>I have been checking into what medicaid covers as far as
>breastfeeding goes.  I called them twice and received conflicting
>information.

It is correct that each state administers its own Medicaid programs and
it is necessary to learn the rules of the game and the hoops you have to
jump through.
A complicating factor in Colorado (and I suspect some other states) is
the legislative (I think) directive to move Medicaid recipients into
HMOs. While there is supposed to be a standard Medicaid coverage that
would bind any Medicaid HMO which has a state contract to serve Medicaid
patients, in fact there is a variety of interpretations.
So, we have been successful in reimbursement for pump rentals for
Medicaid moms depending on which Medicaid provider's program they are in.
There are a few exceptions where a health care provider has negotiated
the structures and red tape personally for a pre-authorization, but the
general rule for rental coverage is for a pump for mom as long as baby
and mom are separated by hospitalization.
The saddest, most infuriating case where only a manual pump was
authorized was with an 18 yo mom who had <2# hydrocephalic twins. I
appealed all the way up to the medical director of the plan, and the
response was: "As long as a patient can physically use a manual pump, as
long as she has arms, a manual pump is all that is authorized." This doc
is a woman who breastfed her own children!

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Sue Petracek              * [log in to unmask]
Bosom Buddies, Inc.       * www.bosombuddies.com
(888) 860-0041 Toll Free  * Helping mothers breastfeed successfully
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