applies to all female subscribers and dependents on an ACA-compliant Blue Cross NC plan. While we encourage moms to sign up for our maternity program, you do not have to be enrolled to be eligible for a covered breast pump. 

Are any Blue Cross NC customers not eligible?

We still have some employer group and individual plans that are non ACA-compliant. If you have coverage under one of these plans or have a traditional 70/30 plan you will not be eligible to receive a breast pump.

The best way to know if you are covered is to call the number on the back of your member ID card.

 What equipment is covered?

Here’s what’s covered under your ACA-compliant plan:

One breast pump per pregnancy will be covered.

The breast pump you receive will include all related supplies such as tubing, shields, and bottles.

 

Here’s what’s not covered under your ACA-compliant plan

  • Additional breast pump supplies that are ordered before you purchase your original breast pump.
  • Hospital-grade breast pumps.
  • Supplies such as nursing bras, milk storage bags or creams are not covered.
  • Breast pumps purchased from a retail location such as Babies R Us, Target or Buy Buy Baby are not reimbursable and will not be covered. Also, if a member submits a claim herself or uses an out-of-network provider the claim will be denied. You must use a DME provider.

If you’re unsure whether your plan includes this benefit or if you have any additional questions about our 6-step process, please call the number on the back of your member ID card. Our team is here to support you.

Securing a breast pump is only the first step to a successful breastfeeding experience. Support from family, friends, and employers will also help new moms transition. If you are having trouble breastfeeding, lactation consultants provide valuable tips and support.

DME Supplier Branch Location Phone Number Hours of Operation
Dressen Medical Supply Holly Springs 919-577-6458 8:30 a.m. – 5 p.m.
Aeroflow Breastpumps

 

N/A 1-844-867-9890 8 a.m. – 6 p.m.

Online ordering and home delivery’

Griffin Home Health Care, Inc.

 

Charlotte 704-347-1993 9 a.m.-5:30 p.m. M-F, 9 a.m.-1 p.m. Saturday
Gastonia 704-868-3132 9 a.m.-5:30 p.m. M-F
 

Liberty Medical Supplies

 

 

 

 

 

 

 

 

 

Whiteville 910-642-2250 8:30 a.m. – 5 p.m.
Wilmington  910-763-8229 8:30 a.m. – 5 p.m.
Supply 910-755-0023 8:30 a.m. – 5 p.m.
Morehead City 252-247-3657 8:30 a.m. – 5 p.m.
Fayetteville 910-864-3810 8:30 a.m. – 5 p.m.
Monroe 704-238-0027 8:30 a.m. – 5 p.m.
Durham 919-490-0145 8:30 a.m. – 5 p.m.
Myrtle Beach 843-448-8315 8:30 a.m. – 5 p.m.
Greenville 252-353-3375 8:30 a.m.- 5 p.m.
Thomasville 336-472-1741 8:30 a.m. – 5 p.m.
Carolinas Home Medical Equipment Inc. Matthews 704-846-7503 8:30 a.m. – 5 p.m.
Byram Healthcare N/A 1-877-773-1972 9:00 a.m.-5 p.m.
Edwards Health Care Services N/A 1-888-344-3434 8:30 a.m.- 5 p.m.

 

 

 

Leah Mararo

About Leah Mararo

Leah Mararo is a Communicators Coordinator at BCBSNC. Leah loves her job because she likes guiding our members through complicated benefits information with simple, effective communication pieces. When she’s not at work, Leah enjoys spending time with her family, playing table tennis and reading.

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