Is Spectra Breast Pump Covered by Insurance?
Your Complete Guide to Getting a Free Spectra Breast Pump Through Insurance
As a registered nurse and mother of two, I bring both professional healthcare expertise and personal breastfeeding experience to my breast pump reviews. I thoroughly test each pump to help fellow moms make informed decisions for their breastfeeding journey.
As a nursing mom, I understand how overwhelming it can be to navigate insurance coverage for breast pumps. The good news? Most insurance plans do cover the Spectra breast pump, and I’m here to guide you through the entire process step by step.
Understanding Your Right to a Free Breast Pump
Since the Affordable Care Act (ACA) was enacted, most health insurance plans are required to cover breast pumps at no cost to you. This means your Spectra breast pump covered by insurance should be completely free, including shipping costs. The law recognizes breastfeeding as essential healthcare, and insurance companies must provide this coverage without copays or deductibles.
Important: Insurance coverage for breast pumps is considered a preventive care benefit, which means you’re entitled to receive a pump even if you haven’t met your annual deductible yet.
Why Choose Spectra Breast Pumps?
As someone who has personally tested multiple breast pump brands, I can confidently say that Spectra pumps are among the most reliable and efficient options available. The Spectra S1 is particularly popular among moms for its hospital-grade performance and user-friendly design.
Hospital-Grade Performance
Closed system design prevents milk backup and contamination
Whisper Quiet
Perfect for pumping without waking baby or disturbing others
Rechargeable Battery
Pump anywhere without being tethered to an outlet
Step-by-Step Guide: How to Get Your Spectra Pump Through Insurance
Step 1: Contact Your Insurance Provider
Call the customer service number on your insurance card and ask about your breast pump coverage. Ask specifically about durable medical equipment (DME) benefits and if they cover Spectra breast pumps.
Call the customer service number on your insurance card and ask about your breast pump coverage. Ask specifically about durable medical equipment (DME) benefits and if they cover Spectra breast pumps.
Step 2: Get a Prescription from Your Doctor
Most insurance companies require a prescription from your healthcare provider. This can be obtained during a prenatal visit or postpartum checkup. Your doctor can write a prescription for a “hospital-grade breast pump” or specifically mention “Spectra breast pump.”
Most insurance companies require a prescription from your healthcare provider. This can be obtained during a prenatal visit or postpartum checkup. Your doctor can write a prescription for a “hospital-grade breast pump” or specifically mention “Spectra breast pump.”
Step 3: Choose an Approved DME Supplier
Your insurance will provide a list of approved durable medical equipment suppliers. Many offer online ordering, which makes the process more convenient for busy moms.
Your insurance will provide a list of approved durable medical equipment suppliers. Many offer online ordering, which makes the process more convenient for busy moms.
Step 4: Submit Required Documentation
Provide your prescription, insurance information, and any other required documentation to your chosen DME supplier. They’ll handle most of the insurance paperwork for you.
Provide your prescription, insurance information, and any other required documentation to your chosen DME supplier. They’ll handle most of the insurance paperwork for you.
Step 5: Receive Your Pump
Once approved, your Spectra breast pump will be shipped directly to your home. Most suppliers offer expedited shipping for expectant mothers.
Once approved, your Spectra breast pump will be shipped directly to your home. Most suppliers offer expedited shipping for expectant mothers.
Common Insurance Coverage Scenarios
Private Insurance Plans
Most private insurance plans, including those offered through employers, cover breast pumps under the ACA mandate. This includes major insurers like Blue Cross Blue Shield, Aetna, Cigna, and UnitedHealthcare. The coverage typically includes one pump per pregnancy, and some plans may allow upgrades to premium models like the Spectra S1 or S2.
Medicaid Coverage
Medicaid also covers breast pumps in all states, though the specific models available may vary. Many Medicaid programs do include Spectra pumps in their approved equipment lists. Contact your state’s Medicaid office for specific information about breast pump coverage. If you want more information read our indepth guide on how to get a free breast pump through insurance.
Military Insurance (TRICARE)
TRICARE provides excellent breast pump coverage for military families. They typically cover hospital-grade pumps, including Spectra models, through their network of approved suppliers.
What to Do If Your Claim Is Denied
If your insurance initially denies coverage for your Spectra breast pump, don’t give up. Denials are often due to paperwork issues or lack of proper documentation. Here’s what I recommend:
Contact your insurance company to understand the specific reason for denial
Work with your doctor to provide additional medical documentation if needed
File an appeal with your insurance company – most denials can be overturned
Consider contacting your state’s insurance commissioner if the appeal is unsuccessful
Timing Your Breast Pump Order
From my experience advising new moms, I recommend ordering your Spectra breast pump during your third trimester, ideally around 32-36 weeks of pregnancy. This gives you enough time to receive the pump and familiarize yourself with its operation before baby arrives. However, you can also order postpartum if you prefer.
Pro Tip: If you’re planning to pump exclusively or return to work early, consider ordering your pump as soon as your insurance allows (usually after 27-30 weeks of pregnancy).
Maximizing Your Breast Pump Benefits
Many insurance plans also cover breast pump accessories and replacement parts. This can include extra bottles, tubing, flanges in different sizes, and storage bags. Ask your DME supplier about what additional items are covered under your plan.
Some insurance plans allow you to receive a new pump for each pregnancy, while others provide one pump that you can use for multiple children. Check your specific plan details to understand your coverage limits.
Final Thoughts
Getting your Spectra breast pump covered by insurance doesn’t have to be complicated. With the right information and a little persistence, you can secure this valuable breastfeeding tool at no cost to you. Remember, this is a benefit you’re entitled to, and insurance companies are required to provide this coverage.
As you navigate your breastfeeding journey, having a reliable pump like the Spectra can make all the difference. For more detailed information about Spectra pump features and my personal testing experience, be sure to check out my comprehensive Spectra S1 review.
Remember: Every insurance plan is different, so always verify your specific coverage details with your insurance provider. Don’t hesitate to advocate for yourself – you deserve the best tools to support your breastfeeding goals.
