I got some bad news yesterday (<–slightly dramatic statement): Unless my baby is born premature (no thanks), has a problem sucking (again, no thanks), or is a multiple (pretty sure that’s not possible) they won’t reimburse me/pay for a breast pump.
Woomp, woomp.
Now, I don’t normally expect insurance to cover such things – but with the introduction of the Affordable Healthcare Act and Women’s Preventative Services I had my hopes up that it would be covered. I was wrong. Not only that, but if I DID qualify for the pump, my insurance would cover 80% of the cost and ONLY if I had already met my yearly deductible of $200 (I’ve only paid $10). So basically, I would be paying roughly the same price.
All things considered, I would MUCH rather have a healthy baby who is a breastfeeding champ – over a “free” breast pump. In fact, I feel very lucky that my insurance is actually pretty kickass — 100% of my maternity care (as well as newborn care in the hospital) is covered. But in the grand scheme of things it pisses me off that loopholes like this are brushed under the rug. Not everyone has kickass insurance. Not everyone can afford to buy a quality breast pump. Yet people wonder why more mothers, especially working mothers, choose to formula feed?
The kicker in all of this is the the NPR post that Jackie Jovi tweeted to me today.
@crzyrunninglegs @marielys2k NPR covers the breast pump insurance woes npr.org/blogs/health/2…
— Jackie Jovi (@momjoviblog) March 20, 2013
How timely!
If anything, this article basically explained why some people ARE getting coverage and other aren’t. Like most things in life, this law seems to be up to interpretation. Most importantly, the law doesn’t state that the pump has to be an ELECTRIC pump. It seems as though most plans and policies ARE providing manual pumps (FYI – mine is not). But, umm, have these people ever USED a manual pump? This is a manual pump:
It literally involves pumping your boob with your hand — like you’re cranking water from a well. One at a time.
I could see a manual pump being useful if you were using it occasionally — or if you were using it while nursing on the other side. But in the article a pediatrician (A WOMAN) made this comment and it really buttered my biscuit:
Dr. Kimberly Luft, a pediatrician with Kaiser Permanente, says the insurer would cover an electric pump if it were deemed a medical necessity. But manual pumps meet the basic needs of most moms, Luft says. She suggests women work with their employers to find enough time to use the devices.
The only rationale I have for Dr. Luft making this dumbass comment is that she has never had to pump at work. Or at all. Unless you want me to spend at least 3 hours of my day sitting at my desk ,with at least one of my boobs hanging out, there’s no way I could successfully use a manual pump for a year (which is how long I intend to pump) and actually still get my job done.
First of all — pumping IS work. It’s mind-numbing and tedious, and if you aren’t getting enough milk – it’s stressful. Hell it’s stressful even if you aren’t getting enough. Even with the BEST electric pump, pumping takes about 15-20 minutes (not including cleanup). And you usually have to do it 2-3 times a day (sometimes more when when you are going back to work when the baby is 8-10 weeks old, like me). With a manual pump?? We’re talking 30 minutes a side — MINIMUM.
Secondly – discussing pumping with your employer is awkward regardless of what type of pump you are using. Let’s be real – we are talking about boobs here. Yes, they are a food source, but seriously…boobs. Plus, we’re talking about time that COULD cut into your regular work hours. While I work for a very flexible and family-friendly company, not everyone is in the same boat as me. What if you’re a teacher? Or a nurse? Or you do a lot of traveling for a living? Yeah, that manual pump is doing jack shit for you.
I mean really… SHE WANTS US TO USE A MANUAL PUMP?? Even cows are milked with electric pumps.
But I guess on the plus side – think of how strong my hand would be?
While I do actually think the government is making a teeny, tiny step in the right direction – I don’t necessarily think that this was what was intended when the law was signed in 2010. These loopholes impact working mothers more than anything. And in a time where we have Marissa Mayer and Sheryl Sandberg implying that women need to “learn” how to play with the men in the corporate world (instead of actually breaking the mold and demanding change) – we need all the support we can get. And I’m not talking about this kind of support (<–sorry couldn’t help myself, this picture is too much).
(FYI – This is NOT what pumping really looks like. Well, the getup might be realistic, but the last thing I’m doing while pumping is walking around the house drinking a glass of water)
Seriously ladies (and men — who must be really interested in boobs if you’ve gotten this far), while we have come a really long way even in the past 7 years when it comes to breastfeeding – this is just ridiculous. I always go back to this silliness when someone questions WHY the government/insurance should provide coverage for breastfeeding and breastfeeding supplies: Viagra. Viagra is covered by insurance, but the means to make feeding our infants are not?
Yeah, that makes sense.
Ugh, it’s so frustrating. As you know, I’ve been going through similar battles with my insurance over birth control. Devices like IUDs are fully covered, yet my body rejects every one I try to have put in. But devices like NuvaRings would cost me $70 a month. And where’s my free pill??? I STILL have to pay $15 a month, which I know isn’t very much but it’s like you said, it’s the principle of it. The loopholes kill me. I’ve spent hours on the phone w/ my insurance company trying to figure this out, to no avail. I just want to be off the pill dammit but it’s the only thing that’s even remotely affordable.
Boobs.
Sorry, just thought you needed one more for good measure.
I’m annoyed that I still pay for my pill. Like, really annoyed.
I can’t get past the fact that you used “butter my biscuit.” Does it also chap your hide? Also, I thought that was a martini at first. Really disappointed to hear it’s water.
My new insurance covers the pill under the affordable care act. I wonder if this is all insurances or just some. I feel like I lucked out with a really great plan.
Like the pump – it’s insurance plan specific. Some insurance companies are covering it, some aren’t. It’s not actually paid for by the govt (just read up on this) – but the insurance company is eating the cost (because of this they are allowed to raise premiums), which explains the loopholes. There’s also the whole “grandfathering” thing – where a certain plan is grandfathered in and for right now doesn’t have to follow the new laws put into place. Should be interesting to see where it goes from here though…
Yes, I did say butter my biscuit. I think I’m going to start saying it all the time now. Just to butter YOUR biscuit.
Maybe it IS really a martini. That would make more sense, actually.
That is so frustrating!! Our health insurance system makes zero sense to me. If I had to use a manual pump when I went back to work, I would be pumping all day long!! It takes forever and is really unrealistic. It’s hard enough as it is to navigate new baby, return to work, breastfeeding alone.
I think if i had to use a manual pump I would have quit within the first 2 weeks of going back to work!! Like you said – you already have everything working against you.
This topic 100% chaps my ass! I am a nurse and trying to get away twice during my 10.5 hour shift was a stressful overwhelming experience. One that often reduced me to tears often. I hate that I feel like I’m getting penalized for doing the right thing for my child and that somehow I’m supposed to be the perfect mom who breast feeds, makes my own baby food, and never skips a beat at my 70 hour a week job(I work 7 10.5 hour shifts and then have a week off). I felt like a failure when my supply dwindled at least I made it 9 months and my baby is happy and healthy. I agree with you! I’m also a farmers daughter and if a cow gets a electric milk machine why can’t I? I’m currently pregnant with #2 this topic stresses me out and pisses me off lol cuz I’m soon going to have to deal with it all Over again. Wow what an emotional stressful experience to be a working mom be a mom period. Thanks for this post I see I’m not alone
Yikes on the 7 10.5 hour shifts!! I am exhausted for you.
BFing and pumping IS worth it, but it is definitely hard. And being a working mom is definitely what I WANT to be, but it’s not always where I want to be.
Hopefully baby #2 is easier for you (it was for me, surprisingly. I think it’s because I knew what to expect)! And you are definitely NEVER alone.
I couldn’t agree more. I’m lucky enough to have had a medela for my last two and it has been wonderful.
I used my Pump InStyle Advanced for both B & L — and lent it out to a friend to use for her baby – so yes, it’s definitely worth the $$$!! I don’t think it’s going last through another though – so I’m just buying the Freestyle from a friend. Hopefully I can pass it on/sell it when I’m done!
Great post! Since having kids is hopefully in the nearish future for me I worry about crap like this. I have no idea how you are supposed to talk to your boss about needing time to pump. I can’t imagine talking to my boss about this! The thought terrifies me, so uncomfortable. I don’t know how teachers are supposed to find the time to use a manual pump. Insane.
Yes, parenthood is a whole new world of WTFs!! So much to look forward to 🙂 Truthfully, a good employer won’t require you to talk extensively about plan to pump or anything. It’s your right to do it: http://www.dol.gov/whd/regs/compliance/whdfs73.htm and they can’t tell you to pump in the bathroom. It’s against the law.
I hope that by the time you do have a baby (even if it’s early next year!) – they will iron all of this out or at least some of it!
I’m lucky that a friend has let me borrow her medela pump and I just bought replacement parts for $30. When she offered I returned the pump I bought. Also, as a teacher pumping is so annoying. My recess is and hour and 40 minutes after I would normally feed him and then lunch is an hour and half after that. It’s been an adjustment when from when I as able to pump or feed every 3 hours. And with recess only 20 minutes it doesn’t give me uch time once I kick the kids out. Luckily, I work with mostly females so they are understanding. I’ve wanted to give up but I push through these last 3 months. I have a huge supply built that when I go back to teaching next August I plan on stopping breastfeeding. He should enough, or close to it, to make it to his birthday towards the end if Seotember.
I lent out my Medela Pump In Style Advanced to a friend for the same reason! (I would use it again – but it’s on it’s last legs, though it did last through 3 babies!!)
I have friends who are teachers and a lot of them stopped pumping because it was so difficult to fit into their schedules (I do have a a few that’ve kept it up) – I honestly admire you guys for even trying. It’s tough enough when I have a very flexible schedule.
Good for you for stocking up and good luck pushing through. You can do it!!
What a great post! I am extremely frustrated by this too. I started doing research on it back in August, then they told me the coverage for pumps would kick in in January, so I waited, and on January 2nd, called back and checked on how to proceed. They told me to find a DME provider and they would cover it. I found a provider, they checked with the insurance, and put in the order. (The insurance got to decide which pump, but I was thrilled when they told me in was a double electric one that cost $359). I got the pump, had my baby, started using the pump, and then got a letter from my insurance saying that since there wasn’t a medical need, I had to pay for the whole thing by myself! I called, enraged, and from
what I gather, the person who answered back in January must have screwed up. At least, they agreed to pay 80% and negotiated the price down, so I only have to pay $24.
Oh and then, the New Affordable Care Act says that well-baby visits should be co-pay-free… Well my insurance found a loophole for that!
By the way, you are so lucky to have 100% coverage for maternity, I keep getting my hospital bills and this baby is costing me over $3,000! (I know, he’s worth it, but if I were in my home country -France- all this would be free)
Sorry for the rambling
Wow – How freaking frustrating. I’m happy they were willing to work with you in the end. I guess I’m happy that my insurance flat out told me that they weren’t going to cover it for me!
Insurance can find a loophole in EVERYTHING. And since this a law mandated to insurance companies (as in the govt isn’t paying for it – but they are mandates that insurance companies cover it) — we get to pay more and are provided less. Yay!
As much as it sounds like I’m complaining – I love, love, love my insurance. I had different insurance with my first and paid about $2k. My 2nd was in the hospital when she 3 weeks old for 10 days and we paid the $200 deductible for her – and then everything else was covered (it was actually for a different company – but the same exact plan). Her total bill was close to $25k!!
My insurance would have paid for a double electric but not the brand I wanted — I could have lived with that, but it required a letter of medical necessity which is surprisingly hard to get (at least it was for me). Despite my arguments (and a stack of paperwork) I could not convince my doctor that breastfeeding was, in fact, a necessity. Ugh. So I paid and am still stewing.
I do think you made the right choice and went with the brand you did! I have a few friends who have used other pumps with less success. And yes, my Dr. told me it’s hard for them to write a letter of medical necessity. There are very strict guidelines they have to adhere by. I get it, but it sucks (umm again, no pun intended!).
Fuck, now all I want is that pump so I can walk around and drink water. My stupid Pump InStyle doesn’t let me do that!
You have the slacker pump. I mean, you can’t even multitask. (The scariest thing is that apparently people drive in that contraption because the pump is operated on chargeable batteries – can you imagine driving down the street and pulling up to someone dressed like that? Lol)
Great post! This kind of crap really pisses me off. I’m lucky to be a SAHM mom and there were times when I did have to pump (with my manual pump) and it took me forever! I had oversupply and it still took me a good 30+ minutes per boob to get enough milk. That kind of time is just not feasible for a working mom.
…and that Dr. Luft can take a hike! What a joke.
I have oversupply too — so yeah, the 30 minutes is minimum!!
As for Dr. Luft — I just hate statements about things people obviously know nothing about.
This makes me crazy! I called my insurance company and was told that b/c my policy doesn’t renew until July 1 (we’re on a academic calendar) and my baby will be born in June I don’t qualify. Apparently it doesn’t go into effect until your policy renews? So unless my baby is two weeks late (no thank you) I don’t qualify… and even if I did, it’d only cover a manual pump. Again, no thank you. I’d rather invest my own money in the top-of-the-line electric pump than suffer using a manual, especially because, like you, I’ll be pumping at work and plan to do so for at least a year.
So, yeah, a step in the right direction, but until these loopholes are closed it’s not helping all that many women.
Oh, and agreed on Marissa Mayer and Sheryl Sandberg.
Ahh – sounds like you have a grandfathered plan — which I honestly don’t understand. I was thinking that my plan was grandfathered too, but it has changed, so I don’t know!
I do recommend a Medela pump. I used the pump in style advanced for Braeden and Livie (and my friend used it as well) — but I don’t think it will make it through another kid, so I’m buying a Medela Freestyle from a friend (who barely used it).
That would be so frustrating to deal with! Insurance companies sometimes do not make any “common” sense. On paper it looks dandy, but actual application on the other hand does not.
The MD statement was probably one of the most ignorant statements. If a lactating mother has to manually pump everyday so many negatives can arise (decreased milk supply, hostile working environment due to “pump breaks”, etc). Preaching to the choir here!
Hey, this started quite a discussion! Great and interesting post. You were talking about how hard it is to post, and it made me think of the emotional side for me. I realized in the midst of nursing my third child that I would often feel like I was about to cry when I first started pumping. I would feel panicked and like, if I let myself, I would just start bawling. I looked it up and found that there is an actual condition called letdown dysphoria, which just happens sometimes when letdown occurs, for me especially related to the pump. If I had to use a manual pump, I probably really would have broken down!! 😉 Just one more reason why we need every accommodation in this area!!
Oh wow on the crying when starting to pump! Yes, just one more reason we need accommodations. We’re not asking for them forever – just as long as it takes. I feel like there is just such a mixed message.