As this is all unfolding I know there will be much to learn and understand. 



I am confused as to what I am reading from the links posted regarding coverage for women regarding breastfeeding and what I am hearing from the DME's . This link www.healthcare.gov/news/factsheets/2011/08/womensprevention08012011a.html   states that both pregnant and postpartum women will have access to comprehensive lactation support and counseling as well as breastfeeding equipment. It goes on to say "One of the barriers for breastfeeding is the cost of purchasing or renting breast pumps and nursing related supplies". 



I hear that the insurance dictates the coverage, what type of pump, how long it can be rented if in fact they cover a rental. Here in MA Blue Cross as of today will not cover a rental, even to a NICU mom. They are only eligible for a personal pump. Other insurances are limiting the time a mother can have a rental pump, 3 months, 6 months. And the kit used to pump is NOT covered. Isn't that part of breastfeeding supplies? What are these supplies? Do they include  breast pads, nipple shields, creams such as Lansinoh, ComfortGels, specialty feeders? How does the mother submit a claim for these supplies? We have been told that a mother cannot buy a pump and submit a claim but has to go through a DME (Durable Medical Equipment  Provider). Is this true or just what we are being told? The DME's stand to make money here if the mothers of NICU babies are forced into renting a pump to sustain their supply when their insurance will only cover personal pump. 



As for consults, how many consults are "allowed"? I am sure that it is not an infinite amount. 



Are these charges in hospital part of the capitation for a mother/baby stay or is this a separate billable charge? 



While I think there is some good to come from all of this I feel that we need more concrete answers. Leaving things up to each individual insurer is confusing to say the least. 



Lisa Enger RN BSN IBCLC CEIM 

Boston, MA 

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