What breastfeeding moms need to know about their Aetna health plan
Aetna health plans cover breastfeeding equipment and sometimes more
Thanks to the Affordable Care Act, insurance providers are required to cover personal use breast pumps for new and expecting mothers. If you’re covered by Aetna, you can choose a manual or electric pump. Several different brands of breast pumps are 100% covered, including the Luna Motif, Spectra S2, and Medela Pump in Style with Max Flow. In addition, your Aetna plan may also cover up to six visits with a lactation consultant if you need breastfeeding support.
What are the limitations of Aetna breastfeeding equipment coverage?
Moms only get one benefit with Aetna. Therefore, if you choose to get a 100% covered manual pump, you can’t also get a fully covered electric breast pump. It’s one or the other.
In the past, many Aetna plans were also limited in terms of how often you were able to receive a new pump. While many insurance providers allowed one plan per birth event, Aetna restricted moms to one breast pump during a 36-month period. However, in a 2020 clinical policy bulletin, Aetna stated that “ a replacement manual or standard electrical breast pump is considered medically necessary for each subsequent pregnancy, for initiation or continuation of breastfeeding during pregnancy or following delivery.”
However, the same policy bulletin stated that “the purchase of heavy duty electrical (hospital grade) breast pumps [are] not medically necessary.”
Replacement supplies that are strictly for comfort and convenience, such as replacement polycarbonate bottles, replacement caps, nipples, or lids for breast pump bottle, and replacement locking rings, are not covered. Furthermore, some grandfathered Aetna plans that pre-date the March 23, 2010 ACA may not follow all of the requirements for coverage of breast pumps.
Not sure what your policy covers?
Don’t worry. We can give Aetna a call and confirm your benefit coverage for you.
Aside from the coverage, you’ll need a prescription to qualify for your 100% covered breast pump. You can upload it easily when your place your order (though a prescription is not required when placing an order). If your hands are full, we can even contact your doctor and request a prescription on your behalf. Once you’ve placed your order, we’ll get your new pump to you quickly and with absolutely no cost to you. Even our shipping is free, and we service Aetna moms anywhere in the U.S.A.