Dear New Parent,

We want to alert you to some important changes to your health insurance coverage as the result of the Patient Protection and Affordable Care Act. As January 1, 2013, breastpumps are now a fully covered benefit under the County health plans.

If you are a Blue Shield Health plan member:
  • Breast Pumps are covered at 100% when utilizing an in-network provider. You can request an electric breast pump or a manual breast pump by calling the Blue Shield customer service number. The hospital breast pump is covered for certain criteria and is a rental only.
  • HMO and POS plans members will need to use an in-network provider such as Apria, Byram & Edgepark to obtain the breast pump at no cost to you.
  • *Note: there are no authorizations or prescriptions needed for HMO members.

For more information about the breast pump benefit, please call Blue Shield customer service at 800-642-6155.

If you are a Kaiser Permanente member:
  • Breast Pumps are covered at no cost to a member who is a new mom.
  • Kaiser will cover at no charge one retail-grade manual breast pump per pregnancy and the necessary supplies to operate it, such as one set of bottles. Kaiser will decide whether to rent or purchase the item and will choose the vendor.
  • The pump is not subject to prior authorization requirements or the formulary guidelines.

For more information about the breast pump benefit, please call Kaiser customer service. The phone number is located on the back of your Kaiser membership card.

If you receive your health insurance through the Operating Engineer’s Trust Fund:
  • If you belong to Blue Shield or Kaiser, follow the guidelines posted above. For other health plan coverage, contact your health plan customer service department. Its phone number is usually printed on the back of your membership card.
If you have health insurance coverage elsewhere, for example, through your spouse/partner’s company:
  • Contact the company benefits department or website for information.

Thank you,

Rosa Vigil, IBCLC
San Mateo County Worksite Lactation Program