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Medicare and Breast Pumps: Coverage Rules and Cost (2024)
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py-4 mb-2 space-y-2 text-primary-500"> <div class="font-semibold">Table of Contents</div> <a class="list-item toc-h2" href="#toc-0">What kind of breast pump is covered by Medicare?</a> <a class="list-item toc-h3" href="#toc-1">Does Medicare Advantage cover breast pumps?</a> <a class="list-item toc-h2" href="#toc-2">Can I get a free breast pump with Medicare?</a> <a class="list-item toc-h2" href="#toc-3">How do I get a breast pump with Medicare?</a> <a class="list-item toc-h2" href="#toc-4">What other medical devices are covered by Medicare?</a> <a class="list-item toc-h2" href="#toc-5">Takeaway</a> </div> <div class="text-center my-2 sm:my-4 " > <ins class="adsbygoogle adsense h-ad3 " data-ad-client="ca-pub-5240180246042932" style="display:block" data-ad-format="auto" data-ad-slot="9667766790" data-full-width-responsive="true" data-adtest="off" > </ins> <script> (adsbygoogle = window.adsbygoogle || []).push({}); </script> </div> <article class="article-detail"> <section class="entry-content paragraph"><article><div><div><p>Medicare can cover a breast pump for you, but your specific coverage may depend on the pump type and whether you have Original Medicare or Medicare Advantage insurance.</p></div><p>Medicare primarily provides coverage for people above 65 years old. Younger people who have received Social Security disability benefits for at least <a href="https://www.medicare.gov/basics/get-started-with-medicare/other-paths" rel="noopener nofollow" target="_blank">24 months</a> can also qualify for the government insurance program.</p><p>If you fall into this category and are pregnant or have had a baby recently, you may want to purchase a breast pump. Medicare can provide some coverage because <span>the Affordable Care Act <a data-type="link" href="https://www.healthcare.gov/coverage/breast-feeding-benefits/" rel="noopener nofollow" target="_blank">requires</a> all insurance </span>companies to cover breast pumps.</p><p>Read on to learn more about Medicare coverage for breast pumps.</p></div><div><div><h2 id="toc-0"><div><p><a name="coverage-details" target="_blank">What kind of breast pump is covered by Medicare?</a></p></div></h2></div><p>Original Medicare’s Part B <a href="https://www.medicare.gov/publications/11045-medicare-coverage-of-dme-and-other-devices.pdf" rel="noopener nofollow" target="_blank">includes</a> suction pumps in its covered durable medical equipment (DME) list.</p><p>Original Medicare may not consider an electric pump as DME, so you <a href="https://www.cms.gov/files/document/r12684bp.pdf" rel="noopener nofollow" target="_blank">may need</a> to select a manual pump to get full coverage.<div class="bg-primary-100 rounded-lg my-6 px-2 py-3 font-semibold insert" style="color: rgb(37, 99, 235)"><div class="text-common !leading-common ml-1 insert" style="margin-top: 0.2rem; margin-bottom: 0.2rem">See Also</div><a class="list-item toc-h2 py-1" style="border-bottom: none" href="https://peterec.com/article/vacuum-erection-devices-ved-l34824/4014" target="_blank" rel="noopener">Vacuum Erection Devices (VED) (L34824)</a><a class="list-item toc-h2 py-1" style="border-bottom: none" href="https://peterec.com/article/medicare-coverage-for-erectile-dysfunction-ed-clearmatch-medicare/4014" target="_blank" rel="noopener">Medicare Coverage for Erectile Dysfunction ED | ClearMatch Medicare</a><a class="list-item toc-h2 py-1" style="border-bottom: none" href="https://peterec.com/article/medicare-coverage-erectile-dysfunction-drugs-implants-ed-pumps/4014" target="_blank" rel="noopener">Medicare Coverage & Erectile Dysfunction: Drugs, Implants & ED Pumps</a><a class="list-item toc-h2 py-1" style="border-bottom: none" href="https://peterec.com/article/does-medicare-cover-viagra-and-cialis-erectile-dysfunction-medication/4014" target="_blank" rel="noopener">Does Medicare Cover Viagra and Cialis Erectile Dysfunction Medication?</a></div></p><p>Your coverage may depend on the specific brand, even with a manual pump. You can get breast pump coverage because the <a href="https://www.healthcare.gov/coverage/breast-feeding-benefits/" rel="noopener nofollow" target="_blank">law requires</a> it, but you may not get coverage for the breast pump brand you want.</p><p>Also, you might need a breast pump while still hospitalized after giving birth or during any stay at a Medicare-approved hospital or skilled nursing facility. Medicare Part A can cover this for up to <a href="https://www.medicare.gov/publications/11045-medicare-coverage-of-dme-and-other-devices.pdf" rel="noopener nofollow" target="_blank">100 days</a>.</p><p></p><h3 id="toc-1">Does Medicare Advantage cover breast pumps?</h3><p>Medicare Advantage usually provides the same coverage as Original Medicare. But it may cover a wider selection of pumps because private insurance companies manage Medicare Advantage plans.</p><p>Even so, your specific coverage might depend on what plan you select from those available in your area.<div class="sm:flex sm:items-center sm:justify-center sm:flex-row sm:space-x-1 insert" style="margin-top:0; margin-bottom:0;"><ins class="adsbygoogle sm:w-1/2" style="display:block; text-align:center;" data-ad-layout="in-article" data-ad-format="fluid" data-full-width-responsive="true" data-ad-slot="9667766790" data-ad-client="ca-pub-5240180246042932" data-adtest="off"></ins><script>(adsbygoogle = window.adsbygoogle || []).push({});</script><ins class="adsbygoogle sm:w-1/2" style="display:block; text-align:center;" data-ad-layout="in-article" data-ad-format="fluid" data-full-width-responsive="true" data-ad-slot="9667766790" data-ad-client="ca-pub-5240180246042932" data-adtest="off"></ins><script>(adsbygoogle = window.adsbygoogle || []).push({});</script></div></p><div class="sm:flex sm:items-center sm:justify-center sm:flex-row sm:space-x-1 insert" style="margin-top:0; margin-bottom:0;"><ins class="adsbygoogle sm:w-1/2" style="display:block; text-align:center;" data-ad-layout="in-article" data-ad-format="fluid" data-full-width-responsive="true" data-ad-slot="9667766790" data-ad-client="ca-pub-5240180246042932" data-adtest="off"></ins><script>(adsbygoogle = window.adsbygoogle || []).push({});</script><ins class="adsbygoogle sm:w-1/2" style="display:block; text-align:center;" data-ad-layout="in-article" data-ad-format="fluid" data-full-width-responsive="true" data-ad-slot="9667766790" data-ad-client="ca-pub-5240180246042932" data-adtest="off"></ins><script>(adsbygoogle = window.adsbygoogle || []).push({});</script></div></div><div><div><h2 id="toc-2"><div><p><a name="cost" target="_blank">Can I get a free breast pump with Medicare?</a></p></div></h2></div><p>If Original Medicare approves a breast pump for home use, your coverage doesn’t kick in until you reach the <a href="https://www.medicare.gov/basics/costs/medicare-costs" rel="noopener nofollow" target="_blank">$257</a> deductible. In 2025, you’ll also have to pay the monthly premium of $185. </p><p>The average cost of manual, handheld pumps usually ranges between <a href="https://llli.org/breastfeeding-info/pumping-milk/" rel="noopener nofollow" target="_blank">$50 and $150</a>, whereas electric pumps may be more costly at around $300. You may only pay 20% of the out-of-pocket cost if you can get Medicare coverage.<div class="bg-primary-100 rounded-lg my-6 px-2 py-3 font-semibold insert" style="color: rgb(37, 99, 235)"><div class="text-common !leading-common ml-1 insert" style="margin-top: 0.2rem; margin-bottom: 0.2rem">See Also</div><a class="list-item toc-h2 py-1" style="border-bottom: none" href="https://peterec.com/article/will-medicare-cover-penile-implant-surgery/4014" target="_blank" rel="noopener">Will Medicare Cover Penile Implant Surgery?</a></div></p><p>When using a breast pump in the hospital, you don’t need to pay anything for the first 60 days of your stay. From day 61 to 90, your cost is <a href="https://www.medicare.gov/basics/costs/medicare-costs" rel="noopener nofollow" target="_blank">$419</a><span> per day, and from day 91 to 150, it</span>’s $838 per day. If you stay beyond that, you need to pay 100% of the cost of your stay, including the use of any DMEs.</p><p>Your out-of-pocket costs for a breast pump with Medicare Advantage may depend on the plan.</p></div><div><div><h2 id="toc-3"><div><p><a name="how-to-get-it" target="_blank">How do I get a breast pump with Medicare?</a></p></div></h2><div class="sm:flex sm:items-center sm:justify-center sm:flex-row sm:space-x-1 insert" style="margin-top:0; margin-bottom:0;"><ins class="adsbygoogle sm:w-1/2" style="display:block; text-align:center;" data-ad-layout="in-article" data-ad-format="fluid" data-full-width-responsive="true" data-ad-slot="9667766790" data-ad-client="ca-pub-5240180246042932" data-adtest="off"></ins><script>(adsbygoogle = window.adsbygoogle || []).push({});</script><ins class="adsbygoogle sm:w-1/2" style="display:block; text-align:center;" data-ad-layout="in-article" data-ad-format="fluid" data-full-width-responsive="true" data-ad-slot="9667766790" data-ad-client="ca-pub-5240180246042932" data-adtest="off"></ins><script>(adsbygoogle = window.adsbygoogle || []).push({});</script></div></div><p>To get a breast pump through Original Medicare or a Medicare Advantage plan, start by calling your insurance provider to confirm the benefits. Doing this a few weeks before giving birth is a good idea because getting approval and receiving the pump might take time.</p><p>You may need to provide a doctor’s prescription for a breast pump, and the clinician needs to have an affiliation with Medicare or your Medicare Advantage plan network. Similarly, your doctor must make a medical order for a breast pump during hospitalization under Medicare Part A.</p><p>From here, your insurance provider may ask that you choose from certain suppliers or brands. Once you select what you want, the supplier must order and ship it directly to you.</p></div><div><div><h2 id="toc-4"><div><p><a name="other-coverage" target="_blank">What other medical devices are covered by Medicare?</a></p></div></h2></div><p>Original Medicare and Medicare Advantage <a href="https://www.medicare.gov/publications/11045-medicare-coverage-of-dme-and-other-devices.pdf" rel="noopener nofollow" target="_blank">cover</a> many types of medical devices. These include but aren’t limited to:<div class="sm:flex sm:items-center sm:justify-center sm:flex-row sm:space-x-1 insert" style="margin-top:0; margin-bottom:0;"><ins class="adsbygoogle sm:w-1/2" style="display:block; text-align:center;" data-ad-layout="in-article" data-ad-format="fluid" data-full-width-responsive="true" data-ad-slot="9667766790" data-ad-client="ca-pub-5240180246042932" data-adtest="off"></ins><script>(adsbygoogle = window.adsbygoogle || []).push({});</script><ins class="adsbygoogle sm:w-1/2" style="display:block; text-align:center;" data-ad-layout="in-article" data-ad-format="fluid" data-full-width-responsive="true" data-ad-slot="9667766790" data-ad-client="ca-pub-5240180246042932" data-adtest="off"></ins><script>(adsbygoogle = window.adsbygoogle || []).push({});</script></div></p><div><ul><li>canes (except for vision loss)</li><li>commode chairs</li><li>continuous passive motion machines</li><li>crutches</li><li>glucose monitors and supplies</li><li>hospital beds</li><li>infusion pumps and supplies </li><li>wheelchairs</li><li>nebulizers </li><li>people lifts</li><li>continuous positive airway pressure devices</li><li>walkers</li></ul></div><div><p>Learn more: <span>What Medical Devices Are Approved by Medicare?</span></p></div></div><div><div><h2 id="toc-5"><div><p><a name="takeaway" target="_blank">Takeaway</a></p></div></h2></div><p>Some people younger than 65 years old may qualify for Medicare under certain conditions. Medicare usually provides coverage under Part B for pregnant people who want to purchase a breast pump.</p><p>Coverage may depend on whether you want a manual or electric pump and whether you have Medicare Advantage or Original Medicare coverage.</p></div></article><p>The information on this website may assist you in making personal decisions about insurance, but it is not intended to provide advice regarding the purchase or use of any insurance or insurance products. Healthline Media does not transact the business of insurance in any manner and is not licensed as an insurance company or producer in any U.S. jurisdiction. Healthline Media does not recommend or endorse any third parties that may transact the business of insurance.<div class="sm:flex sm:items-center sm:justify-center sm:flex-row sm:space-x-1 insert" style="margin-top:0; margin-bottom:0;"><ins class="adsbygoogle sm:w-1/2" style="display:block; text-align:center;" data-ad-layout="in-article" data-ad-format="fluid" data-full-width-responsive="true" data-ad-slot="9667766790" data-ad-client="ca-pub-5240180246042932" data-adtest="off"></ins><script>(adsbygoogle = window.adsbygoogle || []).push({});</script><ins class="adsbygoogle sm:w-1/2" style="display:block; text-align:center;" data-ad-layout="in-article" data-ad-format="fluid" data-full-width-responsive="true" data-ad-slot="9667766790" data-ad-client="ca-pub-5240180246042932" data-adtest="off"></ins><script>(adsbygoogle = window.adsbygoogle || []).push({});</script></div></p></section> <img class="lazyload" data-src="https://ts2.mm.bing.net/th?q=Medicare and Breast Pumps: Coverage Rules and Cost (2024)" alt="Medicare and Breast Pumps: Coverage Rules and Cost (2024)" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABCAQAAAC1HAwCAAAAC0lEQVR42mP8/h8AAvMB+NzmkbcAAAAASUVORK5CYII="/> <section> </section> </article> <div class="text-2xl font-semibold mt-5 mb-5">Top Articles</div> <div class="container-doc"> <a href="https://peterec.com/article/apple-intelligence-chatgpt-coming-to-iphones-in-ai-overhaul/4014" target="_blank" rel="noopener" class="group mb-20 flex flex-col items-center"> <img class="lazyload h-56 object-cover" data-src="https://ts2.mm.bing.net/th?q=Apple Intelligence: ChatGPT coming to iPhones in AI overhaul" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABCAQAAAC1HAwCAAAAC0lEQVR42mP8/h8AAvMB+NzmkbcAAAAASUVORK5CYII="/> <div class="group-hover:text-primary-500 block font-medium mt-5 text-2xl"> Apple Intelligence: ChatGPT coming to iPhones in AI overhaul </div> </a> <a href="https://peterec.com/article/2024-u-s-open-fantasy-golf-rankings-picks-strategy-back-keegan-bradley-avoid-viktor-hovland/4014" target="_blank" rel="noopener" class="group mb-20 flex flex-col items-center"> <img class="lazyload h-56 object-cover" data-src="https://ts2.mm.bing.net/th?q=2024 U.S. Open fantasy golf rankings, picks, strategy: Back Keegan Bradley, avoid Viktor Hovland" src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAAEAAAABCAQAAAC1HAwCAAAAC0lEQVR42mP8/h8AAvMB+NzmkbcAAAAASUVORK5CYII="/> <div class="group-hover:text-primary-500 block font-medium mt-5 text-2xl"> 2024 U.S. Open fantasy golf rankings, picks, strategy: Back Keegan Bradley, avoid Viktor Hovland </div> </a> <a href="https://peterec.com/article/why-does-my-bunn-coffee-pot-leak-water-causes-and-solutions-kitchensurfers/4014" target="_blank" rel="noopener" class="group mb-20 flex flex-col items-center"> <img class="lazyload h-56 object-cover" data-src="https://ts2.mm.bing.net/th?q=Why Does My Bunn Coffee Pot Leak Water: Causes and Solutions - 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Frankie Simonis</a></span> </p> <p><span class="font-semibold">Last Updated</span>: <span class="posted-on"><time class="entry-date published" datetime="2024-12-02T13:45:58+07:00" itemprop="datePublished">2024-12-02T13:45:58+07:00</time></span> </p> <p><span class="font-semibold">Views</span>: 6332</p> <p><span class="font-semibold">Rating</span>: 4.6 / 5 (56 voted)</p> <p><span class="font-semibold">Reviews</span>: 95% of readers found this page helpful</p> </div> <div class="text-gray-700 bg-gray-200 rounded px-5 py-4 space-y-2 my-3"> <div class="font-semibold text-center">Author information</div> <p><span class="font-semibold">Name</span>: Amb. Frankie Simonis</p> <p><span class="font-semibold">Birthday</span>: 1998-02-19</p> <p><span class="font-semibold">Address</span>: 64841 Delmar Isle, North Wiley, OR 74073</p> <p><span class="font-semibold">Phone</span>: +17844167847676</p> <p><span class="font-semibold">Job</span>: Forward IT Agent</p> <p><span class="font-semibold">Hobby</span>: LARPing, Kitesurfing, Sewing, Digital arts, Sand art, Gardening, Dance</p> <p><span class="font-semibold">Introduction</span>: My name is Amb. 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