Can My Husband Get A Breast Pump Through His Insurance?

Understanding Family Insurance Coverage for Breast Pumps

Yes, your husband’s insurance can often cover a breast pump for you! As a mother who has navigated this process multiple times, I’m excited to share that many fathers can indeed help obtain a breast pump through their insurance plan. This is especially valuable information for moms covered as dependents on their husband’s health insurance policy. Today, I’ll walk you through everything you need to know about getting a breast pump through your husband’s insurance – from eligibility requirements to the exact steps you’ll need to follow.

How Insurance Coverage Works for Breast Pumps

When I had my first baby, I was actually covered under my husband’s insurance plan. I remember feeling confused about whether I could get a breast pump through his policy. After making some calls and doing research, I discovered that the coverage doesn’t depend on whose name is on the insurance card – it depends on who is covered by the policy.

The Affordable Care Act (ACA) mandates that most health insurance plans must provide coverage for breastfeeding support, counseling, and equipment for the duration of breastfeeding. This includes breast pumps! This provision applies to the person who will be using the breast pump, regardless of whether they are the primary policyholder or a dependent.

Types of Insurance Plans That Cover Breast Pumps

From my experience reviewing different insurance policies for breast pump coverage, here are the types of plans that typically cover breast pumps:

• Employer-sponsored health plans – Most plans offered through employers must comply with ACA requirements
• Plans purchased through the Health Insurance Marketplace – These plans are required to cover breast pumps
• Most private insurance plans – Plans created after March 23, 2010, generally must provide coverage

For a comprehensive overview of how to get a breast pump through insurance, check out my Definitive Guide to Free Breast Pumps Through Insurance.

There are some exceptions, including grandfathered plans (those that existed before March 23, 2010, and haven’t made significant changes) and certain religious employers who may be exempt.

Steps to Get a Breast Pump Through Your Husband’s Insurance

When I needed to get my breast pump through my husband’s insurance, I followed these steps, which I recommend to all the moms I consult with:

1. Verify coverage – Call the insurance company directly using the number on your husband’s insurance card. Ask specifically about breast pump coverage for dependents.
2. Get a prescription – Most insurance companies require a prescription from your healthcare provider for a breast pump.
3. Understand timing – Ask when you can order the pump. Some insurance companies allow ordering during pregnancy, while others require waiting until after delivery.
4. Know your options – Ask what types of pumps are covered (rental vs. purchase, manual vs. electric) and if there are specific in-network suppliers you must use.
5. Submit necessary documentation – This typically includes the prescription and may require additional forms from your husband as the policyholder.

Common Questions About Husband’s Insurance Coverage for Breast Pumps

Does My Husband Need to Be Present or Sign Anything?

In my experience testing this process with various insurance providers, I’ve found that in most cases, your husband doesn’t need to be physically present when you order or pick up your breast pump. However, since he’s the primary policyholder, he may need to sign certain authorization forms or provide verbal authorization during phone calls with the insurance company. Every insurance provider has different requirements, so it’s important to ask about this specifically.

If you’re covered under specific insurance providers, I have detailed guides for several major companies:

• United Healthcare Breast Pumps Coverage Guide
• Blue Cross Blue Shield Breast Pumps Guide
• Breast Pumps Through Aetna Insurance
• Cigna Breast Pumps Coverage Guide
• Kaiser Permanente Breast Pumps Guide

Can I Choose Any Breast Pump I Want?

This is one of the most common questions I receive on my blog. The answer depends entirely on your husband’s specific insurance plan. Some insurance plans allow you to select from a wide range of breast pumps, while others limit your options to specific brands or models. Some plans may cover the full cost of a basic pump but require you to pay the difference if you choose a more expensive model.

From my extensive testing of various pumps, I can tell you that even the basic models covered by insurance are often quite good, but if you have specific needs (like exclusively pumping or returning to work), it might be worth paying the upgrade fee for a higher-end model.

What If My Husband’s Insurance Denies Coverage?

If your initial request is denied, don’t give up! I’ve helped many moms navigate this situation. First, ask for the specific reason for denial in writing. Common reasons include:

• Missing or incorrect prescription
• Ordering from an out-of-network supplier
• Requesting a pump before the insurance allows (some require you to wait until the third trimester or after delivery)
• Documentation issues

Once you know the reason, you can address it specifically. If the denial seems incorrect based on your understanding of your coverage, you can file an appeal. I’ve seen many successful appeals when moms reference the ACA requirements for breast pump coverage.

Timeline: When to Start the Process

As someone who has gone through two pregnancies and helped countless moms through this process, I strongly recommend starting early. Ideally, begin researching your husband’s insurance coverage for breast pumps during your second trimester. This gives you plenty of time to:

• Understand your coverage details
• Get the necessary prescription from your doctor
• Research which pump will best meet your needs
• Handle any potential issues or denials
• Receive and familiarize yourself with your pump before baby arrives

Many of my readers have thanked me for this specific advice, as waiting until the last minute often leads to unnecessary stress during an already busy time.

Alternative Options If Your Husband’s Insurance Won’t Cover a Breast Pump

If after exploring all options, you find that your husband’s insurance won’t cover a breast pump, don’t worry! I’ve been there too. Here are some alternatives I’ve personally recommended to mothers facing this challenge:

• Check if you qualify for WIC (Women, Infants, and Children) – Many WIC offices provide breast pumps to eligible participants
• Look into HSA or FSA funds – If you or your husband have a Health Savings Account or Flexible Spending Account, breast pumps are eligible expenses
• Consider renting a hospital-grade pump – This can be more cost-effective than purchasing if you only need it short-term
• Look for certified pre-owned or open-box pumps – These can offer significant savings on high-quality pumps
• Research breast pump assistance programs – Some hospitals and non-profit organizations offer assistance programs for breast pumps

If you’re covered by Medicaid, you may be eligible for a free breast pump. Check out my detailed guide on Getting Breast Pumps Through Medicaid. Military families should explore my article on Tricare Breast Pumps Coverage.

My Personal Experience Getting a Breast Pump Through My Husband’s Insurance

When I was pregnant with my first child, I was covered under my husband’s employer-sponsored health plan. I called the insurance company during my second trimester and was pleasantly surprised by how straightforward the process was. They explained that as a dependent on the policy, I was fully entitled to breast pump benefits.

I needed to get a prescription from my OB-GYN, which was simple – she wrote it during my regular prenatal visit. The insurance company had a list of preferred suppliers and covered models. I was able to choose a Spectra S2, which was fully covered. The supplier handled all the insurance paperwork, and the pump arrived at my doorstep about three weeks later.

With my second pregnancy, I knew the process better. This time, I asked more specific questions about upgrade options and learned I could pay the difference to get the Spectra S1 (with battery) instead. For me, the mobility was worth the extra cost, especially with a toddler keeping me busy!

Insurance Coverage Differences for Various Types of Breast Pumps

Through my work testing dozens of breast pumps and helping moms navigate insurance coverage, I’ve noticed patterns in what different insurance plans typically cover:

Manual Pumps

Almost all insurance plans that cover breast pumps will cover a manual pump. These are simple, portable, and inexpensive. While not ideal for exclusive pumping, they’re great as backup pumps.

Personal Electric Pumps

Most insurance plans cover standard electric breast pumps from major brands like Medela, Spectra, and Lansinoh. These are typically perfect for most mothers’ needs.

Hospital-Grade Pumps

Coverage for hospital-grade pumps usually requires medical necessity documentation. If you have premature twins or specific medical conditions affecting breastfeeding, your doctor can help you obtain coverage for a hospital-grade pump rental.

Wearable Pumps

Newer wearable pump models like Elvie and Willow are sometimes partially covered, with the mother paying an upgrade fee. I’ve seen more insurance companies beginning to fully cover these innovative pumps, but it’s still relatively rare.