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Breast Pump Coverage and Breastfeeding

Breast pumps

Check your plan to see which of these providers is in network. You may be able to buy a breast pump and supplies from one of our suppliers at no charge or at a discounted rate. Covered items may include:

  • A standard electric pump (non-hospital-grade) while you are pregnant or for the duration of breastfeeding, once every three years, or
  • A manual breast pump while pregnant or for the duration of breastfeeding, if you have not received an electric or a manual breast pump in the last three years, and 
  • Another set of breast pump supplies if you get pregnant again before you are eligible for a new pump

The facts about breastfeeding

Deciding whether or not to breastfeed is a very personal choice. Below are a few research-based facts about the importance of breast milk that may help inform your choice:

Breastfeeding benefits for baby:

  • Helps the baby’s immune system mature. This protects the baby from infections and increases the effectiveness of immunizations.
  • Gives babies greater emotional security and enhances bonding with mom.
  • The benefits appear to last even after the baby has stopped breastfeeding.
     

Breastfeeding benefits for mom:

  • Increases the rate of weight loss in most nursing mothers.
  • Women report benefits such as increased self-confidence and a stronger sense of connection with their babies.
  • Combined with getting milk with a breast pump, breastfeeding costs far less than baby formula.

Lactation consultants

Many Aetna plans also cover up to six visits with a lactation consultant if you need support with breastfeeding. Your in-network ob/gyn or pediatrician may offer these services through his or her office.

The clinics we select meet high medical standards and have a successful record of treatment. Women have access to doctors and clinics that can improve their chances for healthy pregnancies and healthy babies.

– James D. Cross, M.D., head of National Medical Policy and Operations at Aetna

1Source: Centers for Disease Control and Prevention. Reproductive Health.  https://www.cdc.gov/reproductivehealth/infertility/index.htm. Accessed June 24, 2010.

Some plans are not subject to the women’s preventive breastfeeding services requirements under the Affordable Care Act (also known as the health care reform law). This includes plans that are grandfathered or otherwise exempt. These plans may not include all of these benefits. Or there may be different member cost-sharing on certain benefits. Consult your plan documents or call member services at the number on your member ID card if you are not sure if your plan covers these benefits. The changes for women’s preventive services go into effect when applicable plans become effective or renew on or after August 1, 2012. Employers with grandfathered plans may choose not to cover some of these preventive services or to include cost share (deductible, copay or coinsurance).

Health benefits and health insurance plans are offered, underwritten and/or administered by Aetna Health Inc., Aetna Health of California Inc., Aetna Health Insurance Company of New York, Aetna Health Insurance Company and/or Aetna Life Insurance Company (Aetna).  In Florida, by Aetna Health Inc. and/or Aetna Life Insurance Company.  In Maryland, by Aetna Health Inc., 151 Farmington Avenue, Hartford, CT 06156.  Each insurer has sole financial responsibility for its own products.

For general health information only. Information is not a substitute for diagnosis or treatment by a physician or other health care professional. Health benefits and health insurance plans contain exclusions and limitations. Not all services are covered. See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by location and are subject to change.

Providers are independent contractors and are not agents of Aetna. Provider participation may change without notice. Aetna does not provide care or guarantee access to health services. Information is believed to be accurate as of the production date; however, it is subject to change.

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