Your insurance plan covers breast pumps at no cost to you, but you have to request it through the right channel and meet a few basic requirements
The Affordable Care Act requires most health insurance plans to cover breast pumps as preventive care. This means your plan pays for the pump itself — you do not buy it and get reimbursed later. The catch is that you cannot just walk into a store and expect insurance to pay. You have to go through your plan's durable medical equipment (DME) supplier, follow their ordering process, and usually provide a prescription or statement that you are pregnant or nursing.
The timing matters. Most plans cover one pump per pregnancy, and you can typically request it after you are about 20 weeks pregnant or after you give birth. If you wait until after birth, the process still works, but it takes longer — usually two to four weeks for the pump to arrive. Ordering while pregnant gives you time to receive it before you need it.
Key Takeaways
- Your insurance plan covers one breast pump per pregnancy at no cost, but you must order through your plan's designated durable medical equipment supplier, not a retail store.
- You will need either a prescription from your doctor or a signed statement confirming you are pregnant or nursing, depending on what your plan requires.
- Contact your insurance company's customer service line to find out which DME supplier they use and what documents you need to submit.
- The entire process — from first contact to receiving your pump — usually takes two to four weeks, so ordering around 20 weeks of pregnancy gives you time before birth.
- If your plan denies coverage, you can request an appeal with your doctor's support, or purchase a pump out of pocket and check whether you can deduct it as a medical expense.
Finding your insurance plan's durable medical equipment supplier
Your insurance company contracts with one or more DME suppliers to handle breast pump orders. These are not retail stores — they are medical equipment companies that work directly with insurance plans. To find yours, call the customer service number on the back of your insurance card and ask: "Which durable medical equipment supplier do you use for breast pumps?" Write down the company name and phone number.
Some large plans use national suppliers like Aeroflow Health, Byram Healthcare, or Edgepark. Others use regional companies. The supplier your plan uses is the only one that can bill your insurance directly. If you order from anywhere else, you will pay out of pocket and may not be able to get reimbursed.
While you have your insurance company on the phone, also ask whether you need a prescription or a written statement from your doctor. Some plans require a formal prescription; others accept a straightforward note saying you are pregnant or nursing. Knowing this before you contact the supplier saves a back-and-forth.
What documents you will need to provide
The DME supplier will ask for proof that you are pregnant or nursing. This is usually one of the following: a prescription from your obstetrician or midwife that says "breast pump," a letter from your doctor on letterhead confirming you are pregnant or postpartum, or a copy of your hospital discharge paperwork if you just gave birth. Some suppliers also accept a straightforward email from your doctor's office.
You will also need your insurance information — your member ID number, group number, and date of birth. Have your insurance card handy when you call the supplier. If you are ordering before you give birth, the supplier may ask for your expected due date.
Do not worry about getting a formal prescription if your plan does not require one. A quick phone call to your doctor's office asking them to send a note to the supplier is usually enough. Most offices can send this within a day or two.
How the ordering process works
Once you contact the DME supplier with your insurance information and documentation, they will verify your coverage. This means they call your insurance company to confirm that your plan covers breast pumps and that you have not already received one under your current plan. This verification usually takes one business day.
After verification, the supplier will ask you which pump you want. Most plans cover a standard electric pump — common models include the Spectra S1, Medela Pump in Style, or Philips Avent. Some plans offer a choice between two or three models. The supplier will explain what is available under your plan and what the differences are.
Once you choose, the supplier ships the pump directly to you. Shipping usually takes five to ten business days. You do not pay anything — the supplier bills your insurance company directly. If your plan has a copay for durable medical equipment, you may owe a small amount when the pump arrives, but this is rare for breast pumps.
What happens if your insurance plan denies coverage
Occasionally a plan will deny a breast pump request, usually because of an error in the verification process or because the plan mistakenly thinks you already received one. If this happens, ask the DME supplier for the reason in writing. Common reasons include a missing prescription, a plan that does not cover breast pumps (rare, but some grandfathered plans are exempt), or a claim that you already received one.
If the denial is a mistake, the supplier can resubmit with corrected information. If your plan genuinely does not cover breast pumps, you have two options: purchase one out of pocket, or file an appeal with your insurance company. For an appeal, ask your doctor to write a letter to your insurance company explaining that a breast pump is medically necessary for you. Include this letter with a written appeal requesting coverage. Your plan must respond within 30 days.
If you purchase a pump out of pocket because your plan will not cover it, keep your receipt. Breast pumps may be deductible as a medical expense on your federal income tax return if your total medical expenses exceed a certain threshold, though this depends on your individual tax situation.
Timing: when to order and when to expect delivery
The best time to order is between 20 and 32 weeks of pregnancy. This gives you time to receive the pump before labor, test it out, and contact the supplier if something is wrong. If you order this early, the pump will arrive well before your due date.
If you do not order until after you give birth, the process still works, but the timeline is tighter. You can request a pump in the hospital or within the first few weeks postpartum. The supplier will still need a prescription or statement from your doctor, and delivery will take two to four weeks. Many people order in the hospital before they leave, which speeds things up slightly.
If you need a pump urgently — for example, you are returning to work sooner than expected — tell the supplier when you call. Some can expedite shipping for an additional cost, though your insurance may not cover the expedited fee. It is worth asking.
What to do if you want a different pump than your plan covers
If your plan covers one model but you prefer another, you have a few options. Some suppliers will let you upgrade to a more expensive model and pay the difference out of pocket. For example, if your plan covers a basic electric pump but you want a wearable pump, you might pay $100 to $200 extra and receive the wearable model instead.
Before you do this, confirm with the supplier that the upgrade cost is what you expect. Some plans also cover a manual pump or a different electric pump if your doctor writes that you have a medical reason — for example, if you have limited mobility and need a hands-free option. It is worth asking your doctor whether they would support a request for a different model.
If you cannot afford an upgrade and your plan's covered pump does not meet your needs, some nonprofits and community organizations loan or donate breast pumps. La Leche League and local WIC programs sometimes have pumps available. Your hospital's lactation consultant can point you toward local resources.
Frequently Asked Questions
Can I get a breast pump if I am not pregnant yet, just planning to be?
No. You need to be pregnant or already nursing. Most plans require either a prescription from your doctor or proof that you are at least 20 weeks pregnant. If you are just planning ahead, wait until you have a positive pregnancy test and have told your doctor.
What if I had a breast pump covered under my old insurance and now have a new plan?
Each plan covers one pump per pregnancy. If you received a pump under your previous plan during the same pregnancy, your new plan may deny coverage because you already have one. If you are in a new pregnancy, your new plan should cover a pump. Contact your new plan's customer service to confirm.
Do I have to use the pump the insurance company sends, or can I choose any pump?
You can choose from the models your plan covers, but you cannot choose any pump on the market. Your plan's DME supplier will tell you which two to four models are available. If none of them work for you, you can pay out of pocket for a different model, but your insurance will not reimburse you.
What if the pump arrives broken or does not work?
Contact the DME supplier when ready. They will either replace it or send a repair kit. This is covered under your insurance — you do not pay for the replacement. Keep the original pump until the replacement arrives in case the supplier needs you to return it.
Can my partner or family member order the pump for me?
Yes. The DME supplier only needs your insurance information and a prescription or statement from your doctor. Your partner can call on your behalf, provide your information, and arrange delivery to your home. Make sure they have your insurance card number and your doctor's contact information.